Impact of Bariatric Surgery in Reducing Macrovascular Complications in Severely Obese T2DM Patients

Hussain, Salman; Khan, Mohd Shahnawaz; Jamali, Mohammad Chand; Siddiqui, Almas; Gupta, Gaurav; Hussain, Sarfaraj; Husain, Fohad Mabood

doi:10.1007/s11695-020-05155-2

Cited by 10 publications

(6 citation statements)

References 38 publications

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“…Patients who underwent bariatric surgery had a reduced risk of stroke (OR = 0.46; 95% CI: 0.30 to 0.69) ( 32 ), cardiovascular events (OR = 0.49; 95% CI: 0.40 to 0.60) ( 33 ), myocardial infarction (OR = 0.54; 95% CI: 0.41 to 0.70) ( 32 ), and atrial fibrillation (OR = 0.42; 95% CI: 0.22 to 0.83) ( 34 ) compared to those who did not undergo bariatric surgery ( Figure 3 ). Bariatric surgery was also associated with a significant reduction in cardiovascular events (HR=0.53; 95% CI: 0.38 to 0.74), myocardial infarction (RR = 0.40; 95% CI: 0.26 to 0.61) ( 35 ), and macrovascular complications (RR = 0.50; 95% CI: 0.35 to 0.73) ( 36 ) in patients with type 2 diabetes mellitus over five years of follow-up ( Figure 3 ). However, bariatric surgery did not reduce the incidence of stroke (RR = 0.53; 95% CI: 0.28 to 1.01) in patients with type 2 diabetes mellitus ( 35 ) ( Figure 4 ).…”

Section: Resultsmentioning

confidence: 99%

Bariatric surgery and health outcomes: An umbrella analysis

Liao

Yin²,

Zhong³

et al. 2022

Front. Endocrinol.

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BackgroundThere is a relative lack of data that systematically investigates the breadth and validity of the association between bariatric surgery and health-related outcomes. We aimed to evaluate the quantity, validity, and credibility of evidence regarding the association between bariatric surgery and health-related outcomes using an umbrella review of meta-analyses.MethodsWe systematically searched PubMed, Embase, and the Web of Science databases from inception until December 2, 2021, to identify meta-analyses of observational or interventional studies that investigated the association between bariatric surgery and multiple health outcomes. We extracted the summary effect size and 95% confidence interval (CI) data. The Assessment of Multiple Systematic Reviews (AMSTAR-2) and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) guidelines were used for methodological and evidence quality assessments, respectively.ResultsTwenty-eight studies with 82 different health-related outcomes were included in this umbrella review. Beneficial effects of bariatric surgery have been observed in cancer incidence, mortality, cardiovascular risk, polycystic ovary syndrome (PCOS), anxiety symptoms, depressive symptoms, gestational diabetes mellitus, gestational hypertension, large for gestational age (LGA), macrosomia, post-term birth, risk of kidney stones, albuminuria, urinary incontinence, fecal incontinence, Barrett’s esophagus, and diabetic retinopathy. However, adverse effects of bariatric surgery were observed for maternal anemia, perinatal mortality, congenital anomalies, preterm birth, neonatal intensive care unit (NICU) admission, intrauterine growth restriction, small for gestational age (SGA), fracture risk, upper limb fracture, suicide, self-harm, and alcohol use disorder (AUD).ConclusionsCurrent evidence suggests that bariatric surgery improves the majority of health-related outcomes; however, caution is advised given it may increase the risk of adverse mental effects, perinatal problems, and fractures.

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Section: Resultsmentioning

confidence: 99%

Bariatric surgery and health outcomes: An umbrella analysis

Liao

Yin²,

Zhong³

et al. 2022

Front. Endocrinol.

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“…The recent meta-analysis of five observational studies including 49211 participants showed significantly lower risk of macrovascular complications in patients with T2D who underwent bariatric surgery as compared to those with non-surgical interventions (0.50 [95% CI, 0.35-0.73]) [84]. These results were confirmed by a meta-analysis of 17 nonrandomized studies which showed that patients with type 2 diabetes who underwent bariatric surgery lived 9 years longer compared with patients not treated with bariatric surgery, and those without diabetes lived 5 years longer than untreated patients without diabetes.…”

Section: Surgical Treatment Of Obesitymentioning

confidence: 99%

Management of obesity in the times of climate change and COVID-19: an interdisciplinary expert consensus report

Płaczkiewicz-Jankowska¹,

Czupryniak²,

Gajos³

et al. 2022

Polish Archives of Internal Medicine

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Obesity is a chronic disease that is associated with increased metabolic and cardiovascular risk, excessive morbidity and mortality worldwide. The authors of the present consensus, clinicians representing medical specialties related to the treatment of obesity and its complications, reviewed a number of European and American guidelines mostly published in 2019-2021, and summarized the principles of obesity management to provide a practical guidance considering the impact that increased adiposity poses to health. The primary goal of obesity treatment from clinical perspective is to prevent or slow down the progression of diseases associated with obesity, reduce metabolic and cardiovascular risk and improve the quality of life by achieving adequate and stable weight reduction. However, obesity should not only be considered as a disease requiring treatment in an individual patient, but also as a civilization disease requiring preventive measures at the population level. Despite the evident benefits, obesity management within the health care systemwhether through pharmacotherapy or bariatric surgeryis only a symptomatic treatment, with all its limitations, and will not ultimately solve the problem of obesity. The important message is that available treatment options fail to correct the true drivers of the obesity pandemic. To this end, new solutions and efforts to prevent obesity in the populations are needed.

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“…Only studies with at least a moderate level of quality were included in the systematic review. After the quality assessment was performed [ 23 ], the following data were extracted from the studies: type of study, location of study, number of participants, etiology of cirrhosis, indication for FMT, method of FMT administration, and parameters for efficacy and safety. SAEs and AEs that were attributable to FMT per Data and Safety Monitoring Board (DSMB) guidelines were considered for the systematic review.…”

Section: Reviewmentioning

confidence: 99%