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Weight-reducing obesity surgery (OS) generally gives good results but complications are common; e.g. impaired weight loss, weight regain, bowel pain, diarrhea, vitamin/mineral deficiency, osteoporosis and impaired dental health. The BASUN study is a prospective 10-year comparison of 1000 surgically and 400 conventionally treated individuals regarding adverse side-effects, risk factors for complications and poor outcome.
The use of obesity surgery (OS) has increased dramatically due to the lack of effective conventional weight reducing methods. OS generally gives a sustained weight reduction and improves metabolic co-morbidities but complications are not uncommon, e.g. weight regain, bowel pain, diarrhea, vitamin/mineral deficiency, osteoporosis and impaired dental health. Studies of OS regarding adverse side-effects, risk factors for complications and poor outcomes are few or missing.
The BASUN study is a prospective 10-year comparison of 1000 surgically and 400 conventionally treated individuals. Inclusion started in April 2015 and will be completed in 2017. Subjects are consecutively included from the whole western region of Sweden and are followed by detailed checkups at 2, 5 and 10 years. Protocol includes nutritional and bone status, oral health, psychiatric health, GI symptoms, socioeconomics and health economy. Data are collected by interviews, blood and fecal samples, questionnaires, dual energy x-ray absorptiometry, dentist examinations, patients' record and registries. The study is carried out in close cooperation with experts in surgery, medicine, psychiatry, endocrinology, gastroenterology, hematology, molecular biology, osteoporosis, oral medicine, physiology and general medicine.
The BASUN study will be able to form the basis for more individualized medical guidelines with the objective of improving therapeutic quality and the utilization of health care resources.
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| Measure | Description | Time Frame |
|---|---|---|
| Ionized Calcium in serum | Difference between pre- and posttreatment level; unit: mM | 10 years |
| Measure | Description | Time Frame |
|---|---|---|
| Bone mineral density (BMD) | DXA based assessment; units: areal density (g/cm2) | 10 years |
| Bone mineral density (T-score) | T-score is bone mineral density (BMD)in relation to young healthy adults of the same sex; unit: number of standard deviations below or above BMD of controls |
| Measure | Description | Time Frame |
|---|---|---|
| Nutritional status | Blood biochemistry package: Retinol, RBP, Vitamins B, Vid D, methylmalonate, homocysteine, hemoglobulin, MCV, MCH, MCHC, reticulocytes, iron, transferrin, ferritin , Zn, S-Albumin, creatinine, blood lipid profile, ALP; reported value will be number of patients with one or more abnormal laboratory value(-s). | 2, 5 & 10 years |
Inclusion Criteria:
Exclusion Criteria:
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All patients eligible for obesity treatment under specialist care with medical methods or with surgery are asked for participation.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Lars Fandriks, M.D., PhD. | Contact | +46313424123 | lars.fandriks@gastro.gu.se |
| Name | Affiliation | Role |
|---|---|---|
| Lars Fandriks, M.D., PhD. | Institute of Clinical Sciences, the Sahlgrenska Academy, University of Gothenburg | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Gastrosurgical R & E, the Sahlgrenska Academy,University of Gothenburg | Recruiting | Gothenburg | SE41345 | Sweden |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41486025 | Derived | Celander J, Engstrom M, Hoskuldsdottir G, Lener F, Simons K, Wallenius V, Eliasson B, Hedberg S, Mossberg K. Anaemia and weight outcomes 5 years after metabolic and bariatric surgery - a prospective cohort study. Nutr Metab Cardiovasc Dis. 2026 Apr;36(4):104521. doi: 10.1016/j.numecd.2025.104521. Epub 2025 Dec 11. | |
| 37586350 | Derived |
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| ID | Term |
|---|---|
| D009767 | Obesity, Morbid |
| D044342 | Malnutrition |
| D001847 | Bone Diseases |
| ID | Term |
|---|---|
| D009765 | Obesity |
| D050177 | Overweight |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
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Blood
| 10 years |
| Bone mineral density (Z-score) | Z-score is bone mineral density (BMD) in relation adults of the same age; unit: number of standard deviations below or above BMD of controls of the same age | 10 years |
| Arterial blood pressure | arterial systolic and diastolic pressure at rest; mmHg | 2, 5 & 10 years |
| Quality of Life | 36-item Short Form Survey(RAND36); Reported value: reported value: number of (or percentage) patients reporting physical and mental health summary scores indicating moderately to severely reduced quality of life as compared to a general reference population. | 2, 5 & 10 years |
| Plasma Glucose Concentration | Fasting value; unit: mM | 2, 5 & 10 years |
| Serum Insulin Concentration | Fasting value; unit: mIE/L | 2, 5 & 10 years |
| Glycated Hemoglobin (HbA1c) | Unit: mmol/mol | 2, 5 & 10 years |
| Change in Body Weight From Baseline | kg | 2, 5 & 10 years |
| Change in Body Mass Index (BMI) | kg x m2 | 2, 5 & 10 years |
| Psychomorbidity1: Depression |
Patient Health Questionnaire 9 (PHQ-9); reported value: number of (or percentage) patients reporting scores indicating a moderate to severe depressive state |
| 2, 5 & 10 years |
| Psychomorbidity2: Anxiety | Beck Anxiety Inventory (BAI); reported value: number of (or percentage) patients reporting high scores indicating moderate to severe anxiety | 2, 5 & 10 years |
| Psychomorbidity3: Adult ADHD | Adult ADHD Self-Report Scale -Screener (ASRS); reported value: number (or percentage) of patients reporting scores above cut-off indicating adult ADHD symptoms | 2, 5 & 10 years |
| Psychomorbidity4: Drug use | Drug Use Disorders Identification Test (DUDIT); reported value: number (or percentage) of patients reporting scores above cut-off indicating risk for drug-related problems | 2, 5 & 10 years |
| Psychomorbidity5: Alcohol | Alcohol Use Disorders Identification Test (AUDIT); reported value: number (or percentage) of patients reporting scores above cut-off indicating risk for alcohol-related problems | 2, 5 & 10 years |
| Gastrointestinal symptomatology | Rome III Diagnostic criteria; reported value: number (or percentage) of patients fulfilling the criteria for functional gastrointestinal gastrointestinal disorder | 2, 5 & 10 years |
| Oral Health questionnaire | Oral Health Impact Profile (OHIP-14); reported value: number (or percentage) of patients scoring above cut-off for oral health impacting quality of life. | 2, 5 & 10 years |
| Taghat N, Mossberg K, Lingstrom P, Petzold M, Ostberg AL. Impact of Medical and Surgical Obesity Treatment on Dental Caries: A 2-Year Prospective Cohort Study. Caries Res. 2023;57(3):231-242. doi: 10.1159/000533609. Epub 2023 Aug 16. |
| 36890072 | Derived | Lener F, Hoskuldsdottir G, Landin-Wilhelmsen K, Bjorkelund C, Eliasson B, Fandriks L, Wallenius V, Engstrom M, Mossberg K. Anaemia in patients with self-reported use of iron supplements in the BAriatric surgery SUbstitution and nutrition study: A prospective cohort study. Nutr Metab Cardiovasc Dis. 2023 May;33(5):998-1006. doi: 10.1016/j.numecd.2023.02.008. Epub 2023 Feb 16. |
| 35876084 | Derived | Taghat N, Lingstrom P, Mossberg K, Fandriks L, Eliasson B, Ostberg AL. Oral health by obesity classification in young obese women - a cross-sectional study. Acta Odontol Scand. 2022 Nov;80(8):596-604. doi: 10.1080/00016357.2022.2063942. Epub 2022 Jul 24. |
| 35396282 | Derived | Hoskuldsdottir G, Engstrom M, Rawshani A, Lener F, Wallenius V, Fandriks L, Mossberg K, Eliasson B. Comparing effects of obesity treatment with very low energy diet and bariatric surgery after 2 years: a prospective cohort study. BMJ Open. 2022 Apr 8;12(4):e053242. doi: 10.1136/bmjopen-2021-053242. |
| 34507573 | Derived | Hoskuldsdottir G, Engstrom M, Rawshani A, Wallenius V, Lener F, Fandriks L, Mossberg K, Eliasson B. The BAriatic surgery SUbstitution and nutrition (BASUN) population: a data-driven exploration of predictors for obesity. BMC Endocr Disord. 2021 Sep 10;21(1):183. doi: 10.1186/s12902-021-00849-9. |
| 32059719 | Derived | Hoskuldsdottir G, Mossberg K, Wallenius V, Al Nimer A, Bjorkvall W, Lundberg S, Behre CJ, Werling M, Eliasson B, Fandriks L. Design and baseline data in the BAriatic surgery SUbstitution and Nutrition study (BASUN): a 10-year prospective cohort study. BMC Endocr Disord. 2020 Feb 14;20(1):23. doi: 10.1186/s12902-020-0503-z. |
| D009750 |
| Nutritional and Metabolic Diseases |
| D001835 | Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009140 | Musculoskeletal Diseases |