Ann Surg Treat Res.  2021 Oct;101(4):197-205. 10.4174/astr.2021.101.4.197.

Bariatric surgery versus medical therapy in Korean obese patients: prospective multicenter nonrandomized controlled trial (KOBESS trial)

• Park DJ
• An S
• Park YS
• Lee JH
• Lee HJ
• Ha TK
• Kim YJ
• Ryu SW
• Han SM
• Yoo MW
• Park S
• Han SU
• Kang JH
• Kwon JW
• Heo Y

• KMID: 2520650
• DOI: http://doi.org/10.4174/astr.2021.101.4.197

Abstract

Purpose
The aim of this study was to show that bariatric surgery (BS) is more effective than medical therapy (MT) in Asian obese patients.
Methods
In this prospective, multicenter, nonrandomized, controlled trial, obese patients with body mass index of ≥35 kg/m² or 30.0–34.9 kg/m² with obesity-related comorbidities were assigned to undergo BS, such as laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass, or MT. Patients who underwent BS were evaluated 4, 12, 24, and 48 weeks after surgery, whereas patients who received MT were monitored at a hospital every 6 weeks for 1 year. At each visit, weight, waist and hip circumference, and blood pressure were measured, and patients underwent physical examination and laboratory testing. Health-related quality of life (HQOL) was investigated using Euro QOL-5 Dimension, Impact of Weight on Quality of Life questionnaire-Lite and Obesity-related Problems scale.
Results
The study included 264 patients from 13 institutions; of these, 64 underwent BS and 200 received MT. Of the patients who underwent BS, 6.3% experienced early complications. Relative weight changes from baseline to 48 weeks were significantly greater in the BS than in the MT group (26.9% vs. 2.1%, P < 0.001), as were the rates of remission of diabetes (47.8% vs. 16.7%, P = 0.014), hypertension (60.0% vs. 26.1%, P < 0.001), and dyslipidemia (63.2% vs. 22.0%, P < 0.001). HQOL was better in the BS than in the MT group at 48 weeks.
Conclusion
BS was safe and effective in Korean obese patients, with greater weight reduction, remission of comorbidities, and quality of life improvement than MT.

Keyword

Asia; Bariatric surgery; Metabolic diseases; Obesity

Figure

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  Fig. 1 Percentages of weight change. MT, medical therapy group; BMI, body mass index; BS, bariatric surgery group.

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  Fig. 2 Laboratory results. (A) HbA1c, (B) fasting blood sugar (FBS), (C) systolic (SBP) and diastolic blood pressure (DBP), and (D) total cholesterol (TC), TG, LDL, HDL. BS, bariatric surgery group; MT, medical therapy group.

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