Objective: To determine predictors of metabolic syndrome and its resolution in a large, ethnically diverse adult population undergoing bariatric surgery.
Background: There is still limited knowledge about the impact of bariatric surgery on chronic health conditions such as metabolic syndrome.
Methods: Adults having had a laparoscopic Roux-en-Y gastric bypass or a laparoscopic vertical sleeve gastrectomy between 2007 and 2009 (n = 4088) without revision during the study period of January 1, 2007 through December 31, 2011 were eligible for the study. Diagnosis and resolution of metabolic syndrome were determined using standard criteria with electronic medical records of laboratory, diagnosis, and pharmacy information.
Results: Patients were primarily women (82%), non-Hispanic black (17%) or Hispanic (32%), 45 ± 11 years old, and had a body mass index (BMI) of 47.10 ± 7.73 kg/m2 at the time of surgery. After multivariate adjustment, metabolic syndrome was less likely to resolve in patients if they had a laparoscopic vertical sleeve gastrectomy procedure and a higher BMI at surgery, were older, were male or were either Hispanic or non-Hispanic black. The effects of age, race/ethnicity, and BMI at the time of surgery remained after accounting for weight loss.
Conclusions: On the basis of our findings, bariatric surgery may be most effective for younger, less obese patients who are early in the course of their cardiometabolic disease. Future research should investigate the factors that lead to lower rates of disease resolution after bariatric surgery for racial/ethnic minority groups.
*Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena; and
†Department of Metabolic and Bariatric Medicine, Kaiser Permanente Southern California Panorama City Medical Center, Panorama City.
Reprints: Karen J. Coleman, PhD, Department of Research and Evaluation, Kaiser Permanente Southern California, 100 S Los Robles, 2nd Floor, Pasadena, CA 91101. E-mail: Karen.J.Coleman@kp.org.
Disclosure: Supported in part by a grant from the Southern California Permanente Medical Group. The authors declare no conflicts of interest.