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Obesity Surgery
Published in: Obesity Surgery 1/2019

01-01-2019 | Original Contributions

Outcomes After Metabolic Surgery in Asians—a Meta-analysis

Authors: Danson Yeo, Charleen Yeo, Tze Yi Low, Saleem Ahmed, Sheena Phua, Aung Myint Oo, Jaideepraj Rao, Aaryan Koura, Kavita Venkataraman, Sanghvi Kaushal

Published in: Obesity Surgery | Issue 1/2019

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Abstract

Background

Obesity and type 2 diabetes mellitus (T2DM) are now increasingly epidemic in Asia. As obesity and T2DM have different disease patterns in Asians compared to Westerners, outcomes after metabolic surgery may differ. The aim of this meta-analysis was to gather the current available evidence on the outcomes after metabolic surgery in Asians.

Methods

A literature search was conducted in September 2017. Four outcome measures were examined: (1) % excess weight loss (EWL), (2) post-intervention body mass index (BMI), (3) T2DM resolution or improvement, and (4) hypertension resolution.

Results

Thirteen publications with a total of 1052 patients were analyzed, of which nine were randomized controlled trials, and four were case-matched studies. All the studies had a minimum follow-up duration of at least 1 year. % EWL was significantly higher in those who have undergone Roux-en-Y gastric bypass (RYGB) (SMD 0.53, 95% CI 0.12 to 0.94) versus sleeve gastrectomy (SG). T2DM resolution/improvement was favorable in those who have undergone RYGB (pooled OR 1.39, 95% CI 0.53 to 3.67) versus SG, although not statistically significant. Hypertension resolution was not significantly different between patients who have undergone SG versus RYGB (pooled OR 0.96, 95% CI 0.44 to 2.11).

Conclusion

RYGB results in better weight loss compared to SG in Asians, but the rate of T2DM resolution/improvement and improvement of hypertension appears to be similar. In Asian patients without symptoms of gastro-esophageal reflux disease in whom metabolic surgery is performed mainly for T2DM and metabolic syndrome, SG may be the surgery of choice.
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Metadata
Title
Outcomes After Metabolic Surgery in Asians—a Meta-analysis
Authors
Danson Yeo
Charleen Yeo
Tze Yi Low
Saleem Ahmed
Sheena Phua
Aung Myint Oo
Jaideepraj Rao
Aaryan Koura
Kavita Venkataraman
Sanghvi Kaushal
Publication date
01-01-2019
Publisher
Springer US
Published in
Obesity Surgery / Issue 1/2019
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-018-3484-5

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