# Long-Term Metabolic Remission and Predictive Factors After Sleeve Gastrectomy and Roux-en-Y Gastric Bypass in an Asian Population

## TL;DR

This study examines long-term metabolic outcomes after two types of bariatric surgery in an Asian population and identifies factors that predict successful remission.

## Contribution

The study provides novel insights into metabolic remission predictors and outcomes of sleeve gastrectomy versus gastric bypass in Asian patients with obesity.

## Key findings

- RYGB showed higher remission rates for dyslipidemia compared to sleeve gastrectomy.
- Younger age and shorter diabetes duration were predictive of better metabolic outcomes.
- Most patients achieved remission of metabolic syndrome and type 2 diabetes after bariatric surgery.

## Abstract

Background/Objective: Bariatric surgery is an established treatment for individuals with severe obesity, providing sustained weight loss and improvement in obesity-related comorbidities. However, evidence on long-term outcomes and predictors of metabolic resolution, particularly among Asian populations, remains limited. We aimed to evaluate metabolic outcomes after bariatric surgery and identify predictive factors associated with remission. Methods: We retrospectively reviewed the data of 581 patients who underwent laparoscopic sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) at a tertiary care center between January 2012 and December 2022. Surgical techniques, postoperative follow-up, and baseline characteristics were recorded. Remission and improvement of metabolic comorbidities were assessed during 1–5 years of follow-up. Predictive factors were analyzed, and remission rates between SG and RYGB were compared using propensity score matching. Results: A total of 154 (26.5%) individuals had type 2 diabetes mellitus (T2DM), 162 (27.8%) hypertension (HT), 173 (29.7%) dyslipidemia (DLP), and 407 (70.0%) metabolic syndrome (MetS). Remission occurred in 79.1% of individuals with T2DM, 36.0% with HT, 33.9% with DLP, and 79.6% with MetS. Predictive factors included T2DM duration < 3 years, younger age for HT and DLP remission, male sex, body mass index < 43 kg/m2, and fasting blood glucose level < 126 mg/dL for MetS. RYGB achieved higher remission of DLP than did SG, whereas other outcomes were comparable. Conclusions: Bariatric surgery effectively improves metabolic comorbidities, and several predictive factors influence outcomes. RYGB resulted in superior remission of DLP, while other metabolic outcomes were comparable between the two procedures.