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Weight and Metabolic Outcomes 12 Years after Gastric Bypass.

Publication ,  Journal Article
Adams, TD; Davidson, LE; Litwin, SE; Kim, J; Kolotkin, RL; Nanjee, MN; Gutierrez, JM; Frogley, SJ; Ibele, AR; Brinton, EA; Hopkins, PN ...
Published in: N Engl J Med
September 21, 2017

BACKGROUND: Few long-term or controlled studies of bariatric surgery have been conducted to date. We report the 12-year follow-up results of an observational, prospective study of Roux-en-Y gastric bypass that was conducted in the United States. METHODS: A total of 1156 patients with severe obesity comprised three groups: 418 patients who sought and underwent Roux-en-Y gastric bypass (surgery group), 417 patients who sought but did not undergo surgery (primarily for insurance reasons) (nonsurgery group 1), and 321 patients who did not seek surgery (nonsurgery group 2). We performed clinical examinations at baseline and at 2 years, 6 years, and 12 years to ascertain the presence of type 2 diabetes, hypertension, and dyslipidemia. RESULTS: The follow-up rate exceeded 90% at 12 years. The adjusted mean change from baseline in body weight in the surgery group was -45.0 kg (95% confidence interval [CI], -47.2 to -42.9; mean percent change, -35.0) at 2 years, -36.3 kg (95% CI, -39.0 to -33.5; mean percent change, -28.0) at 6 years, and -35.0 kg (95% CI, -38.4 to -31.7; mean percent change, -26.9) at 12 years; the mean change at 12 years in nonsurgery group 1 was -2.9 kg (95% CI, -6.9 to 1.0; mean percent change, -2.0), and the mean change at 12 years in nonsurgery group 2 was 0 kg (95% CI, -3.5 to 3.5; mean percent change, -0.9). Among the patients in the surgery group who had type 2 diabetes at baseline, type 2 diabetes remitted in 66 of 88 patients (75%) at 2 years, in 54 of 87 patients (62%) at 6 years, and in 43 of 84 patients (51%) at 12 years. The odds ratio for the incidence of type 2 diabetes at 12 years was 0.08 (95% CI, 0.03 to 0.24) for the surgery group versus nonsurgery group 1 and 0.09 (95% CI, 0.03 to 0.29) for the surgery group versus nonsurgery group 2 (P<0.001 for both comparisons). The surgery group had higher remission rates and lower incidence rates of hypertension and dyslipidemia than did nonsurgery group 1 (P<0.05 for all comparisons). CONCLUSIONS: This study showed long-term durability of weight loss and effective remission and prevention of type 2 diabetes, hypertension, and dyslipidemia after Roux-en-Y gastric bypass. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others.).

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Published In

N Engl J Med

DOI

EISSN

1533-4406

Publication Date

September 21, 2017

Volume

377

Issue

12

Start / End Page

1143 / 1155

Location

United States

Related Subject Headings

  • Young Adult
  • Weight Loss
  • Suicide
  • Risk Factors
  • Remission Induction
  • Obesity, Morbid
  • Middle Aged
  • Male
  • Incidence
  • Hypertension
 

Citation

APA
Chicago
ICMJE
MLA
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Adams, T. D., Davidson, L. E., Litwin, S. E., Kim, J., Kolotkin, R. L., Nanjee, M. N., … Hunt, S. C. (2017). Weight and Metabolic Outcomes 12 Years after Gastric Bypass. N Engl J Med, 377(12), 1143–1155. https://doi.org/10.1056/NEJMoa1700459
Adams, Ted D., Lance E. Davidson, Sheldon E. Litwin, Jaewhan Kim, Ronette L. Kolotkin, M Nazeem Nanjee, Jonathan M. Gutierrez, et al. “Weight and Metabolic Outcomes 12 Years after Gastric Bypass.N Engl J Med 377, no. 12 (September 21, 2017): 1143–55. https://doi.org/10.1056/NEJMoa1700459.
Adams TD, Davidson LE, Litwin SE, Kim J, Kolotkin RL, Nanjee MN, et al. Weight and Metabolic Outcomes 12 Years after Gastric Bypass. N Engl J Med. 2017 Sep 21;377(12):1143–55.
Adams, Ted D., et al. “Weight and Metabolic Outcomes 12 Years after Gastric Bypass.N Engl J Med, vol. 377, no. 12, Sept. 2017, pp. 1143–55. Pubmed, doi:10.1056/NEJMoa1700459.
Adams TD, Davidson LE, Litwin SE, Kim J, Kolotkin RL, Nanjee MN, Gutierrez JM, Frogley SJ, Ibele AR, Brinton EA, Hopkins PN, McKinlay R, Simper SC, Hunt SC. Weight and Metabolic Outcomes 12 Years after Gastric Bypass. N Engl J Med. 2017 Sep 21;377(12):1143–1155.

Published In

N Engl J Med

DOI

EISSN

1533-4406

Publication Date

September 21, 2017

Volume

377

Issue

12

Start / End Page

1143 / 1155

Location

United States

Related Subject Headings

  • Young Adult
  • Weight Loss
  • Suicide
  • Risk Factors
  • Remission Induction
  • Obesity, Morbid
  • Middle Aged
  • Male
  • Incidence
  • Hypertension