Preview

Moscow Surgical Journal

Advanced search

THE IMPACT OF BARIATRIC SURGERY ON LIFE EXPECTANCY IN PATIENTS WITH METABOLIC SYNDROME

https://doi.org/10.17238/issn2072-3180.2020.2.63-78

Abstract

Introduction: A correlation was found between the length of chromosome telomeres as a predictor of life expectancy and obesity with metabolic manifestations. The aim of this study was to evaluate the changes of telomere length as an indicator of life expectancy, changes in body mass and other components of the metabolic syndrome after weight loss.
Methods: the study is designed as an interventional, prospective, controlled, a three-arm randomized controlled trial at a single center including 60 participants. The first group is composed of patients who have undergone stapleless laparoscopic one anastomosis gastric bypass with an obstructive stapleless pouch and anastomosis. The second group of patients underwent staple use laparoscopic mini-gastric bypass-one anastomosis gastric bypass. The patients in the third group received non-surgical weight loss therapy, including a hypocaloric diet with energy restriction. Primary outcome measures included changes in the length of leukocyte telomeres. Secondary outcome measurements included changes in body mass index, other components of the metabolic syndrome.
Results: 60 patients were randomized and allocated for intervention: first group (n=20), second group (n=20), third group (n=20). The surgical groups (first, second) after 12 months postop had the greatest weight loss compared to third group with average changes BMI. The surgical groups also had the most significant change in telomere length.
Conclusions: Compared with the non-surgical treatment of obese patients with metabolic syndrome, bariatric surgery leads to greater body weight loss and a significant increase in telomere length and greater resolved metabolic syndrome.

About the Authors

O. B. Ospanov
Research Group of University Medical Center, UMCЖ Dept. of Laparoscopic and Bariatric Surgery, Astana Medical University
Kazakhstan

Ospanov Oral Bazarbaevich, prof., MD, chief researcher of the research project AP05135241 of the University Medical Center;

Professor of the Department of Surgical Diseases and Bariatric Surgery, Astana Medical University

NurSultan, 010000. 49a Beibitshilik street



A. R. Akilzhanova
Laboratory of Genomic and Personalized Medicine, National Laboratory Astana, Nazarbayev University
Kazakhstan

Akilzhanova Ainur Rakhmetulovna, prof., MD, head

Nur-Sultan, 010000, 53 Kabanbai batyr ave



F. K. Bekmurzinova
Dept. of Laparoscopic and Bariatric Surgery, Astana Medical University
Kazakhstan

Bekmurzinova Farida Kairatovna, clinical resident of the department, NJSC “MUA”

Nur-Sultan, 010000. 49a Beybitshilik street



S. E. Rakhimova
Laboratory of Genomic and Personalized Medicine, National Laboratory Astana, Nazarbayev University
Kazakhstan

Rakhimova Saule Eslamovna, candidate of biological sciences, employee

Nur-Sultan, 010000, 53 Kabanbai batyr ave



G. A. Eleuov
Research Group of University Medical Center, UMC
Kazakhstan

Eleuov Galymzhan Almasbekovich, Ph.D., a member of the research group of the KF “UMC” under the grant scientific project of the Ministry of Education and Science of the Republic of Kazakhstan No. AP05135241

Nur-Sultan, 010000, Kabanbai batyr ave. 53



U. A. Kozhamkulov
Laboratory of Genomic and Personalized Medicine, National Laboratory Astana, Nazarbayev University
Kazakhstan

Ulan Anetovich Kozhamkulov, Ph.D., employee

Nur-Sultan, 010000, 53 Kabanbai batyr ave



Z. D. Abdina
Research Group of University Medical Center, UMC
Kazakhstan

Abdina Zhanar Davletovna, Master of Medicine, member of the research group of the KF “UMC” on the grant scientific project of the Ministry of Education and Science of the Republic of Kazakhstan No. AP05135241

Nur-Sultan, 010000, 53 Kabanbai batyr ave



R. A. Fursov
Dept. of Laparoscopic and Bariatric Surgery, Astana Medical University
Kazakhstan

Fursov Roman Aleksandrovich, Candidate of Medical Sciences, Associate Professor of the Department of Laparoscopic and Bariatric Surgery, NJSC “MUA”

Nur-Sultan, 010000. 49a Beybitshilik street



References

1. Cornier M.A., Dabelea D., Hernandez T.L., Lindstrom R.C., Steig A.J., Stob N.R., Van Pelt R.E., Wang H., Eckel R.H. The metabolic syndrome. Endocr. Rev., 2008, Dec., 29(7), рр.777−822. http://doi.org/10.1210/er.2008-0024 Epub. 2008 Oct. 29. PMID: 18971485; PMCID: PMC5393149.

2. Rubino F., Nathan D.M., Eckel R.H., et al. Metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by international diabetes organizations. Diabetes Care, 2016, 39, рр. 861–877.

3. Wadden T.A., Foster G.D., Letizia K.A. One-year behavioral treatment of obesity: comparison of moderate and severe caloric restriction and the effects of weight maintenance therapy. J. Consult. Clin. Psychol., 1994, 62(1), pp. 165–171. PubMed PMID: 8034818.

4. Park H.S., Song Y.M., Cho S.I. Obesity has a greater impact on cardiovascular mortality in younger men than in older men among non-smoking Koreans. Int. J. Epidemiol., 2006, 35, pp.181–187.

5. Gloy V.L., Briel M., Bhatt D.L., Kashyap S.R., Schauer P.R., Mingrone G., Bucher H.C., Nordmann A.J. Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ, 2013; 347: f5934. http://doi.org/10.1136/bmj.f5934 Review. PubMed PMID: 24149519; PubMed Central PMCID: PMC3806364.

6. Ospanov, O., Buchwald, J.N., Yeleuov, G. et al. Laparoscopic OneAnastomosis Gastric Bypass with Band-Separated Gastric Pouch (OAGBBSGP): a Randomized Controlled Trial. Obes. Surg., 2019, 29, pp. 4131–4137. http://doi.org/10.1007/s11695-019-04236-1

7. Mundstock E., Sarria E.E., Zatti H. et al. Effect of obesity on telomere length: systematic review and meta-analysis. Obesity. 2015, 23: 2165–74.

8. Njajou O.T., Cawthon R.M., Blackburn E.H. et al. Shorter telomeres are associated with obesity and weight gain in the elderly. Int. J. Obes., 2012, 36, pp. 1176–1179.

9. O’Callaghan N.J., Clifton P.M., Noakes M., Fenech M. Weight loss in obese men is associated with increased telomere length and decreased abasic sites in rectal mucosa. Rejuvenation Res., 2009, 12, pp. 169–176.

10. Ospanov O., Yeleuov G., Kadyrova I. et al. The life expectancy of patients with metabolic syndrome after weight loss: study protocol for a randomized clinical trial (LIFEXPE-RT). Trials, 2019, 20, р. 202. http://doi.org/10.1186/s13063-019-3304-9

11. Ospanov O.B. Surgical technique of laparoscopic mini-gastric bypass with obstructive stapleless pouch creation: A case series. Int. J. Surg., 2019, Jul.; 67, pp. 70-75. http://doi.org/10.1016/j.ijsu.2019.05.011 PubMed PMID: 31158507.

12. Bhandari M., Fobi M.A.L., Buchwald J.N. Standardization of Bariatric Metabolic Procedures: World Consensus Meeting Statement. Obes. Surg., 2019, Jul.; 29(Suppl. 4), pp. 309−345. http://doi.org/doi:10.1007/s11695-019-04032-x PubMed PMID: 31297742.

13. Cawthon R.M. Telomere measurement by quantitative PCR. Nucleic acids research, 2002, 30(10), e47. http://doi.org/10.1093/nar/30.10.e47

14. Kirchner H., Shaheen F., Kalscheuer H. et al. The telomeric complex and metabolic disease. Genes., 2017, 8, р.176.

15. Brethauer S.A., Kim J., el Chaar M., et al. Standardized outcomes reporting in metabolic and bariatric surgery. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 2015, May-Jun; 11(3), pp. 489−506. http://doi.org/10.1016/j.soard.2015.02.003

16. Cummings D.E., Cohen R.V., Beyond B.M.I.: the need for new guidelines governing the use of bariatric and metabolic surgery. Lancet Diabetes Endocrinol., 2014, Feb.; 2(2), pp. 175−181. http://doi.org/10.1016/S2213-8587(13)70198-0 Epub. 2014 Feb. 3. PMID: 24622721; PMCID: PMC4160116.

17. Schauer P.R., Bhatt D.L., Kirwan J.P. et al.; STAMPEDE Investigators. Bariatric surgery versus intensive medical therapy for diabete —3-year outcomes. N. Engl. J. Med., 2014, 370, pp. 2002–2013.

18. Jongbloed F., Meijers R.W.J., IJzermans J.N.M. et al. Effects of bariatric surgery on telomere length and T-cell aging. Int. J. Obes., 2019, 43, pp. 2189–2199. https://doi.org/10.1038/s41366-019-0351-y

19. Shantavasinkul P.C., Muehlbauer M.J., Bain J.R., Ilkayeva O.R., Craig D.M., Newgard C.B., Svetkey L.P., Shah S.H., Torquati A. Improvement in insulin resistance after gastric bypass surgery is correlated with a decline in plasma 2-hydroxybutyric acid. Surg. Obes. Relat. Dis., 2018, Aug; 14(8), pp.1126−1132. http://doi.org/10.1016/j.soard.2018.03.033. Epub. 2018 Apr. 17. PMID: 29805089; PMCID: PMC6153057.

20. Ribaric G., Buchwald J.N., McGlennon T.W. Diabetes and weight in comparative studies of bariatric surgery vs conventional medical therapy: a systematic review and meta-analysis. Obes. Surg., 2014, 24, pp. 437−455.

21. Schauer P.R., Ikramuddin S., Gourash W., Ramanathan R., Luketich J. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. An. Surg., 2000, 232, pp. 515−529.

22. Cummings D.E., Arterburn D.E., Westbrook E.O. et al. Gastric bypass surgery vs intensive lifestyle and medical intervention for type 2 diabetes: the CROSSROADS randomised controlled trial. Diabetologia, 2016, 59, pp. 945–953.

23. Mingrone G., Panunzi S., De Gaetano A., Guidone C., Iaconelli A., Leccesi L. et al. Bariatric surgery versus conventional medical therapy for type 2 diabetes. N. Engl. J. Med., 2012, 366, pp.1577−1585.

24. Ikramuddin S., Korner J., Lee W.J., Connett J.E., Inabnet W.B., Billington C.J. et al. Roux-en-Y gastric bypass vs intensive medical management for the control of type 2 diabetes, hypertension, and hyperlipidemia: the Diabetes Surgery Study randomized clinical trial. JAMA, 2013, 309, pp. 2240−2249.

25. Batsis J.A., Sarr M.G., Collazo-Clavell M.L., Thomas R.J., Romero-Corral A., Somers V.K., Lopez-Jimenez F. Cardiovascular risk after bariatric surgery for obesity. Am. J. Cardiol., 2008, Oct. 1; 102(7), pp. 930−907. http://doi.org/10.1016/j.amjcard.2008.05.040 Epub 2008 Jul. 17. PMID: 18805125; PMCID: PMC2773706.

26. Schiavon C.A., Bersch-Ferreira A.C., Santucci E.V., Oliveira J.D., Torreglosa C.R., Bueno P.T., Frayha J.C., Santos R.N., Damiani L.P., Noujaim P.M., Halpern H., Monteiro F.L.J., Cohen R.V., Uchoa C.H., de Souza M.G., Amodeo C., Bortolotto L., Ikeoka D., Drager L.F., Cavalcanti A.B., Berwanger O. Effects of Bariatric Surgery in Obese Patients With Hypertension: The GATEWAY Randomized Trial (Gastric Bypass to Treat Obese Patients With Steady Hypertension). Circulation, 2018, Mar 13; 137(11), pp. 1132−1142. http://doi.org/10.1161/CIRCULATIONAHA.117.032130 Epub. 2017 Nov. 13. Erratum in: Circulation. 2019 Oct. 140(14):e718. PMID: 29133606; PMCID: PMC5865494.

27. Liang Z., Wu Q., Chen B., Yu P., Zhao H., Ouyang X. Effect of laparoscopic Roux-en-Y gastric bypass surgery on type 2 diabetes mellitus with hypertension: a randomized controlled trial. Diabetes Res. Clin. Pract., 2013, 101, pp. 50–56.


Review

For citations:


Ospanov O.B., Akilzhanova A.R., Bekmurzinova F.K., Rakhimova S.E., Eleuov G.A., Kozhamkulov U.A., Abdina Z.D., Fursov R.A. THE IMPACT OF BARIATRIC SURGERY ON LIFE EXPECTANCY IN PATIENTS WITH METABOLIC SYNDROME. Moscow Surgical Journal. 2020;(3):63-78. (In Russ.) https://doi.org/10.17238/issn2072-3180.2020.2.63-78

Views: 726


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2072-3180 (Print)