Purpose: Laparoscopic sleeve gastrectomy has proven 
effectiveness regarding weight reduction, but metabolic 
consequences, especially in the long-term, have not yet been 
adequately clarified. The aim of the present study is to 
examine metabolic changes after laparoscopic sleeve 
gastrectomy in a two-year prospective survey. 
Methods: Eighty-one patients were examined before 
laparoscopic sleeve gastrectomy and 3, 6, 12, 18, and 24 
months postoperatively. Different markers of metabolic 
diseases including blood lipids and liver enzymes, 
inflammation markers and markers of glucose metabolism 
were assessed.  
Results: Body weight was significantly reduced from 144.4 
± 23.0 kg before surgery to 101.3 ± 20.0 kg 24 months 
postoperatively. Excess weight loss  after 24 months was 58 
± 20 % in our study population. Besides body weight 
changes, significant improvements were found for 
triglycerides (p < 0.001), low density lipoprotein cholesterol 
(p < 0.01), and high density lipoprotein cholesterol  (p < 0.001). Moreover, C-reactive protein and leukocytes, 
as well as the liver enzymes improved in the 2-years
course (all p < 0.001). These changes resulted in a sharp 
reduction of the prevalence of the metabolic syndrome 
from 69 to 26 % (p < 0.001). Furthermore, the number of 
patients with hypertension and diabetes – assessed by 
fasting glucose and glycated hemoglobin –, were reduced 
to less than half. 
Conclusions: Laparoscopic sleeve gastrectomy 
improves lipid profile and liver enzyme status, and 
reduces signs of inflammation in obese patients within 2 
years. These changes suggest a significant risk reduction 
of metabolic diseases in obese patients undergoing 
laparoscopic sleeve gastrectomy.