Comparison of Gastric Bypass and Sleeve Gastrectomy in Metabolic and Cardiovascular Indices
Primary Purpose
Morbid Obesity
Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Bariatric surgery
Sponsored by
About this trial
This is an interventional treatment trial for Morbid Obesity focused on measuring Bariatric surgery, gut peptides, weight loss, glycemia
Eligibility Criteria
Inclusion Criteria:
- BMI >40 kg/m2
- Age between 18 and 65 years
- Proven failure to lose weight through non-surgical interventions
Exclusion Criteria:
- Serious and life threatening comorbidities (renal, cardiac, liver failure, or malignancy)
- Patients' inability to adhere to postsurgical instructions
- Alcohol or other substance abuse
- Concurrent psychiatric illness
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Active Comparator
Arm Label
Gastric bypass bariatric surgery
Sleeve gastrectomy bariatric surgery
Arm Description
Patients in this arm underwent Roux-en-Y gastric bypass bariatric surgery for the treatment of morbid obesity
Patients in this arm underwent sleeve gastrectomy bariatric surgery for the treatment of morbid obesity
Outcomes
Primary Outcome Measures
Change in postprandial ghrelin responses
Change in the cumulative postprandial response for ghrelin
Change in postprandial GLP-1 responses
Change in the cumulative postprandial response for GLP-1
Change in postprandial PYY responses
Change in the cumulative postprandial response for PYY
Secondary Outcome Measures
Change in weight
Change in weight (percentage of weight lost through each procedure)
Change in postprandial glycemia
Change in the cumulative postprandial response for glucose
Change in postprandial insulinemia
Change in the cumulative postprandial response for insulin
Change in postprandial triglyceridemia
Change in the cumulative postprandial response for triglycerides
Full Information
NCT ID
NCT03851874
First Posted
February 21, 2019
Last Updated
February 21, 2019
Sponsor
National and Kapodistrian University of Athens
Collaborators
Beth Israel Deaconess Medical Center
1. Study Identification
Unique Protocol Identification Number
NCT03851874
Brief Title
Comparison of Gastric Bypass and Sleeve Gastrectomy in Metabolic and Cardiovascular Indices
Official Title
A Comparative Study of the Effects of Roux en Y Gastric Bypass and Sleeve Gastrectomy on Postprandial Gut Hormone Responses, Glycemia and Lipid Profile, Weight Loss, and Indices of Cardiovascular Risk
Study Type
Interventional
2. Study Status
Record Verification Date
February 2019
Overall Recruitment Status
Completed
Study Start Date
October 2011 (Actual)
Primary Completion Date
January 2014 (Actual)
Study Completion Date
January 2014 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
National and Kapodistrian University of Athens
Collaborators
Beth Israel Deaconess Medical Center
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
Morbidly obese patients undergoing either Roux en Y gastric bypass or sleeve gastrectomy were examined preoperatively, 3, 6, and 12 months after surgery. On each occasion, anthropometric data were collected, resting metabolic rate was measured, and the patients underwent a panel of cardiovascular examinations (heart rate variability, baroreflex sensitivity, heart ultrasound). Following that, they consumed a test meal and completed visual analog scales for the subjective assessment of hunger and fullness every 30 minutes for 3 hours. At the same time points, blood samples were collected for the consequent measurement of glucose, insulin, lipids, and gastrointestinal hormones.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Morbid Obesity
Keywords
Bariatric surgery, gut peptides, weight loss, glycemia
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
28 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Gastric bypass bariatric surgery
Arm Type
Active Comparator
Arm Description
Patients in this arm underwent Roux-en-Y gastric bypass bariatric surgery for the treatment of morbid obesity
Arm Title
Sleeve gastrectomy bariatric surgery
Arm Type
Active Comparator
Arm Description
Patients in this arm underwent sleeve gastrectomy bariatric surgery for the treatment of morbid obesity
Intervention Type
Procedure
Intervention Name(s)
Bariatric surgery
Intervention Description
Bariatric surgery
Primary Outcome Measure Information:
Title
Change in postprandial ghrelin responses
Description
Change in the cumulative postprandial response for ghrelin
Time Frame
3, 6, and 12 months
Title
Change in postprandial GLP-1 responses
Description
Change in the cumulative postprandial response for GLP-1
Time Frame
3, 6, and 12 months
Title
Change in postprandial PYY responses
Description
Change in the cumulative postprandial response for PYY
Time Frame
3, 6, and 12 months
Secondary Outcome Measure Information:
Title
Change in weight
Description
Change in weight (percentage of weight lost through each procedure)
Time Frame
3, 6, and 12 months
Title
Change in postprandial glycemia
Description
Change in the cumulative postprandial response for glucose
Time Frame
3, 6, and 12 months
Title
Change in postprandial insulinemia
Description
Change in the cumulative postprandial response for insulin
Time Frame
3, 6, and 12 months
Title
Change in postprandial triglyceridemia
Description
Change in the cumulative postprandial response for triglycerides
Time Frame
3, 6, and 12 months
Other Pre-specified Outcome Measures:
Title
Change in baroreflex sensitivity
Description
Changes in baroreflex sensitivity
Time Frame
3, 6, and 12 months
Title
Change in heart rate variability
Description
Changes in heart rate variability
Time Frame
3, 6, and 12 months
Title
Change in aortic distensibility
Description
Changes in aortic distensibility
Time Frame
3, 6, and 12 months
Title
Change in Tei index
Description
Changes in echocardiographic Tei index
Time Frame
3, 6, and 12 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
BMI >40 kg/m2
Age between 18 and 65 years
Proven failure to lose weight through non-surgical interventions
Exclusion Criteria:
Serious and life threatening comorbidities (renal, cardiac, liver failure, or malignancy)
Patients' inability to adhere to postsurgical instructions
Alcohol or other substance abuse
Concurrent psychiatric illness
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alexandros Kokkinos, MD, PhD
Organizational Affiliation
First Department of Propaedeutic Medicine, NKUA
Official's Role
Principal Investigator
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
27313194
Citation
Holst JJ, Madsbad S. Mechanisms of surgical control of type 2 diabetes: GLP-1 is key factor. Surg Obes Relat Dis. 2016 Jul;12(6):1236-42. doi: 10.1016/j.soard.2016.02.033. Epub 2016 Mar 3.
Results Reference
background
PubMed Identifier
17936091
Citation
Korner J, Bessler M, Inabnet W, Taveras C, Holst JJ. Exaggerated glucagon-like peptide-1 and blunted glucose-dependent insulinotropic peptide secretion are associated with Roux-en-Y gastric bypass but not adjustable gastric banding. Surg Obes Relat Dis. 2007 Nov-Dec;3(6):597-601. doi: 10.1016/j.soard.2007.08.004. Epub 2007 Oct 23.
Results Reference
background
PubMed Identifier
28780756
Citation
Dimitriadis GK, Randeva MS, Miras AD. Potential Hormone Mechanisms of Bariatric Surgery. Curr Obes Rep. 2017 Sep;6(3):253-265. doi: 10.1007/s13679-017-0276-5.
Results Reference
background
PubMed Identifier
20501690
Citation
Laferrere B, Swerdlow N, Bawa B, Arias S, Bose M, Olivan B, Teixeira J, McGinty J, Rother KI. Rise of oxyntomodulin in response to oral glucose after gastric bypass surgery in patients with type 2 diabetes. J Clin Endocrinol Metab. 2010 Aug;95(8):4072-6. doi: 10.1210/jc.2009-2767. Epub 2010 May 25.
Results Reference
background
PubMed Identifier
23996294
Citation
Yousseif A, Emmanuel J, Karra E, Millet Q, Elkalaawy M, Jenkinson AD, Hashemi M, Adamo M, Finer N, Fiennes AG, Withers DJ, Batterham RL. Differential effects of laparoscopic sleeve gastrectomy and laparoscopic gastric bypass on appetite, circulating acyl-ghrelin, peptide YY3-36 and active GLP-1 levels in non-diabetic humans. Obes Surg. 2014 Feb;24(2):241-52. doi: 10.1007/s11695-013-1066-0.
Results Reference
background
PubMed Identifier
27465935
Citation
Farey JE, Preda TC, Fisher OM, Levert-Mignon AJ, Stewart RL, Karsten E, Herbert BR, Swarbrick MM, Lord RV. Effect of Laparoscopic Sleeve Gastrectomy on Fasting Gastrointestinal, Pancreatic, and Adipose-Derived Hormones and on Non-Esterified Fatty Acids. Obes Surg. 2017 Feb;27(2):399-407. doi: 10.1007/s11695-016-2302-1.
Results Reference
background
PubMed Identifier
36375643
Citation
Angelidi AM, Kokkinos A, Sanoudou D, Connelly MA, Alexandrou A, Mingrone G, Mantzoros CS. Early metabolomic, lipid and lipoprotein changes in response to medical and surgical therapeutic approaches to obesity. Metabolism. 2023 Jan;138:155346. doi: 10.1016/j.metabol.2022.155346. Epub 2022 Nov 12.
Results Reference
derived
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Comparison of Gastric Bypass and Sleeve Gastrectomy in Metabolic and Cardiovascular Indices
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