Table 2.
Metabolic Changes Following RYGB and Diabetes and Weight Medical Management
| End Point | Baseline, Mean (SD) | Baseline-Adjusted Mean Change (95% CI) | P Valuea | ||||
|---|---|---|---|---|---|---|---|
| 10% Weight Lost or 3 mo | 12 mo | ||||||
| RYGB | Why WAIT | RYGB | Why WAIT | RYGB | Why WAIT | ||
| Waist, cm | 117.8 (14.9) | 114.1 (12.2) | −9.8 (−12.9 to −6.6) | −5.3 (−8.4 to −2.1) | −26.9 (−30.4 to −23.5) | −6.6 (−10.3 to −2.9) | <.001b |
| Mass, kg | |||||||
| Lean | 59.2 (14.1) | 60.1 (10.8) | −1.8 (−3.0 to −0.6) | −1.3 (−2.5 to −0.1) | −5.1 (−7.0 to −3.3) | −1.4 (−3.4 to 0.6) | .04b |
| Fat | 45.5 (9.4) | 42.6 (9.8) | −9.4 (−11.4 to −7.5) | −6.1 (−8.0 to −4.1) | −22.7 (−25.6 to −19.8) | −6.2 (−9.3 to −3.0) | <.001b |
| BP, mm Hg | |||||||
| Systolic | 132.8 (10.5) | 126.3 (14.7) | −7.3 (−13.1 to −1.4) | −6.3 (−12.1 to −0.4) | −12.3 (−18.5 to −6.2) | −1.0 (−7.2 to 5.3) | .02c |
| Diastolic | 81.7 (7.4) | 76.6 (8.8) | 0.9 (−2.3 to 4.1) | −4.3 (−7.5 to −1.1) | −5.1 (−8.3 to −1.9) | −2.1 (−5.3 to 1.2) | <.001c |
| Laboratory values | |||||||
| Total cholesterol, mg/dL | 154.2 (34.0) | 162.5 (38.6) | −18.6 (−32.3 to −4.9) | −3.7 (−17.4 to 10.0) | −3.2 (−17.7 to 11.3) | 8.3 (−7.0 to 23.5) | .11 |
| Triglycerides, mg/dL | 120 (66) | 156 (76) | −32 (−43 to −21) | −31 (−42. to −19) | −47 (−63 to −30) | −5 (−23 to 12) | .02b |
| HDL-C, mg/dL | 43.6 (9.7) | 39.1 (9.9) | −5.8 (−8.5 to −3.2) | 0.1 (−2.5 to 2.8) | 10.2 (6.7 to 13.6) | 0.4 (−3.3 to 4.0) | <.001c |
| LDL-C, mg/dLd | 88.1 (27.7) | 98.9 (29.3) | −7.4 (−19.0 to 4.1) | −4.4 (−16.1 to 7.3) | −5.4 (−17.8 to 6.9) | 8.6 (−4.5 to 21.6) | .22 |
| ALT, IU/L | 32.2 (16.3) | 27.7 (12.3) | −7.4 (−10.7 to −4.0) | −3.8 (−7.2 to −0.5) | −10.6 (−15.5 to −5.6) | −4.7 (−10.1 to 0.6) | .06 |
| AST, IU/L | 30.6 (21.6) | 23.3 (13.4) | −1.4 (−5.5 to 2.6) | −0.8 (−4.8 to 3.2) | −5.8 (−10.0 to −1.6) | −3.3 (−7.6 to 1.1) | .49 |
| Creatinine, mg/dL | 0.71 (0.14) | 0.86 (0.21) | −0.06 (−0.10 to −0.02) | 0.02 (−0.02 to 0.06) | −0.07 (−0.11 to −0.03) | 0 (−0.05 to 0.04) | .01 |
| Urinary albumin to creatinine ratioe | 3 (0 to 7)f | 3 (0 to 10)f | ND | ND | −1.0 (−5.0 to 5.0) | 0 (−4.5 to 2.0) | .96f |
| Vitamin D3, ng/mL | 22.2 (9.0) | 21.0 (8.8) | 7.0 (4.3 to 9.7) | 0.3 (−3.1 to 3.7) | 4.6 (0.5 to 8.6) | 1.0 (−3.3 to 5.3) | .01 |
| Hematocrit, % | 36.8 (3.3) | 40.2 (4.3) | −4.4 (−5.4 to −3.5) | 0.0 (−1.0 to 1.0) | −2.3 (−3.6 to −1.1) | 0.2-(−1.2-to1.5) | <.001 |
| WBCs, ×103/μL | 6.8 (2.1) | 6.5 (1.8) | −1.2 (−1.7 to −0.7) | −0.4 (−0.9 to 0.1) | −0.9 (−1.4 to −0.4) | 0.1 (−0.4 to 0.6) | .01 |
| 6-Min walk, m | 458.7 (65.5) | 466.7 (55.9) | −6.4 (−29.7 to 16.8) | 33.2 (10.0 to 56.5) | 17.8 (−8.3 to 44.0) | 27.7 (0.4 to 55.1) | .11 |
| Heart rate recovery (1 min), beats/min | 92.2 (15.2) | 87.5 (12.0) | −4.6 (−9.2 to 0) | −1.1 (−5.8 to 3.5) | −10.7 (−15.9 to −5.5) | 1.0 (−4.5 to 6.5) | .01 |
Abbreviations: ALT, alanine aminotransferase; AST, aspartate aminotransferase; BP, blood pressure; HDL-C, high-density lipoprotein cholesterol; IQR, interquartile range; LDL-C, low-density lipoprotein cholesterol; ND, not determined; RYGB, Roux-en-Y gastric bypass; WAIT, Weight Achievement and Intensive Treatment; WBCs, white blood cells.
SI conversion factors: To convert ALT and AST to microkatals per liter, multiply by 0.0167; creatinine to micromoles per liter, 88.4; glucose to millimoles per liter, 0.0555; HDL-C, LDL-C, and total cholesterol to millimoles per liter, 0.0259; hematocrit to proportion of 1.0, 0.01; triglycerides to millimoles per liter, 0.0113; and WBCs to ×109/L, 1.0.
P values represent treatment effects from linear mixed model corrected for baseline, unless otherwise noted.
P value for time × treatment interaction was also significant at P < .05.
P value represents time × treatment interaction; treatment effect was not significant.
Direct measurement was performed.
Urinary albumin reported in micrograms of protein per milligrams of creatinine, obtained in a spot morning void.
Median and IQR are provided and were analyzed using the Kruskal-Wallis test for nonparametric data.