SAN FRANCISCO — At 6 months after undergoing laparoscopic adjustable gastric banding, a small group of morbidly obese teenagers showed significant improvements in risk factors associated with the development of cardiovascular disease and diabetes, according to study findings.
Although the study included just 14 teens, it shows the potential of gastric banding in improving the metabolic profiles of young patients who are at risk for developing weight-related heart disorders, Dr. Ilene Fennoy reported in a poster presented at the annual meeting of the Endocrine Society.
The findings also may shed light on the causes of weight gain, said Dr. Fennoy, medical director of the comprehensive adolescent bariatric surgery program at New York-Presbyterian Hospital.
These initial data suggest that gastric banding “could be not only a weight-loss surgery, but a 'metabolic surgery.' We hope in the future to better understand changes in other markers, such as adipocytokines and gut peptides, that cause weight gain. Ultimately, we hope to use these data to design a preventive approach to obesity in the periadolescent population.”
The study included 14 patients (mean age, 16 years; 6 males, 8 females). The group included five white teens, one black, five Hispanics, and three of other racial/ethnic origins. They all were morbidly obese, with a mean initial weight of 152 kg, and a mean initial body mass index of 53 kg/m
All patients underwent laparoscopic adjustable gastric banding between April 2006 and April 2008; they were followed for 6 months. At 6 months, the mean weight loss was 20 pounds (9 kg), a significant difference. The mean BMI decreased from 53 to 47, which was also a significant reduction.
The patients also showed significant improvements in the following risk factors for cardiovascular disease and diabetes. The mean waist circumference decreased from 145 cm to 132 cm. Liver function tests improved, with alanine aminotransferase decreasing from 35 to 24 IU/L, and aspartate aminotransferase from 27 to 23 IU/L. Glycosylated hemoglobin (HbA1c) decreased from a mean of 5.6% to a mean of 5.5%. C-reactive protein improved, dropping from 9 to 6 mg/L, as did triglycerides, falling from 129 to 95 mg/dL.
In some patients, insulin resistance as measured by the homeostasis model assessment (HOMA-IR) and the percentage of β-cell secretory capacity also improved, Dr. Fennoy noted. These changes were most pronounced in the teens who lost the most weight, and decreased as the weight loss became less.