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Laparoscopic adjustable banding improved, reversed metabolic syndrome in adolescents

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The Endocrine Society's 91st Annual Meeting

Laparoscopic adjustable gastric banding surgery significantly improved inflammatory markers and components of metabolic syndrome in morbidly obese adolescents, according to new data presented today.

“Increasingly, laparoscopic adjustable gastric banding has been shown to be safe and effective in weight-loss in adults, but in adolescents we have limited data,” said Ilene Fennoy, MD, clinical professor of pediatrics in the Division of Pediatric Endocrinology, Diabetes and Metabolism at Columbia University and Morgan Stanley Children’s Hospital of NY Presbyterian.

“Our study showed a significant decrease in the prevalence for metabolic syndrome in adolescents from about 42% to about 17% at 12 month follow-up,” she said at a press conference.

The researchers examined data from 24 morbidly obese adolescents (15 girls) aged between 14 and 17 who underwent laparoscopic adjustable gastric banding surgery. Metabolic and anthropometric data were compared at baseline, six months (n=24) and 12 months (n=12).

Thirteen adolescents met the criteria for metabolic syndrome at baseline.

At six months, the prevalence of metabolic syndrome decreased from about 54.2% to 29.2%. The researchers also reported significant changes in BMI, C-reactive protein, systolic blood pressure, triglycerides and waist circumference.

At one year, the decrease in prevalence of metabolic syndrome was even greater: from 41.7% to 16.7%. The researchers found significant changes in BMI, C-reactive protein and waist circumference.

The researchers concluded that rapid improvement of metabolic syndrome parameters occurred during the first six months but less dramatic changes were reported at one year.

“Laparoscopic gastric banding surgery may be a useful intervention for morbidly obese adolescents to decrease the risk for early development of cardiovascular disease and other illnesses related to obesity,” Fennoy said. – by Jennifer Southall

Preliminary data in a carefully selected, small cohort of patients suggest that the procedure of gastric banding may be using - at least in the short term - on reducing risk factors for metabolic syndrome. Factors such as drop-out rate, long-term adjustments, adherence and success remain to be determined. The number of patients studied is small and the responses declined, such that at 12 months about half of the cohort did not respond or were not available. Did they drop out of the study? Did the banding fail? Did patients choose to have the band removed? Second, these are still early days; a follow-up of 12 months is not sufficient time to be sure that the procedure was a long-term success.

– Mark A. Sperling, MD

Endocrine Today Editorial Board member

For more information:

• Fennoy I. #P2-420. Presented at: The Endocrine Society’s 91st Annual Meeting; June 10-13, 2009; Washington, D.C.