Surgery for Obesity and Related Diseases ] (2016) 00–00 Original article Long-term effects of laparoscopic Roux-en-Y gastric bypass on metabolic syndrome Q3 in patients with morbid obesity Kamran Shah, M.D., Bent Johnny Nergard, M.D., Katinka Stray Frazier, M.Sc., R.D., Björn Geir Leifsson, M.D., Ebrahim Aghajani, M.D., Ph.D., Hjörtur Gislason, M.D., Ph.D. * Q1 Aleris Obesity Clinic and Department of Surgery, Aleris Hospital, Oslo, Norway Received January 22, 2016; accepted March 15, 2016 Abstract Background: Diseases associated with obesity such as type 2 diabetes (T2D), hypertension, and dyslipidemia are common and together are defined as metabolic syndrome (MetS). The aim of this study was to evaluate long-term effects of laparoscopic Roux-en-Y gastric bypass (LRYGB) in morbidly obese patients with MetS. Methods: This was a retrospective study of data from a prospective database in a single center from 2005 to 2013 including 3795 LRYGB operated obese patients. Metabolic syndrome was defined according to the International Diabetes Federation Consensus Definition of Metabolic Syndrome from 2006. Results: In the study population, 79% of the patients were women, the preoperative median age was 42.4 years, and median body mass index (BMI, kg/m 2 ) was 40.9. MetS was diagnosed in 60% of the patients (2275/3795), with increased frequency in men and in those with higher age, higher BMI, and greater waist circumference; 27.5% of patients had impaired glucose metabolism, 40% hypertension, and 30% dyslipidemia. Postoperative follow-up rate 45 years was 71% (595/839). We found that 86.2% had resolution of MetS. After 5–9 years, complete remission of T2D was achieved in 78%, hypertension in 51%, and dyslipidemia in 89%. Mean excess BMI loss was significantly lower for patients with MetS (73.1%) compared with patients without MetS (75.6%) (P o .01). Early complications (leakage or hemorrhage) occurred in 1.2% (48/3975) and internal hernia in 7.8% (310/3975). Presence of MetS did not increase complication rates. Conclusion: LRYGB in obese patients is associated with a significant and sustained reduction in excessive weight. In the present study, 86.2% of patients with MetS achieved complete remission and complication rates were low. Early bariatric surgery should be considered in patients with obesity and concurrent MetS. (Surg Obes Relat Dis 2016;]:00–00.) r 2016 American Society for Metabolic and Bariatric Surgery. All rights reserved. Keywords: Roux-en-Y gastric bypass; Metabolic syndrome; Remission Obesity is an increasing global problem in developed countries and has nearly doubled since 1980 [1]. The correlation between central obesity and several diseases has been well established, particularly the association with changes in metabolism of glucose, dyslipidemia, and hyper- tension [2,3]. Central obesity in association with the above mentioned metabolic changes has been defined by the World Health Organization as the clinical unit metabolic syndrome (MetS) [3]. Studies have found that 4 50% of individuals with morbid obesity meet the MetS criteria [4–6], and approx- imately 80% of patients with type 2 diabetes (T2D) and 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 http://dx.doi.org/10.1016/j.soard.2016.03.017 1550-7289/ r 2016 American Society for Metabolic and Bariatric Surgery. All rights reserved. * Correspondence: H. Gislason, Department of Surgery, Aleris Hospital, Fredrik-Stangsgate 11–13, 0264 Oslo, Norway. E-mail: hjortur.gislason@aleris.no