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Obesity Surgery
Published in: Obesity Surgery 3/2020

01-03-2020 | Obesity | Original Contributions

Relevant Weight Reduction and Reversed Metabolic Co-morbidities Can Be Achieved by Duodenojejunal Bypass Liner in Adolescents with Morbid Obesity

Authors: Matjaž Homan, Jernej Kovač, Rok Orel, Tadej Battelino, Primož Kotnik

Published in: Obesity Surgery | Issue 3/2020

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Abstract

Background

Duodenojejunal bypass liner (DJBL) is an endoscopic, reversible bariatric procedure resulting in weight loss and metabolic co-morbidities improvements in the adults.

Objectives

To determine safety and effectiveness of 12-month treatment with DJBL in adolescents with severe obesity (BMI > 35 kg/m2) and co-morbidities.

Methods

Post-pubertal subjects were treated with DJBL in an open-label, prospective clinical trial (NTC0218393). They were examined at 3 monthly intervals during the 12 months of DJBL treatment and 12 months of follow-up.

Results

DJBL was successfully placed in 19/22 adolescents (13 females, mean age (95%CI); 17.3 (16.7–17.9) years, BMI-SDS 3.7 (3.6–3.9)). There were no serious device-related adverse effects. Clinically relevant percent total weight loss (%TWL) (mean (95%CI)) 11.4 (7.4–15.3) % and BMI decrease − 4.9 (− 2.4 to − 7.4) kg/m2 was observed at DJBL removal (n = 19). At 12 months after device removal, %TWL was 4.1 (− 2.6–10.8) % and BMI decrease − 2.6 (0.2 to − 5.4) kg/m2 when compared with values at baseline (n = 13). HOMA-IR (− 2.1 (− 3 to − 1.3), WBISI 1.15 (0.23 to 2.07), total cholesterol, LDL-c, and triglycerides levels also improved during DJBL treatment and relapsed similarly to weight at 12-month follow-up. A decrease in iron stores, Zn, and Se levels was determined during DJBL treatment and spontaneously improved at follow-up.

Conclusions

Twelve months of DJBL treatment was safe and effective in adolescents with morbid obesity. Weight regain following device removal and relapse of metabolic complications should be expected.
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Metadata
Title
Relevant Weight Reduction and Reversed Metabolic Co-morbidities Can Be Achieved by Duodenojejunal Bypass Liner in Adolescents with Morbid Obesity
Authors
Matjaž Homan
Jernej Kovač
Rok Orel
Tadej Battelino
Primož Kotnik
Publication date
01-03-2020
Publisher
Springer US
Published in
Obesity Surgery / Issue 3/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-019-04279-4

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