Laparoscopic adjustable gastric banding for the treatment of morbid (grade 3) obesity and its metabolic complications: A three-year study

Antonio E. Pontiroli, Pierluigi Pizzocri, Maria Cristina Librenti, Paola Vedani, Monica Marchi, Emanuele Cucchi, Corrado Orena, Michele Paganelli, Maurizio Giacomelli, Gianfranco Ferla, Franco Folli

Research output: Contribution to journalArticle

Abstract

Weight loss ameliorates arterial hypertension and glucose metabolism in obese patients, but the dietary approach is unsatisfactory because obesity relapses. Durable reduction of body weight, obtained through major nonreversible surgical procedures, such as jejunal and gastric bypass, allows improvement of glucose metabolism and arterial blood pressure in morbid (grade 3) obesity. Laparoscopic adjustable gastric banding (LAGB) is a minimally invasive and reversible surgical procedure that yields a significant reduction of gastric volume and hunger sensation. In this study, 143 patients with grade 3 obesity [27 men and 116 women; age, 42.9 ± 0.83 yr; body mass index (BMI), 44.9 ± 0.53 kg/m 2; normal glucose tolerance (NGT; n = 77); impaired glucose tolerance (IGT; n = 47); type 2 diabetes mellitus (T2DM; n = 19)] underwent LAGB and a 3-yr follow-up for clinical (BMI, waist circumference, waist to hip ratio, and arterial blood pressure) and metabolic variables (glycosylated hemoglobin, fasting insulin and glucose, insulin and glucose response to oral glucose tolerance test, homeostasis model assessment index, total and high-density lipoprotein cholesterol, triglycerides, uric acid, and transaminases). At baseline and 1 yr after LAGB, patients underwent computerized tomography and ultrasound evaluation of visceral and sc adipose tissue. One-year metabolic results were compared with 120 obese patients (51 men and 69 women; age, 42.9 ± 1.11 yr; BMI, 43.6 ± 0.46 kg/m 2; NGT, n = 66; IGT, n = 8; T2DM, n = 46) receiving standard dietary treatment. LAGB induced a significant and persistent weight loss and decrease of blood pressure. Greater metabolic effects were observed in T2DM patients than in NGT and IGT patients, so that at 3 yr glycosylated hemoglobin was no longer different in NGT and T2DM subjects. Clinical and metabolic improvements were proportional to the amount of weight loss. LAGB induced a greater reduction of visceral fat than sc fat. At 1-yr evaluation, weight loss and metabolic improvements were greater in LAGB-treated than diet-treated patients. We conclude that LAGB is an effective treatment of grade 3 obesity in inducing long-lasting reduction of body weight and arterial blood pressure, modifying body fat distribution, and improving glucose and lipid metabolism, especially in T2DM.

Original languageEnglish
Pages (from-to)3555-3561
Number of pages7
JournalJournal of Clinical Endocrinology and Metabolism
Volume87
Issue number8
DOIs
Publication statusPublished - 2002

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Stomach
Obesity
Glucose
Blood pressure
Weight Loss
Insulated gate bipolar transistors (IGBT)
Arterial Pressure
Body Mass Index
Intra-Abdominal Fat
Fats
Glycosylated Hemoglobin A
Therapeutics
Metabolism
Body Weight
Insulin
Body Fat Distribution
Hunger
Glucose Intolerance
Waist-Hip Ratio
Gastric Bypass

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

Laparoscopic adjustable gastric banding for the treatment of morbid (grade 3) obesity and its metabolic complications : A three-year study. / Pontiroli, Antonio E.; Pizzocri, Pierluigi; Librenti, Maria Cristina; Vedani, Paola; Marchi, Monica; Cucchi, Emanuele; Orena, Corrado; Paganelli, Michele; Giacomelli, Maurizio; Ferla, Gianfranco; Folli, Franco.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 87, No. 8, 2002, p. 3555-3561.

Research output: Contribution to journalArticle

Pontiroli, AE, Pizzocri, P, Librenti, MC, Vedani, P, Marchi, M, Cucchi, E, Orena, C, Paganelli, M, Giacomelli, M, Ferla, G & Folli, F 2002, 'Laparoscopic adjustable gastric banding for the treatment of morbid (grade 3) obesity and its metabolic complications: A three-year study', Journal of Clinical Endocrinology and Metabolism, vol. 87, no. 8, pp. 3555-3561. https://doi.org/10.1210/jc.87.8.3555
Pontiroli, Antonio E. ; Pizzocri, Pierluigi ; Librenti, Maria Cristina ; Vedani, Paola ; Marchi, Monica ; Cucchi, Emanuele ; Orena, Corrado ; Paganelli, Michele ; Giacomelli, Maurizio ; Ferla, Gianfranco ; Folli, Franco. / Laparoscopic adjustable gastric banding for the treatment of morbid (grade 3) obesity and its metabolic complications : A three-year study. In: Journal of Clinical Endocrinology and Metabolism. 2002 ; Vol. 87, No. 8. pp. 3555-3561.
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