Evolução do perfil glicolipídico em pacientes submetidos a cirurgia bariátrica: um estudo comparativo entre GASTRECTOMIA VERTICAL E BYPASS GÁSTRICO EM Y DE ROUX

Abstract

Introduction: Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) have been the most commonly performed bariatric procedures worldwide. Few studies have compared these techniques regarding their impact on glycemic and lipid profiles in obese patients. Objective: To compare the effectiveness of two bariatric surgery techniques (RYGB and SG) in terms of the evolution of the glycolipid profile. Methods: Retrospective cohort study using data obtained from medical records. Patients who underwent bariatric surgery performed by the same surgeon between 2016 and 2020 were included. Patients who did not have follow-up during the evaluated period were excluded. The variables were analyzed in the pre- and postoperative period of 12 months, including percentage of excess weight loss, fasting glucose, HbA1c, total cholesterol, LDL, HDL, and triglycerides. The statistical analysis was conducted using Pearson correlation, Student's t-tests for independent, for paired samples Mann-Whitney U test and Wilcoxon test. The significance level was set at 0.05. Results: The sample consisted of 85 patients, with 29.6% undergoing SG and 70.4% undergoing RYGB. When comparing surgical techniques, the mean percentage of excess weight loss was 64.5% in SG vs. 67.1% in RYGB. Regarding the lipid profile analysis, the reduction in total cholesterol in the SG group was 15.8% vs. 18.7% in RYGB. The increase in HDL was higher in the RYGB group (13.2% vs. 7.9%). The reduction in LDL was 23.5% in SG vs. 23.4% in RYGB. The reduction in triglycerides was greater in the RYGB group (45.8% vs. 36.2%). As for the reduction in fasting glucose, the SG group had a reduction of 16.4%, while it was 9.7% in the RYGB group. The same trend was observed for the reduction in HbA1c, which was higher in the SG group (8.8% vs. 5.2%). There were no statistically significant differences in the analyzed variables. Conclusions: RYGB and SG are equivalent techniques in terms of percentage of excess weight loss and improvement in the glycolipid profile, evaluated 12 months after surgery.