ESPE2016 Free Communications Management of Obesity (6 abstracts)
Efficacy and Safety of Duodenal-Jejunal Bypass Liner in Morbidly Obese Adolescents-1 Year Experience
Primoz Kotnik a, , Matjaz Homan c, , Rok Orel c, & Tadej Battelino a,
aDepartment of Endocrinology, Diabetes and Metabolism, University Children’s Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia; bMedical Faculty Ljubljana, Ljubljana, Slovenia; cDepartment of Gastroenterology, Hepatology and Nutrition, University Children’s Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
Background: The duodenal-jejunal bypass liner (DJBL) is an endoscopically placed and removable bariatric device associated with weight loss and metabolic improvements in adults.
Objective and hypotheses: To determined efficacy and safety of DJBL up to 1 year in morbidly obese adolescents.
Method: About 14 obese adolescents with prediabetes or type 2 diabetes (10 female, mean (SD) age 17.7 (1.1) years) underwent endoscopic placement of DJBL under general anesthesia. Inclusion and exclusion criteria are described in detail at www.ClinicalTrials.gov (NCT02183935). Subjects were examined at months 1, 3, 6, 9 and 12 following DJBL placement.
Results: Relevant weight loss and improved glucose and cholesterol metabolism were determined. None of the devices needed to be explanted and there were no serious device related side effects. Decrease in iron levels without a relevant effect on erythropoesis was however determined. Of importance no changes in B12 and folic acid levels were determined (DNS). A decrease in Se, Zn, vitamins A, D3 and E was also determined (DNS).
| Baseline (n=14) | 6 months (n=10) | 12 months (n=6) | |
| BMI (kg/m2) | 42,5 (4,1) | 37.6 (3.7)* | 38.2 (5.3)* |
| BMI SDS | 3.74 (.32) | 3.25 (.37)* | 3.26 (.54)* |
| Waist circumference (cm) | 127 (12) | 116 (11) | 116 (13)* |
| Systolic pressure (mmHG) | 124 (12) | 116 (10) | 117 (14)* |
| Cholesterol (mmol/l) | 4.6 (.9) | 3.7 (.5)* | 3.7 (.7)* |
| Triglycerides (mmol/l) | 2.1 (1.0) | 1.2 (.4)* | 1.2 (.3)* |
| WBISI | 1.8 (07) | 2.8 (1.4)* | 3.3 (1.1)* |
| HOMA-IR | 5.5 (2.1) | 3.8 (1.5)* | 2.8 (.8)* |
| A1c (%) | 5.3 (.5) | 5.2 (.3) | 5.0 (.3) |
| Fe | 14.3 (5.5) | 8.1 (2.4)* | 8.8 (3.2)* |
| Ferritin | 82 (55) | 25 (10)* | 38 (28)* |
| Hemoglobine | 144 (12) | 131 (10)* | 138 (15) |
| Ht | 0.41 (0.03) | 0.39 (0.03) | 0.40 (0.03) |
| MCV | 82 (3) | 82 (4) | 82 (3) |
| Difference between means (SD) was determined by ANOVA and Dunnett’s postHoc test. *P<0.05 when compared to baseline. | |||
Conclusion: This is the first report on the use of endoscopically placed and removable DJBL in adolescents for up to 1 year. Relevant weight loss, metabolic improvements and no serious side effects of DJBL were determined. However monitoring of vitamins and trace elements status, especially iron is needed in these subjects.
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