Lavryk O. Possibility of surgical correction of key components of metabolic syndrome

The aim was to study the possibility of surgical correction of key components of metabolic syndrome in patients with morbid obesity. The study included 143 patients who underwent bariatric surgery for morbid obesity and metabolic syndrome. In postoperative period we analyzed changes in frequency of metabolic syndrome components. After gastric bypass and biliopancreatic diversion in comparison to gastric banding decrease in excess body weight was more prominent, as well as normalization of glucose and lipid metabolism, correction of arterial hypertension and stabilization of proinflammatory markers. After gastric banding frequency of type 2 diabetes decreased from 21 to 14 %, after gastric bypass from 22 to 6 %, after biliopancreatic diversion from 40 to 5 % (р < 0,05). During first 6 months of postoperative period the goal level of HbA1C (HbA1С < 7 %) among patients with type 2 diabetes was established in 94 % after biliopancreatic diversion, in 95 % patients after gastric bypass, in 58 % patients after gastric banding, what allowed to stop hypoglycemic agents. Bariatric surgery has positive effect on lipid metabolism: number of patients with atherogenic dyslipidemia decreased from 70 % to 10 % after biliopancreatic diversion, gastric bypass from 78 to 16 %, gastric banding from 47 to 25 % (р < 0,05). Gastric banding led to decrease of excessive weight and correction of metabolic syndrome. However in 12 months after gastric banding we observed recurrence of type 2 diabetes and weight regain what led to recurrence of metabolic syndrome. The choice of bariatric operation depends on severity of metabolic syndrome. Malabsorbptive operation biliopancreatic diversion is the most radical method to normalize lipid and glucose metabolism, what allows to achieve diabetes remission in 95 % of cases.