Metabolic and bariatric surgery for obesity in Prader Willi syndrome: systematic review and meta-analysis.
Gunnar WolfeVesta SalehiAllen BrowneRenee RiddleErin HallJohn FamDavid TichanskyStephan MyersPublished in: Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery (2023)
Obesity is the leading cause of morbidity and mortality in patients with Prader-Willi Syndrome (PWS). Our objective was to compare changes in body mass index (BMI) after metabolic and bariatric surgery (MBS) for the treatment of obesity (BMI ≥35 kg/m 2 ) in PWS. A systematic review of MBS in PWS was performed using PubMed, Embase, and Cochrane Central, identifying 254 citations. Sixty-seven patients from 22 articles met criteria for inclusion in the meta-analysis. Patients were organized into 3 groups: laparoscopic sleeve gastrectomy (LSG), gastric bypass (GB), and biliopancreatic diversion (BPD). No mortality within 1 year was reported in any of the 3 groups after a primary MBS operation. All groups experienced a significant decrease in BMI at 1 year with a mean reduction in BMI of 14.7 kg/m 2 (P < .001). The LSG groups (n = 26) showed significant change from baseline in years 1, 2, and 3 (P value at year 3 = .002) but did not show significance in years 5, 7, and 10. The GB group (n = 10) showed a significant reduction in BMI of 12.1 kg/m 2 in the first 2 years (P = .001). The BPD group (n = 28) had a significant reduction in BMI through 7 years with an average reduction of 10.7 kg/m 2 (P = .02) at year 7. Individuals with PWS who underwent MBS had significant BMI reduction sustained in the LSG, GB, and BPD groups for 3, 2, and 7 years, respectively. No deaths within 1 year of these primary MBS operations were reported in this study or any other publication.
Keyphrases
- body mass index
- weight gain
- weight loss
- bariatric surgery
- gastric bypass
- end stage renal disease
- metabolic syndrome
- insulin resistance
- roux en y gastric bypass
- systematic review
- ejection fraction
- obese patients
- newly diagnosed
- type diabetes
- chronic kidney disease
- peritoneal dialysis
- prognostic factors
- physical activity
- randomized controlled trial
- growth hormone
- case report
- coronary artery disease
- cardiovascular disease
- patient reported outcomes
- patient reported
- combination therapy