BACKGROUND: Achieving a weight loss is an important goal of bariatric surgery, given the increased risk for weight-related morbidity and mortality. The most common comorbidity at obesity are arterial hypertension, diabetes, non-alcoholic fatty liver disease (NAFLD), depression. Article is devoted to evaluation of comorbidity in patients with obesity III after weight loss after Laparoscopic Sleeve Gastrectomy (LSG) and Intragastric balloon installation (IBI).\r\nOBJECTIVE: To determine effect of Laparoscopic Sleeve Gastrectomy (LSG) and Intragastric balloon installation (IBI) to weight loss and comorbidity in patients with obesity III.\r\nMETHODS: \r\nA total of 20 patients mean age 34,7±2,5 years; 80% female, BMI = 49,4±2,5 kg/m2, 6 of them were with extremely high weight (BMI = 62,1-75,4 kg/m2). Itragastric Balloon (Allergan Inc., USA) was installed to patients with extremely high BMI (n=6), another patients were undergoing Laparoscopic Sleeve Gastrectomy (n=14). Comorbidities was evaluated according to Cardiometabolic Disease Staging (Guo, 2015). \r\n\r\nRESULTS: \r\nIt is established, that adiposity of III (BMI 49,4±2,5 kg / m2) associates with hyperlipidemia / hypertrigliceridemia in 85 % of cases; diabetes mellitus-2 / glucose intolerance - in 50 %, arterial hypertension in - 45 %; non-alcoholic fatty liver disease (NAFLD) - in 35 % of cases. Laparoscopic Sleeve Gastrectomy and Intragastric Balloon Installation allow to achieve weight loss on 21,1% and 16,2 % vs initial weight, LSG and IBI were similar effective to weight loss (p > 0.05); that caused decreasing of comorbidity: glucose intolerance is reduced in 2 times, arterial hypertension - in 3 times; dislipidemia - in 1,9 times; NAFLD - in 1,8 times in 6 months after intervention. LSG and IBI allow to improve parameters on scale Cardiometabolic Disease Staging, having achieved zero cardiometabolic risk at 35% of patients, and at other patients - transition in easier of its stage. Weight loss and reduction of comorbidity after LSG and IBI are combined with decrease of proinflammatory cytokines – IL-6, TNF-a and C-reactive protein in blood serum. \r\n\r\nCONCLUSION. \r\nLSG and IBI were similar effective to weight loss (p > 0.05); that caused decreasing of comorbidity: glucose intolerance is reduced in 2 times, arterial hypertension - in 3 times; dislipidemya - in 1,9 times; NAFLD - in 1,8 times in 6 months after intervention. IBI should be recommended as 1-st step of obesity treatment in patients with extremely high weight, because this procedure cases decreasing of comorbidity and perioperative risk. \r\n
