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Comparative Study
. 2009 Jul 20:8:37.
doi: 10.1186/1475-2840-8-37.

Biliary pancreatic diversion and laparoscopic adjustable gastric banding in morbid obesity: their long-term effects on metabolic syndrome and on cardiovascular parameters

Antonio E Pontiroli  1 , Marco Laneri, Annamaria Veronelli, Francesca Frigè, Giancarlo Micheletto, Franco Folli, Gianfranco Adami, Nicola Scopinaro
Affiliations
Comparative Study

Biliary pancreatic diversion and laparoscopic adjustable gastric banding in morbid obesity: their long-term effects on metabolic syndrome and on cardiovascular parameters

Antonio E Pontiroli et al. Cardiovasc Diabetol. .

Abstract

Background: Bariatric surgery is able to improve glucose and lipid metabolism, and cardiovascular function in morbid obesity. Aim of this study was to compare the long-term effects of malabsorptive (biliary pancreatic diversion, BPD), and restrictive (laparoscopic gastric banding, LAGB) procedures on metabolic and cardiovascular parameters, as well as on metabolic syndrome in morbidly obese patients.

Methods: 170 patients studied between 1989 and 2001 were called back after a mean period of 65 months. 138 patients undergoing BPD (n=23) or LAGB (n=78), and control patients (refusing surgery and treated with diet, n=37) were analysed for body mass index (BMI), blood glucose, cholesterol, and triglycerides, blood pressure, heart rate, and ECG indexes (QTc, Cornell voltage-duration product, and rate-pressure-product).

Results: After a mean 65 months period, surgery was more effective than diet on all items under evaluation; diabetes, hypertension, and metabolic syndrome disappeared more in surgery than in control patients, and new cases appeared only in controls. BPD was more effective than LAGB on BMI, on almost all cardiovascular parameters, and on cholesterol, not on triglyceride and blood glucose. Disappearance of diabetes, hypertension, and metabolic syndrome was similar with BPD and with LAGB, and no new cases were observed.

Conclusion: These data indicate that BPD, likely due to a greater BMI decrease, is more effective than LAGB in improving cardiovascular parameters, and similar to LAGB on metabolic parameters, in obese patients. The greater effect on cholesterol levels is probably due to the different mechanism of action.

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Figures

Figure 1
Figure 1
Decrease of body mass index (BMI, kg/m2) in patients undergoing BPD, LAGB, and in control patients. Means ± SE. at all times intervals, BMI decrease was significantly greater with BPD than with LAGB (°, p < 0.05 or less), and with LAGB than in controls (*, p < 0.05 or less).
See this image and copyright information in PMC

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