LAS VEGAS — Both young and old patients had significant improvements in preoperative cardiovascular comorbidities after laparoscopic Roux-en-Y gastric bypass surgery, results from a large, single-center study showed.
However, the improvements were less pronounced in patients aged 50 years and older, compared with younger patients, Eric Ketchum said at a poster session at the annual meeting of the Society of American Gastrointestinal and Endoscopic Surgeons.
“People over age 50 did pretty well,” Mr. Ketchum, a fourth-year medical student at Stanford (Calif.) University, said in an interview. “For example, 75% of them did not have to take medicines for diabetes [after surgery], but they did a little bit worse than younger people did.”
He and his associates in the department of surgery at Stanford University Medical Center reviewed the records of 273 patients who underwent laparoscopic Roux-en-Y gastric bypass during January 2003-December 2005. They compared the resolution of comorbidities, cardiovascular risk factors, and weight loss 1 year after surgery in patients aged 50 and older with those in patients younger than age 50.
One year postoperatively, the mean body mass index was similar between the older and younger groups (31 kg/m
The older patients showed less postoperative reductions than did the younger patients in levels of total cholesterol (8% vs. 16%, respectively), LDL cholesterol (17% vs. 26%), triglycerides (31% vs. 42%), and HDL cholesterol (15% vs. 19%).
Patients in the older group also required more medicines postoperatively, compared with those in the younger group, for preoperative comorbid conditions including hypertension (65% vs. 78%, respectively), hyperlipidemia (73% vs. 78%), and diabetes (75% vs. 94%).
Patients in the older group also showed less improvement than the younger group in terms of C-reactive protein (55% vs. 81%) and lipoprotein (a) (11% vs. 26%).
However, patients in the older group demonstrated greater improvement than the younger group in terms of hemoglobin A1c levels (15% vs. 12%) and homocysteine levels (26% vs. 17%).
In their poster, the researchers noted that the “12-month postoperative lipid parameters did not show a statistically significant difference between the two cohorts” probably because “a significantly higher proportion of the senior cohort was medicated for hyperlipidemia” preoperatively.