Impact of Weight Loss on the Severity of Albuminuria in Obese Diabetic Patients Undergoing Laparoscopic Sleeve Gastrectomy and One-Anastomosis Gastric Bypass

Abstract

Ahmed Abdallah Salman,1 Mohamed Abdalla Salman,2 Mohamed H Aon,1 Reem Ezzat Mahdy,3 Ahmed Abdallah,2 Gamal Galal Shemy,4 Ahmed M Hassan,4 Fatema Alzahraa Samy Amin,5 Safa Labib1 1Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt; 2General Surgery Department, Faculty of Medicine, Cairo University, Cairo, Egypt; 3Internal Medicine Department, Faculty of Medicine, Assiut University, Assiut, Egypt; 4General Surgery Department, Faculty of Medicine, Al-Azhar University, Assiut Branch, Assiut, Egypt; 5Clinical Pathology Department, Faculty of Medicine, Cairo University, Cairo, EgyptCorrespondence: Ahmed Abdallah Salman, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt, Tel [phone], Email [email protected]: To examine the effect of weight-loss induced bariatric procedures on albuminuria levels among diabetic patients suffering from obesity.Methods: Adults patients who suffer from morbid obesity and type 2 diabetes mellitus (T2DM) were included in a prospective cohort study. Subjects were scheduled to undergo laparoscopic sleeve gastrectomy (LSG) or one-anastomosis gastric bypass (OAGB). The albumin-to-creatinine ratio (ACR) was adopted to assess the degree of albuminuria. Microalbuminuria was determined as a ratio of > 2.5– 30 mg/mmol and > 3.5– 30 mg/mmol for males and females, respectively, while macroalbuminuria was diagnosed when the ACR exceeded > 30 mg/mmol.Results: The mean uACR decreased significantly from 20.95± 16.89 to 9.92± 12.69mg/mmol in LSG cohort (p < 0.001), and from 19.52± 16.65 to 9.34± 11.77mg/mmol in the OAGB cohort, with no statistically considerable differences between both cohorts at the end of follow-up (p = 0.78). Twelve months after the procedures, the percentages of cases with microalbuminuria decreased significantly to 23.8% and 23.9%, respectively (p < 0.001); likewise, the percentages of cases with macroalbuminuria significantly decreased to 7.9% and 7.5% in the LSG and OAGB groups, respectively (p < 0.001). There were no statistically considerable differences between LSG and OAGB regarding the percentages of patients with micro or macroalbuminuria at the end of follow-up. Besides, there were no significant associations between the degree of weight loss and improvement (p = 0.959) or remission (p = 0.73) of microalbuminuria.Conclusion: Bariatric surgery significantly reduced the severity of albuminuria 1-year after the procedure, with no preference for one procedure over the other.Keywords: bariatric surgery, laparoscopic sleeve gastrectomy, one-anastomosis gastric bypass, microalbuminuria

Keywords

• bariatric surgery
• laparoscopic sleeve gastrectomy
• one-anastomosis gastric bypass
• microalbuminuria