Study on mid-term metabolic outcomes of sleeve gastrectomy in adolescents with severe obesity
PENG Gang
ZHANG Hong-wei
WANG Chen
BAN Xu-yan
XU Ting
ZHANG Pin
DI Jian-zhong
Abstract：Objective To investigate the mid-term metabolic outcomes and changes in nutritional status of adolescents with severe obesity undergoing laparoscopic sleeve gastrectomy(LSG).Methods A retrospective analysis was conducted on the clinical data of 93 adolescent patients who underwent LSG at Shanghai Sixth People's Hospital between July 2017 and July 2022.Weight changes,glycemic metabolism indicators(HbA1c and HOMA-IR),and the dynamics of iron defi-ciency,anemia,and vitamin D deficiency were collected and compared from preoperation to up to 3 years postoperatively.Mixed-effects models were used to analyze longitudinal data trends.Results A total of 93 patients were included for baseline analysis,with follow-up data available for 64,49,and 33 patients at 1,2,and 3 years postoperatively,respec-tively.Significant weight loss was achieved,with a mean percentage of excess weight loss(％EWL)of 99.7％at 2 years post-surgery.Glycemic metabolism improved,with mean HbA1c decreasing from 6.2％at baseline to 5.0％at 2 years,and HOMA-IR from 1 1.6 to 3.6(both P＜0.001).However,the prevalence of iron deficiency showed a significant upward trend(trend P=0.002),increasing from 6.5％at baseline to 33.3％at 3 years.More importantly,the prevalence of anemia also showed a significant upward trend(trend P=0.015),reaching 24.2％at 3 years.In contrast,the high preoperative preva-lence of vitamin D deficiency(91.4％)showed a continuous and significant downward trend postoperatively(trend P＜0.001).Conclusion For adolescents with severe obesity,LSG provides significant and durable weight loss and metabolic improvement.However,the risk of postoperative iron deficiency and even clinical anemia is signifi-cantly increased,highlighting the importance of long-term,systematic,multidisciplinary nutritional monitoring and management for these patients.
Keywords：adolescentobesitysleeve gastrectomyweight lossmetabolic improvementnutritional risk
Publication Date：2025-10-01
Online Publishing Date：2025-12-09(First online date of this platform, not the publication date of the document)
Pages：5( 1137-1141 )