A Retrospective Study of 6-Month Reduction in Risk of Developing Cardiovascular Diseases and Type 2 Diabetes Mellitus in Severely Obese Patients Over 60 Years of Age Following Bariatric Surgery

Abstract

Background Controversy exists with regard to the effectiveness and reasons for bariatric procedures in patients older than 60 years. The goal of our study was to determine the reduction in risk of developing cardiovascular disease and type 2 diabetes mellitus after undergoing bariatric surgery in obese patients over age 60 at our institution. Material/Methods Patients with severe obesity (BMI >40 kg/m 2 ) were retrospectively included in the study. Risk of cardiovascular disease and type 2 diabetes at baseline and their reduction during the follow-up period were evaluated with the following selected, currently preferred risk algorithms: (1) the Systemic Coronary Risk Evaluation (SCORE) scale; (2) the Framingham Risk Score (of myocardial infarction or coronary death) for patients with no prior history of diabetes, coronary heart disease, or intermittent claudication; and (3) the Framingham Offspring Diabetes Risk Score, which estimates the 8-year risk of developing type 2 diabetes. Results All 33 elderly patients (32 women and 1 man, mean age 62.3±2.7 (BMI 44.3±6.2 kg/m 2 ) significantly reduced their risk levels. We observed a decrease in the 10-year risk of a first fatal cardiovascular event (3.5±0.5 vs. 2.4±0.5, absolute risk reduction [ARR] 1.0); reduced 10-year risk of myocardial infarction or death (5.0±1.6 vs. 3.25±1.6, ARR 1.7); and reduced predicted 8-year risk of developing type 2 diabetes (7.4±7.2 vs. 3.1±0.3, ARR 4.3). No intra- or postoperative complications were observed. Conclusions Our study showed a significant reduction in risk of developing cardiovascular diseases and type 2 diabetes, as measured by available risk scores, in elderly patients undergoing bariatric procedures.

Reducing the 10-year risk of ischemic cardiovascular disease to receive early cardiovascular benefits from bariatric surgery for obesity in China

“…%EBMIL also obviously reflects the excess weight loss by bariatric surgery. This finding was consistent with the research of Domienik-Karlowicz et al (10).…”

“…%EBMIL also obviously reflects the excess weight loss by bariatric surgery. This finding was consistent with the research of Domienik-Karlowicz et al ( 10 ). In the present research, ICVD total score reduction had a positive correlation with %EBMIL 6 months after surgery.…”

“…Furthermore, we still found that FFA, TG, LDL, and sd-LDL were reduced significantly at 6 months post-operation vs. baseline, and HDL was increased significantly at 6 months post-operation vs. baseline. The above changes were similar to those in previous bariatric surgery studies (10,11,42). In summary, we presumed that bariatric surgery improved insulin resistance, decreased the influx of FFAs from adipose tissue to the liver, reduced triglyceride synthesis, and affected the transportation of lipids, leading to an increase in HDL and a decrease in LDL and sd-LDL, ultimately decreased the atherogenic dyslipidaemia complex (43).…”

“…Domienik-Karłowicz et al confirmed a significant decrease in the risk of cardiovascular diseases assessed by 2 selected risk algorithms: the Systemic Coronary Risk Evaluation (SCORE) scale and the Framingham Risk Score (FRS) in bariatric procedures. The participants and the cardiovascular risk models were from America or Europe ( 10 ). Batsis et al proved the directionality of cardiovascular risk with estimated relative risk reduction for bariatric surgery patients using the FRS and Cardiovascular Munster Heart Study (PROCAM) risk score.…”