Age Influence on Weight Loss and Glycol-lipid Profile After Laparoscopic Sleeve Gastrectomy: Experience with 308 Consecutive Patients

Yoshihiro Nagao, MD, PhD, Michele Diana, MD, Michel Vix, MD, Antonio D’Urso, MD, Didier Mutter, MD, PhD, FACS, Jacques Marescaux, MD, FACS, HonFRCS, HonFJSES

IRCAD-IHU, Department of General, Digestive and Endocrine Surgery, University Hospital of Strasbourg, France

Introduction Sleeve gastrectomy (SG) is gaining acceptance as a standalone bariatric procedure with proven efficacy on weight loss and comorbidity improvement. The aim of this study is to evaluate the impact of age on weight loss and on related glycolipid profile changes at two-year follow-up after SG.

Methods and procedures From July 2005 to July 2010, 336 patients underwent SG and 308 completed a two-year follow-up. Mean age was 39.7 years (SD 10.7), mean weight was 127.9 kg (SD 24.5), mean Body Mass Index (BMI) was 45.9 kg/m2 (SD 6.8). To analyze the effect of age on bariatric outcomes, patients were classified according to age into three groups: 1) young (18-29 years old, n=64); 2) intermediate (30-49 years old, n=183) and 3) seniors (≥ 50 years old, n=57). BMI, Excess Weight Loss (%EWL), Homeostasis Model Assessment for Insulin Resistance (HOMA-IR), cholesterol and triglycerides were assessed at 1 month, 6, 12, and 24 months (M1, M6, M12, and M24) after the procedure.

Results All patients had a significant %EWL and BMI reduction at two years. Mean BMI reduction and %EWL was statistically significantly higher in the younger group at M6, M12, and M24 when compared to intermediate and senior groups (Table 1). A significant lower HOMA-IR improvement was observed at M6 in the older group when compared to both younger (p=0.02) and intermediate (p=0.01) groups of patients. No significant difference was found at M12 (Table 1). Mean total cholesterol and triglycerides were statistically significantly improved in the younger group when compared to both intermediate and senior patients (Table 1).

Conclusions An age-dependent trend towards better %EWL, BMI reduction, and lipid and glycemic profile was observed in younger patients after SG. Although there was a still acceptable 50% EWL, these findings may suggest a limited benefit of SG for senior patients.

Table 1

Time points Young
(18-29 y.o.)
(30-49 y.o.)
(≥50 y.o.)
Young vs. Intermediate Young vs. Seniors Intermediate vs. Seniors
BMI (kg/m2) Preop.


46.2±7.2 46.4±6 p=0.15 p=0.12 p=0.84
M6 31.5±4.8 34.1±6.9 36.1±6.4 p=0.0058 p<0.0001 p<0.0001
M12 29.4±6.1 31.4±6.1 34.3±6 p=0.008 p<0.0001 p=0.0019
M24 28.4±5.4 31.4±7.1 34.84±6 p=0.008 p<0.0001 p=0.0028
%EWL M6 62.6±14.4 53.2±18 48±15.5 p=0.0003 p<0.0001 p=0.05
M12 73.4±17.1 64.8±19.9 54.6±15.3 p=0.002 p<0.0001 p=0.0005
M24 72.5±18.9 66.8±23 54.4±15.4 p=0.15 p<0.0001 p=0.0014
HOMA-IR Preop. 2.49±0.86 3.01±1.68 3.03±1.25 p=0.33 p=0.29 p=0.97
M6 1.30±0.54 1.43±0.82 2.83±1.86 p=0.65 p=0.02 p=0.01
M12 1.01±0.47 1.08±0.47 1.53±0.91 p=0.71 p=0.17 p=0.07
Total cholesterol (g/L) Preop. 1.91±0.41 2.0±0.38 1.99±0.57 p=0.17 p=0.44 p=0.89
M6 1.77±0.47 1.96±0.41 2.06±0.45 p=0.03 p=0.014 p=0.24
M12 1.75±0.31 1.99±0.38 2.01±0.49 p=0.01 p=0.009 p=0.8
M24 1.73±0.26 1.97±0.36 2.06±0.57 p=0.01 p=0.04 p=0.39
Triglycerides (g/L) Preop. 1.23±0.74 1.38±0.75 1.74±0.91 p=0.29 p=0.009 p=0.01
M6 0.94±0.31 1.96±0.34 1.31±0.55 p=0.78 p=0.002 p=0.0001
M12 0.77±0.25 0.82±0.3 1.12±0.43 p=0.41 p=0.0003 p<0.0001
M24 0.89±0.37 0.77±0.3 1.23±0.5 p=0.17 p=0.02 p<0.0001

Session: Podium Presentation

Program Number: S118

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