Evolução ponderal, glicêmica e lipídica em mulheres obesas submetidas à cirurgia bariátrica: seguimento de 12 meses

Abstract

The global epidemic of obesity contributes, substantially, to the high prevalence of cardiometabolic diseases. Both sexes are affected, however, recent data shows that the prevalence in the female population is greater than in males. Differences are also present in the pathophysiology, evolution, and related comorbidities, due to genetic, biological, and psychosocial features, peculiar to each sex. In addition, a greater proportion of women seek surgical treatment after failure with other types of interventions. Bariatric and metabolic surgery have been highlighted and improved over time, especially due to the significant increase in severe obesity in the population. Furthermore, it is known that approximately 80% of obese people who undergo this type of surgery are women. This reality also occurs at the reference service in bariatric and metabolic surgery in the southeastern region in the state of Rio Grande do Sul, Brazil. Therefore, this study evaluated the weight, glycemic, and lipid levels during 12 months of surgical treatment for obesity in the population of women. This was a retrospective cohort study, with data collected from women with severe obesity who underwent bariatric and metabolic surgery using the Roux-en-Y gastric bypass (RYGB) technique in the period between 2017 to 2020. It is noteworthy that the present study was carried out with the population of a public service which is a reference in bariatric and metabolic surgery. The body mass index (BMI), fasting blood glucose, glycated hemoglobin (HbA1c), total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides (TG) were evaluated in five- time frames (T): preoperative evaluation (T1); 30 days of postoperative (PO) (T2); 3 months of PO (T3); 6 months of PO (T4); and 12 months PO (T5). One hundred and fifty women were included, with an average age of 43.69±9.87; BMI of 45.4 ± 5.4, arterial hypertension (79.3%), type 2 diabetes (38%), and dyslipidemia (30.7%). No deaths occurred in the PO. In the period of follow-up, BMI showed a statistically significant reduction (p<0.001) at all times analyzed. The loss of BMI excess was 68.2%. In the comparison T1 vs T5, there was a significant reduction in blood glucose (p<0.01), HbA1c (p<0.01), CT (p<0.001), LDL-c (p<0.01) and TG (p<0.01). HDL-c showed an increase in the period, however, without a statistical difference (p=0.3). At the end of the study, 86%, 87% and 72% of the population were no longer using medication for DM2, dyslipidemia, and arterial hypertension, respectively. It was concluded that in this female population with severe obesity undergoing bariatric and metabolic surgery, there were significant short-term improvements in metabolic health. Furthermore, RYGB proved to be an effective treatment in the remission of comorbidities. [resumo fornecido pelo autor]