Long-term follow-up after bariatric surgery in a national cohort

Thereaux, Jéremie; Lesuffleur, Thécla; Païta, Michel; Czernichow, Sébastien; Basdevant, Arnaud; Msika, Simon; Millat, Bertrand; Fagot-Campagna, A.

doi:10.1002/bjs.10557

Cited by 102 publications

(56 citation statements)

References 33 publications

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“…The 5y-Ad-DiaRem should be further evaluated in an increased number of patients lacking a full 1-year follow-up. Loss of patients to follow-up remains a major issue in the bariatric setting, which can reach 50% of patients at 5 years (46), and has been associated with poor weight loss outcomes. Despite this limitation, the 5y-Ad-DiaRem appeared robust when tested in three independent cohorts from different European countries, yet these were all Caucasian populations.…”

Section: Discussionmentioning

confidence: 99%

Long-term Relapse of Type 2 Diabetes After Roux-en-Y Gastric Bypass: Prediction and Clinical Relevance

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Long-term Relapse of Type 2 Diabetes After Roux-en-Y Gastric Bypass: Prediction and Clinical Relevance

et al. 2018

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“…achieving DR) as compared to post-VSG patients 47 . Even in patients not reaching DR, a significant improvement of glycemic control is nevertheless observed, as evidenced by the reduction in HbA1c 48,49 or the number of glucose lowering agents needed to reach the HbA1c target 50 .…”

Section: Bariatric Surgery and Type 2 Diabetes Improvementmentioning

confidence: 99%

Impact of bariatric surgery on type 2 diabetes: contribution of inflammation and gut microbiome?

et al. 2019

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Obesity is a chronic low-grade inflammatory disease (both at the systemic and adipose tissue level) that continues to rise worldwide. It is associated with an abundance of comorbidities, including type 2 diabetes (T2D). Bariatric surgery, which induces modifications of the intestinal tract, is to date the most successful treatment for obesity. Its use has dramatically increased in number as it enables both weight reduction and metabolic improvements, with 60% of patients even achieving diabetes remission. Several mechanisms are actually demonstrated to be involved in those clinical improvements. Importantly, both obesity and T2D share many phenotypic characteristics, including increased systemic and adipose tissue inflammation, as well as gut microbiota dysbiosis. These characteristics are deeply modulated after bariatric surgery. This review will specifically focus on the host metabolic changes induced by bariatric surgery in regards of the induced gut architectural changes, as well as on the modifications in the inflammatory tone and gut microbiota observed subsequently to bariatric surgery induced weight loss.

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“…It is important to acknowledge the difficulty maintaining prolonged follow-up in this patient group, but routine data collection through health records would allow evaluation. In a nationwide cohort study of 16,620 patients, Thereaux and colleagues observed that follow-up rates at 1 year and 5 years decreased from 87.1 to 29.6% [33]. Factors such as male sex and younger age were predictors of poor 5-year follow-up [33].…”

Section: Discussionmentioning

confidence: 99%

“…In a nationwide cohort study of 16,620 patients, Thereaux and colleagues observed that follow-up rates at 1 year and 5 years decreased from 87.1 to 29.6% [33]. Factors such as male sex and younger age were predictors of poor 5-year follow-up [33].…”

Section: Discussionmentioning

confidence: 99%

“…Malabsorption of micronutrients including vitamin D, protein, and calcium, particularly after certain bypass procedures, may therefore require supplementation, e.g., vitamin D supplementation, to prevent secondary hyperparathyroidism [31]. Despite recommendations for patients post-bariatric surgery to take additional nutrient supplementation [31,32], adherence is poor, e.g., vitamin D supplementation has been reported to be as low as 33% at 1 year [33], with factors such as male sex and working full-time associated with poor concordance [34]. BMD loss due to these factors, when additionally compounded by a sudden rise in physical activity in a previously sedentary adult, may place the bone under increased stress while also increasing the opportunities for the bone to fracture.…”

Section: Discussionmentioning

confidence: 99%

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Fractures in Adults After Weight Loss from Bariatric Surgery and Weight Management Programs for Obesity: Systematic Review and Meta-analysis

2019

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Background Weight loss interventions for obesity, such as bariatric surgery, are associated with reductions in bone mineral density and may increase the risk of fractures. We undertook a systematic review and meta-analysis of bariatric surgery and lifestyle weight management programs (WMPs) with fracture outcomes. Methods We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials from 1966 to 2018, and our trial registry of WMP randomized controlled trials (RCTs). We included RCTs, non-randomized trials, and observational studies of bariatric surgery, and RCTs of WMPs. Studies had follow-up ≥ 12 months, mean group body mass index ≥ 30 kg/m 2 . The primary outcome measure was incidence of any type of fracture in participants, and the secondary outcome was weight change. We used random effects meta-analysis for trial data. Results Fifteen studies were included. Three small trials provided short-term evidence of the association between bariatric surgery and participants with any fracture (365 participants; RR 0.82; 95% CI 0.29 to 2.35). Four out of six observational studies of bariatric surgery demonstrated significantly increased fracture risk. Six RCTs of WMPs with 6214 participants, the longest follow-up 11.3 years, showed no clear effect on any type of fracture (RR 1.04; 95% CI 0.91 to 1.18), although authors of the largest RCT reported an increased risk of frailty fracture by their definition (RR 1.40; 95% CI 1.04 to 1.90).Conclusion Bariatric surgery appears to increase the risk of any fracture; however, longer-term trial data are needed. The effect of lifestyle WMPs on the risk of any fracture is currently unclear.

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Long-term follow-up after bariatric surgery in a national cohort

Abstract: Despite clear national and international guidelines, long-term follow-up after bariatric surgery is poor, especially for young men with poor early follow-up.

Cited by 102 publications

References 33 publications

Long-term Relapse of Type 2 Diabetes After Roux-en-Y Gastric Bypass: Prediction and Clinical Relevance

Long-term Relapse of Type 2 Diabetes After Roux-en-Y Gastric Bypass: Prediction and Clinical Relevance

Impact of bariatric surgery on type 2 diabetes: contribution of inflammation and gut microbiome?

Fractures in Adults After Weight Loss from Bariatric Surgery and Weight Management Programs for Obesity: Systematic Review and Meta-analysis

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