Incidence of Diabetes Mellitus, Cardiovascular Diseases, and Cancer in Patients Undergoing Malabsorptive Surgery (Biliopancreatic Diversion and Biliointestinal Bypass) vs Medical Treatment

Pontiroli, Antonio E.; Ceriani, Valerio; Sarro, Giuliano; Micheletto, Giancarlo; Giovanelli, Alessandro; Zakaria, Ahmed; Fanchini, Marco; Osio, Chiara; Nosari, I.; Veronelli, Anna; Folli, Franco

doi:10.1007/s11695-018-3601-5

Cited by 17 publications

(6 citation statements)

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“…The treatment of obese patients without overt type 2 diabetes with a high dose of liraglutide (Table 1) for a short time induced changes in lipid-lipoprotein and hormonal profile that are suggestive of a lower risk of atherosclerosis and CVD [120]. In contrast, BMS has shown able to prevent diabetes, to prevent micro-and macro-angiopathic diabetic complications, and to prevent CV events [121][122][123][124][125], whatever the age of patients, be it below or above the median age of 43 years [125]. This applied to the reduction of new incident cases of diabetes, CVD, cancer, and impaired kidney function as well as a reduction of hospital admissions for most of the above.…”

Section: Long-term Prevention Of Diabetes and Cardiovascular Disease ...mentioning

confidence: 99%

Prevention of Diabetes and Cardiovascular Disease in Obesity

Sala

Pontiroli

2020

IJMS

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Obesity is one of the major risk factors for the development of both impaired glucose tolerance (IGT, or prediabetes) and type 2 diabetes (T2D), and its prevalence worldwide drives toward an increased rate of cardiovascular morbidity and mortality. Given the estimations of the World Health Organization (WHO) and the recommendation of the Diabetes Prevention Program (DPP), where IGT and diabetes are considered as risk factors for the development of cardiovascular complications and obesity, the development of diabetes should be treated because of its potential reversibility. In this view, several interventions such as diet, lifestyle changes, and pharmacological treatment are effective, including bariatric metabolic surgery (BMS), which is the most incisive way to efficiently lower body weight. In this review, we sought to summarize some of the major aspects linked to diabetes prevention in overweight/obesity, focusing on the use of surgery; we also attempted to elucidate molecular pathways involved in a variety of obesity-induced processes able to favor the progression of chronic diseases, such as diabetes and its complications.

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Section: Long-term Prevention Of Diabetes and Cardiovascular Disease ...mentioning

confidence: 99%

Prevention of Diabetes and Cardiovascular Disease in Obesity

Sala

Pontiroli

2020

IJMS

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“…The metabolic impact of BS on the reduction of cardiovascular risk factors and the prevention of these factors has been documented in several studies [38,74,75,76]. A meta-analysis of the long-term effect of BS, DM, and hypertension showed that the risk decreased after BS, with relative risks of 0.33 (95% CI = 0.26–0.41; I 2 = 42%), 0.54 (95% CI = 0.46–0.64, I 2 = 68%), and 0.33 (95% CI = 0.22–0.46, I 2 = 74%).…”

Section: Discussionmentioning

confidence: 99%

Assessment of Cardiometabolic Risk Factors, Physical Activity Levels, and Quality of Life in Stratified Groups up to 10 Years after Bariatric Surgery

Pereira

Aidar

Matos

et al. 2019

IJERPH

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Obesity is a highly prevalent chronic metabolic disease, with an increasing incidence, and is currently approaching epidemic proportions in developing countries. Ouraim was to evaluate the activity levels, quality of life (QoL), clinical parameters, laboratory parameters, and cardiometabolic risk factors afterbariatric surgery (BS). We classified78 patients who underwentBS into four groups, as follows: Those evaluated 1–2 years after BS (BS2), 2–4 years after BS (BS4), 4–6 years after BS (BS6), and 6–10 years after BS (BS+6). Body weight (BW), body mass index (BMI), comorbidities associated with obesity (ACRO), physical activity level, and QoL were evaluated. Patients exhibited improvements in BW, BMI, cardiometabolic risk, hypertension, dyslipidemia, and diabetes and significant changes in lipid profiles in the first postoperative yearafter BS.The physical activity level inthe BS2, BS4, and BS6 groups was increased, compared with that in the first postoperative year, with a decrease in International Physical Activity Questionnaire scores at 1 year in the BS2 (207.50 ± 30.79), BS4 (210.67 ± 33.69), and BS6 (220.00 ± 42.78) groups. The QoL of patients in theBS2 and BS4 groups was excellent and that of patients in the BS4 and BS+6 groupswas very good. These findings suggest that BS promoted improved physical activity levels and QoL and reduced comorbidities in patients with morbid obesity.

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“…However, each study should be critically analyzed. In several of the comparative studies, imbalance in concomitant comorbidities across study groups may have confounded their analyses and biased them against the BS cohorts, as it is well known that morbidly obese patients undergoing BS tend to have a higher baseline comorbidity burden than morbidly obese patients not undergoing BS [32,33]. For example, Nickel et al found that patients who underwent BS before TKA had a greater risk of complications than either non-obese or obese controls who did not undergo BS [29].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Bariatric Surgery Prior to Lower-Extremity Total Joint Arthroplasty: A Systematic Review

Cohen

Malahias

et al. 2019

HSS Jrnl

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Background Obesity is an independent risk factor for osteoarthritis and has been associated with increased rate of complications following lower-extremity total joint arthroplasty (TJA). Bariatric surgery (BS) is a surgical option for weight loss and for reducing obesity-related comorbidities in morbidly obese patients. Purpose/Questions The goal of this systematic review was to answer the following questions: (1) Does BS prior to TJA correlate with lower post-operative complication rates in morbidly obese patients undergoing TJA? (2) Does BS have an impact on revision rates following TJA? Methods Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and checklist, a systematic review of medical databases (PubMed/ MEDLINE, Cochrane Library, Web of Science, and Clinicaltrials.gov ) was undertaken for articles published in English from January 1990 to September 2018. Inclusion criteria were studies that included at least ten patients who underwent BS prior to TJA, collected data on complications or other outcomes, and followed patients for at least 90 days after TJA. A descriptive and critical analysis of the results was performed. Results From 799 studies, 13 met inclusion criteria. A total of 11,770 patients who had undergone bariatric surgery prior to TJA were analyzed. The quality of the evidence ranged between moderate and high. There was no consensus on the effect of previous BS on early- to short-term outcomes reported after TJA. Conclusion The literature remains conflicted on the impact of BS prior to TJA on early, short-term, and long-term complications after TJA. Additional well-matched, observational studies may further our understanding of the impact of BS prior to TJA on outcomes. In particular the effect of various types of BS prior to TJA on outcomes has yet to be elucidated. Ideally, prospective studies with higher level of evidence will be more definitive on the effects of BS prior to TJA. Prospero Registration Number: CRD42016043025. Electronic supplementary material The online version of this article (10.1007/s11420-019-09674-2) contains supplementary material, which is available to authorized users.

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Incidence of Diabetes Mellitus, Cardiovascular Diseases, and Cancer in Patients Undergoing Malabsorptive Surgery (Biliopancreatic Diversion and Biliointestinal Bypass) vs Medical Treatment

Cited by 17 publications

References 50 publications

Prevention of Diabetes and Cardiovascular Disease in Obesity

Prevention of Diabetes and Cardiovascular Disease in Obesity

Assessment of Cardiometabolic Risk Factors, Physical Activity Levels, and Quality of Life in Stratified Groups up to 10 Years after Bariatric Surgery

The Effect of Bariatric Surgery Prior to Lower-Extremity Total Joint Arthroplasty: A Systematic Review

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