AUTHOR=Stanford Fatima Cody , Mushannen Tasnim , Cortez Priscilla , Campoverde Reyes Karen J. , Lee Hang , Gee Denise W. , Pratt Janey S. , Boepple Paul A. , Bredella Miriam A. , Misra Madhusmita , Singhal Vibha 

TITLE=Comparison of Short and Long-Term Outcomes of Metabolic and Bariatric Surgery in Adolescents and Adults

JOURNAL=Frontiers in Endocrinology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2020.00157

DOI=10.3389/fendo.2020.00157

ISSN=1664-2392

ABSTRACT=<p><bold>Objective:</bold> We sought to compare the short and long-term outcomes of MBS in adolescents vs. adults who have undergone a Roux-en-Y gastric bypass (RYGB) or Sleeve gastrectomy (SG).</p><p><bold>Design:</bold> Retrospective cohort study.</p><p><bold>Setting:</bold> Single tertiary care academic referral center.</p><p><bold>Participants:</bold> One hundred fifty adolescent (≤ 21-years) and adult (&gt;21-years) subjects with severe obesity between 15 and 70 years of age who underwent RYGB or SG.</p><p><bold>Outcomes:</bold> Metabolic parameters, weight and height measures were obtained pre-and post-surgery (at 3 and 6 months, and then annually for 4 years).</p><p><bold>Results:</bold> Median pre-surgical body mass index (BMI) was higher in adolescents (<italic>n</italic> = 76) vs. adults (<italic>n</italic> = 74): 50 (45–57) vs. 44 (40–51) kg/m<sup>2</sup> (<italic>p</italic> &lt; 0.0001). However, obesity related complications were greater in adults vs. adolescents: 66 vs. 21% had hypertension, 68 vs. 28% had dyslipidemia, and 42 vs. 21% had type 2 diabetes mellitus (all <italic>p</italic> &lt; 0.010). % BMI reduction and % weight loss (WL) were greater in adolescents vs. adults at all time points (<italic>p</italic> &lt; 0.050). %WL was higher in adolescents who underwent SG at each time point (<italic>p</italic> &lt; 0.050), and trended higher among adolescents who underwent RYGB (<italic>p</italic> = 0.060), compared to adults with the respective procedure. Follow-up data showed greater resolution of type 2 diabetes and hypertension in adolescents than adults (87.5 vs. 54.8%; <italic>p</italic> = 0.04, and 68.7 vs. 35.4%; <italic>p</italic> = 0.040).</p><p><bold>Conclusion:</bold> Adolescents compared to adults had greater reductions in BMI and weight, even at 4 years, and greater resolution of type 2 diabetes and hypertension. Earlier intervention in the treatment of severe obesity with MBS may lead to better outcomes.</p>