Effects of bariatric surgery on glycemic and lipid metabolism, surgical complication and quality of life in adolescents with obesity: a systematic review and meta-analysis

摘要

Abstract Background Obesity in adolescents is associated with numerous health risks and co-morbidities, including type 2 diabetes and dyslipidemia. Bariatric surgery on adolescents induces weight loss, but little is known about metabolic effects of these operations. Objective To explore weight loss and metabolic effects of bariatric surgery on young people. Setting A systematic review and meta-analysis. University Hospital, China. Methods PubMed and EMBASE were searched for relevant studies up to July 2017. The related studies in adolescents after operation were included. Results A total of 49 studies with 3007 patients were included. The average preoperative age ranged from 13.9 to 19.9 years. Roux-en-Y gastric bypass (n = 1216), laparoscopic adjustable gastric banding (n = 1028), and laparoscopic sleeve gastrectomy (n = 665) were the most common bariatric surgeries performed. At the longest follow-up (range, 12–120 mo), bariatric surgery led to an overall 16.43 kg/m 2 (95% confidence interval [CI]: 14.84–18.01) and 31% (95% CI: 28%–34%) reduction in body mass index. There were significant improvements in glycemic and lipid profiles including glycosylated hemoglobin A1C, fasting blood insulin, fasting blood glucose, total cholesterol, triglyceride, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol, postoperatively at 12 months. The remission rate of dyslipidemia was 55% (95% CI: 34%–76%), 70% (95% CI: 55%–82%), and 95% (95% CI: 80%–100%) at 1, 3, and>5 years after surgery. Roux-en-Y gastric bypass produced better improvements than other surgical procedures. Conclusion Bariatric surgery in adolescents may achieve significant weight loss, and glycemic and lipid control. Further well-designed studies with longer follow-up are warranted to provide more reliable evidence.