{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:42:09Z","timestamp":1760150529540,"version":"build-2065373602"},"reference-count":31,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T00:00:00Z","timestamp":1701216000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>(1) Background and Objectives: Morbid obesity significantly increases the prevalence of comorbidities, such as heart disease, restrictive lung disease, stroke, diabetes mellitus and more. (2) Methods: Patients undergoing gastric sleeve surgery were divided into three groups with BMI between 30\u201334.9 kg\/m2 (Group I), 35\u201339.9 kg\/m2 (Group II), and over 40 kg\/m2 (Group III). Preoperative examinations included cardiac ultrasound, respiratory function and laboratory tests, and preoperative comorbidities were also recorded. Following a one-year follow-up, we compared the rate of weight loss in the three groups at six months and one year following surgery, specifically, the effect of surgery on preoperative comorbidities at one year. (3) Results: The weight loss surgeries performed were successful in all three groups. Preoperative laboratory examinations, an echocardiogram and respiratory function results showed no clinically significant difference, except moderate elevations in blood lipid levels. Hypertension was the most common comorbidity. (4) Conclusions: In our patient population, hypertension and diabetes were the only comorbidities with a high prevalence. It can be explained by the relatively younger age among the patients (mean age 44.5 years) and the fact that they had not yet developed the pathological consequences of severe obesity. Consequently, while performing the surgery at a relatively younger age, it seems far more likely that the patient will return to a more active and productive life and enjoy a better quality of life. Additionally, the perioperative risk is lower, and the burden upon health systems and health expenditure is reduced by preventing comorbidities, in particular, multimorbidity. On this basis, it may be advisable to direct patients who do not exhaust the classical indications for bariatric surgery toward the surgical solution at a younger age. Our results suggest it is not worth waiting for comorbidities, especially multimorbidity, to appear.<\/jats:p>","DOI":"10.3390\/medicina59122092","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T03:48:24Z","timestamp":1701229704000},"page":"2092","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Indications for Sleeve Gastrectomy\u2014Is It Worth Waiting for Comorbidities to Develop?"],"prefix":"10.3390","volume":"59","author":[{"given":"Zsuzsanna","family":"N\u00e9meth","sequence":"first","affiliation":[{"name":"Medical Skills Education and Innovation Centre, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"},{"name":"Southern Transdanubian Region, National Ambulance Service, 1055 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0171-303X","authenticated-orcid":false,"given":"Mikl\u00f3s","family":"Sipt\u00e1r","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Therapy, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nat\u00e1lia","family":"T\u00f3th","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Therapy, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krisztina","family":"T\u00f3th","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Therapy, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Csaba","family":"Csontos","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Therapy, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zolt\u00e1n","family":"Kov\u00e1cs-\u00c1brah\u00e1m","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Therapy, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Csongor","sequence":"additional","affiliation":[{"name":"Department of Languages for Biomedical Purposes and Communication, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5487-3638","authenticated-orcid":false,"given":"Ferenc","family":"Moln\u00e1r","sequence":"additional","affiliation":[{"name":"Medical Skills Education and Innovation Centre, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"},{"name":"Southern Transdanubian Region, National Ambulance Service, 1055 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zsombor","family":"M\u00e1rton","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00e1ndor","family":"M\u00e1rton","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Therapy, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1159\/000350627","article-title":"Obesity: The gateway to ill health\u2014An EASO position statement on a rising public health, clinical and scientific challenge in Europe","volume":"6","author":"Toplak","year":"2013","journal-title":"Obes. Facts"},{"key":"ref_2","unstructured":"Centers for Disease Control and Prevention Home Page (2022, May 17). Obesity is a Common, Serious, and Costly Disease Centers of Disease Control and Prevention, Available online: https:\/\/www.cdc.gov\/obesity\/data\/adult.html."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2440","DOI":"10.1056\/NEJMsa1909301","article-title":"Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity","volume":"381","author":"Ward","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1159\/000442721","article-title":"European Guidelines for Obesity Management in Adults","volume":"8","author":"Yumuk","year":"2015","journal-title":"Obes. Facts"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Ranasinghe, C., Gamage, P.T., Katulanda, P., Andraweera, N.D., Thilakarathne, S., and Tharanga, P. (2013). Relationship between Body mass index (BMI) and body fat percentage, estimated by bioelectrical impedance, in a group of Sri Lankan adults: A cross sectional study. BMC Public Health, 13.","DOI":"10.1186\/1471-2458-13-797"},{"key":"ref_6","unstructured":"(2010, May 06). World Health Organisation Home Page. Available online: https:\/\/www.who.int\/europe\/news-room\/fact-sheets\/item\/a-healthy-lifestyle---who-recommendations."},{"key":"ref_7","unstructured":"Tulassay, Z. (2007). A Belgy\u00f3gy\u00e1szat Alapjai, Medicina K\u00f6nyvkiad\u00f3 Zrt.. [3rd ed.]."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1556\/650.2017.30700","article-title":"Hungarian Diet and Nutritional Status Survey 2014. I. Nutritional status of the Hungarian adult population","volume":"158","author":"Erdei","year":"2017","journal-title":"Orv. Hetil."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1080\/17476348.2018.1506331","article-title":"The effect of obesity on lung function","volume":"12","author":"Ubong","year":"2018","journal-title":"Expert Rev. Respir. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1111\/j.1467-789X.2004.00144.x","article-title":"Obesity as a disease: No lightweight matter","volume":"5","author":"Conway","year":"2004","journal-title":"Obes. Rev."},{"key":"ref_11","unstructured":"Lim, Y., and Boster, J. (2023). Obesity and Comorbid Conditions, StatPearls Publishing LLC."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1016\/j.soard.2013.03.013","article-title":"Prevalence of hiatal hernia in the morbidly obese","volume":"9","author":"Che","year":"2013","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1016\/j.chest.2020.04.006","article-title":"Breathing at Extremes: The Restrictive Consequences of Super- and Super-Super Obesity in Men and Women","volume":"58","author":"Marillier","year":"2020","journal-title":"Chest"},{"key":"ref_14","first-page":"142","article-title":"The Epidemic of Obesity and Diabetes, Trends and Treatments","volume":"38","author":"Smith","year":"2011","journal-title":"Tex. Heart Inst. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3712","DOI":"10.3109\/14767058.2016.1141887","article-title":"Impact of maternal obesity on the fetal electrocardiogram during labor","volume":"29","author":"Hantosi","year":"2016","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"949228","DOI":"10.3389\/fendo.2022.949228","article-title":"Effects of female obesity on conception, pregnancy and the health of offspring","volume":"13","author":"Wei","year":"2022","journal-title":"Front. Endocrinol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e13617","DOI":"10.1111\/and.13617","article-title":"Obesity and male infertility: Mechanisms and management","volume":"53","author":"Leisegang","year":"2021","journal-title":"Andrologia"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.metabol.2018.11.001","article-title":"Obesity and cancer risk: Emerging biological mechanisms and perspectives","volume":"92","author":"Avgerinos","year":"2019","journal-title":"Metabolism"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"13095","DOI":"10.1111\/obr.13095","article-title":"Obesity is a risk factor for developing critical condition in COVID-19 patients: A systematic review and meta-analysis","volume":"21","author":"Farkas","year":"2020","journal-title":"Obes. Rev."},{"key":"ref_20","unstructured":"Seeras, K., Sankararaman, S., and Lopez, P.P. (2023). Sleeve Gastrectomy, StatPearls Publishing LLC."},{"key":"ref_21","first-page":"1","article-title":"Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient\u20142013 update: Cosponsored by American association of clinical endocrinologists, The obesity society, and American society for metabolic & bariatric surgery","volume":"21","author":"Mechanick","year":"2013","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1016\/j.soard.2022.06.284","article-title":"American Society for Metabolic and Bariatric Surgery estimate of metabolic and bariatric procedures performed in the United States","volume":"18","author":"Clapp","year":"2022","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1007\/s00595-007-3648-8","article-title":"Analysis of the results of sleeve gastrectomy for morbid obesity and the role of ghrelin","volume":"38","author":"Frezza","year":"2008","journal-title":"Surg. Today"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.peptides.2017.12.015","article-title":"Ghrelin regulation of glucose metabolism","volume":"100","author":"Poher","year":"2018","journal-title":"Peptides"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1007\/s11695-009-9928-1","article-title":"Obstructive sleep apnea in patients undergoing bariatric surgery\u2014A tertiary center experience","volume":"21","author":"Sareli","year":"2011","journal-title":"Obes. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1001\/jamasurg.2022.2229","article-title":"Effect of Laparoscopic Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass on Weight Loss, Comorbidities, and Reflux at 10 Years in Adult Patients With Obesity. The SLEEVEPASS Randomized Clinical Trial","volume":"157","author":"Salminen","year":"2022","journal-title":"JAMA Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1724","DOI":"10.1001\/jama.292.14.1724","article-title":"Bariatric surgery: A systematic review and meta-analysis","volume":"292","author":"Buchwald","year":"2004","journal-title":"JAMA"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"94","DOI":"10.7326\/0003-4819-150-2-200901200-00007","article-title":"Narrative Review: Effect of Bariatric Surgery on Type 2 Diabetes Mellitus","volume":"150","author":"Vetter","year":"2009","journal-title":"Ann. Intern. Med."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Shirazi, N., Beglaibter, N., Grinbaum, R., Ahmad, W.A., and Aronis, A. (2022). Nutritional Outcomes One Year after One Anastomosis Gastric Bypass Compared to Sleeve Gastrectomy. Nutriens, 14.","DOI":"10.3390\/nu14132597"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1038\/s41366-021-01048-1","article-title":"GENEVA Collaborators 30-day morbidity and mortality of sleeve gastrectomy, Roux-en-Y gastric bypass and one anastomosis gastric bypass: A propensity score-matched analysis of the GENEVA data","volume":"46","author":"Singhal","year":"2022","journal-title":"Int. J. Obes."},{"key":"ref_31","first-page":"1744","article-title":"Efficacy of laparoscopic sleeve gastrectomy on morbidly obese patients","volume":"164","author":"Csongor","year":"2023","journal-title":"Orv. Hetil."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/12\/2092\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:32:58Z","timestamp":1760131978000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/12\/2092"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,29]]},"references-count":31,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["medicina59122092"],"URL":"https:\/\/doi.org\/10.3390\/medicina59122092","relation":{},"ISSN":["1648-9144"],"issn-type":[{"type":"electronic","value":"1648-9144"}],"subject":[],"published":{"date-parts":[[2023,11,29]]}}}