Metabolic Syndrome Rises Sharply in Severely Obese Hong Kong ChineseBariatric Surgery Offers Effective Treatment Options
While rapid growth and development in the economy of Hong Kong and China brings changes in diets and sedentary lifestyles, obesity and its associated metabolic syndrome (MES) are increasingly a health and societal burden to the region. MES is a collection of heart disease risk factors that increase your chance of developing heart disease, stroke, and diabetes. It is also associated with premature mortality. Recent study estimates that the prevalence of MES in Hong Kong Chinese population is around 17%.
The new MES definition is classified by the International Diabetes Federation (IDF) and central obesity is a prerequisite with the following criteria:
Central obesity (waist circumference)
– ≥90 cm (35.4 inch) in men or ≥80 cm (31.5 inch)in women in Chinese
– ≥94 cm (37 inch) in men or ≥80 cm (31.5 inch) in women in Caucasians
Plus 32 of the followings:
– Low HDL-C = HDL-C <1.03 mmol/1 in men or <1.29 mmol/l in women
– Hypertriglyceridaemia = TG ≥1.7 mmol/l
–Hypertension = known HT or BP ≥130/85 mmHg
–Dysglycaemia = FPG ≥5.6 mmol/l or known DM
While life-style modification, exercise, dietary training and medical therapy may be effective in controlling MES in slightly overweight people, those who are severely obese often fail with these simple measures. Bariatric surgery has been proven to be the most effective and long-lasting measures in the management of such a condition. It is becoming one of the most common operations in the western world and gaining popularity in Asia in recent years.
The Department of Surgery and the Department of Medicine and Therapeutics of the Faculty of Medicine at The Chinese University of Hong Kong have recently completed a study on prevalence of MES in patients seeking bariatric surgery. A total of 502 patients were prospectively evaluated since 2002. 82.1% of them (n = 412) were classified as severely obese with body mass index (BMI) of greater than 30 and study results discovered that the prevalence of MES in this group of patients is 67.0% (n = 276) which is 4 times the prevalence of normal population. 116 severely obese patients (BMI >30) with MES were treated with various bariatric procedures which include intragastric balloon, laparoscopic adjustable gastric banding and laparoscopic gastric bypass operation. After surgery, 99.1% showed significant improvement of MES and 61.2% of them were completely cured. All procedures were carried out by minimally invasive approach. There was no mortality with minimal complication. These results confirmed the feasibility and efficacy of bariatric surgery in treating MES among severely obese Chinese patients.
In conclusion, the prevalence of MES among severely obese Hong Kong Chinese (BMI >30) is 4 times higher than normal population and bariatric surgery offers a new effective treatment option for this group of patients.