Abstract 14474: Effect of Statin Therapy on Weight Loss and Diabetes in Bariatric Patients
Introduction: Bariatric surgeries are considered effective treatments to achieve weight loss and improve diabetes control. Statins increase diabetes onset in clinical trials and many bariatric patients with metabolic disease are treated with statin therapy.
Hypothesis: We hypothesized that preoperative statin therapy would reduce the favorable effects of bariatric surgery on diabetes remission and weight loss.
Methods: We retrospectively examined the relationship of statin therapy to weight loss, diabetes mellitus onset and remission, and metabolic outcomes after bariatric surgery. The 1575 patients (1231 women) underwent laparoscopic adjustable gastric banding or LAGB (n=1035), Roux-en-Y gastric bypass or RYGB (n=468), and sleeve gastrectomies or SG (n=72) and were categorized as to statin use (n=671) and diabetes status (n=557) preoperatively and at one year follow-up.
Results: Diabetes resolved after surgery in 159 or 23.7% of patients on preoperative statins whereas 3 had new onset. Diabetes resolved in only 124 or 13.7% of patients not on preoperative statins with 4 new diabetes cases (χ2 = 26.1; p<0.01). Patients ceasing statin therapy after bariatric therapy experienced more diabetes remission (n=85 or 35.7%) than patients consistently using statin therapy at both timepoints (n=57 or 17.0%; χ2 = 27.3;p<0.01). While RYGB patients on preoperative statin therapy reduced BMI more than RYGB patients not on statin therapy (p<0.01), patients with diabetes who ceased statin use across 1 year reduced BMI more than patients whose drug status (consistently on or off statins) did not change (-12.0±6.5 vs. -8.7±5.7 ΔBMI); this effect was greater than in nondiabetic patients (-11.8±6.5 vs. -10.0±6.1 ΔBMI; p=0.04).
Conclusions: In contrast to expectations, our results suggest that diabetes resolves with bariatric surgery more often in patients who undergo surgery on statin therapy than in those never on statin therapy whereas cessation of statin therapy produces the greatest reductions in diabetes prevalence and augments weight loss in diabetic patients. These results indicate an interaction between bariatric surgery and diabetes prevalence, but a randomized control trial is needed to examine carefully this relationship.
Author Disclosures: B.A. Taylor: None. J. Ng: None. A. Stone: None. D.S. Tishler: None. P. Papasavos: None. P.D. Thompson: Other; Modest; Dr. Thompson has received research support from Genomas, Roche, Sanofi, Regeneron, Esperion, Amarin and Pfizer; has served as a consultant for Amgen, Regeneron, Merck, Genomas, Runners World, Sanofi,.
- © 2016 by American Heart Association, Inc.