Sex difference in the safety and efficacy of bariatric procedures: a systematic review and meta-analysis

Risi, Renata; Rossini, Giovanni; Tozzi, Rossella; Pieralice, Silvia; Monte, Lavinia De; Masi, Davide; Castagneto-Gissey, Lidia; Gallo, Ida Francesca; Strigari, Lidia; Casella, Giovanni; Bruni, Vincenzo; Manfrini, Silvia; Gnessi, Lucio; Tuccinardi, Dario; Watanabe, Mikiko

doi:10.1016/j.soard.2022.03.022

Cited by 21 publications

(15 citation statements)

References 63 publications

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“…On the contrary, RYGB is a mixed procedure: both restrictive, due to the small gastric pouch, and malabsorptive of sugars and fats, due to the bypass of the pancreatic duodenum that carries partially digested food to the distal intestine, thus improving glycemic balance [ 81 ]. A recently published meta-analysis in 114,919 patients did not find a clear effect of sex difference on the efficacy outcome of BS procedures, but men were more likely to achieve greater BMI loss, while women were 2.87 times more likely to be classified as weight responders (95% CI 1.90–4.34), with a higher percentage of excess weight loss, in particular after an intragastric balloon (0.72 95% CI: 0.42–1.02) [ 83 ].…”

Section: Surgical Managementmentioning

confidence: 99%

“…In a meta-analysis of 114,919 patients, there were no sex differences regarding co-morbidity resolution (hypertension, diabetes, and obstructive sleep apnea syndrome) or occurrence of short-term complications after BS, whereas women were more likely to develop long-term complications, with an odds ratio of 1.97 (95% CI: 1.57–2.49) [ 83 ].…”

Section: Surgical Managementmentioning

confidence: 99%

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Obesity and Cardiovascular Risk: Systematic Intervention Is the Key for Prevention

Perone¹,

Pingitore

Conte³

et al. 2023

Healthcare

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Obesity is a serious public health issue and associated with an increased risk of cardiovascular disease events and mortality. The risk of cardiovascular complications is directly related to excess body fat mass and ectopic fat deposition, but also other obesity-related complications such as pre-type 2 diabetes, obstructive sleep apnoea, and non-alcoholic fatty liver diseases. Body mass index and waist circumference are used to classify a patient as overweight or obese and to stratify cardiovascular risk. Physical activity and diet, despite being key points in preventing adverse events and reducing cardiovascular risk, are not always successful strategies. Pharmacological treatments for weight reduction are promising strategies, but are restricted by possible safety issues and cost. Nonetheless, these treatments are associated with improvements in cardiovascular risk factors, and studies are ongoing to better evaluate cardiovascular outcomes. Bariatric surgery is effective in reducing the incidence of death and cardiovascular events such as myocardial infarction and stroke. Cardiac rehabilitation programs in obese patients improve cardiovascular disease risk factors, quality of life, and exercise capacity. The aim of this review was to critically analyze the current role and future aspects of lifestyle changes, medical and surgical treatments, and cardiac rehabilitation in obese patients, to reduce cardiovascular disease risk and mortality, and to highlight the need for a multidisciplinary approach to improving cardiovascular outcomes.

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Section: Surgical Managementmentioning

confidence: 99%

Section: Surgical Managementmentioning

confidence: 99%

Obesity and Cardiovascular Risk: Systematic Intervention Is the Key for Prevention

Perone¹,

Pingitore

Conte³

et al. 2023

Healthcare

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show abstract

“…The finding was therefore expected and in line with previous studies ( 45 ). Noteworthy, studies investigating predictors of weight loss following bariatric surgery or pharmacologic treatment showed contrasting data, with some identifying male sex as a negative predictor of weight loss ( 46 , 47 ), and others suggesting that males lose more weight ( 48 ). This is likely due to the heterogeneity in the cohorts and treatments evaluated, and no definitive conclusion may be drawn in this regard.…”

Section: Discussionmentioning

confidence: 99%

Predictors of weight loss in patients with obesity treated with a Very Low-Calorie Ketogenic Diet

et al. 2023

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IntroductionThe Very Low-Calorie Ketogenic Diet (VLCKD) has emerged as a safe and effective intervention for the management of metabolic disease. Studies examining weight loss predictors are scarce and none has investigated such factors upon VLCKD treatment. Among the molecules involved in energy homeostasis and, more specifically, in metabolic changes induced by ketogenic diets, Fibroblast Growth Factor 21 (FGF21) is a hepatokine with physiology that is still unclear.MethodsWe evaluated the impact of a VLCKD on weight loss and metabolic parameters and assessed weight loss predictors, including FGF21. VLCKD is a severely restricted diet (<800 Kcal/die), characterized by a very low carbohydrate intake (<50 g/day), 1.2–1.5 g protein/kg of ideal body weight and 15–30 g of fat/day. We treated 34 patients with obesity with a VLCKD for 45 days. Anthropometric parameters, body composition, and blood and urine chemistry were measured before and after treatment.ResultsWe found a significant improvement in body weight and composition and most metabolic parameters. Circulating FGF21 decreased significantly after the VLCKD [194.0 (137.6–284.6) to 167.8 (90.9–281.5) p < 0.001] and greater weight loss was predicted by lower baseline FGF21 (Beta = −0.410; p = 0.012), male sex (Beta = 0.472; p = 0.011), and central obesity (Beta = 0.481; p = 0.005).DiscussionVLCKD is a safe and effective treatment for obesity and obesity related metabolic derangements. Men with central obesity and lower circulating FGF21 may benefit more than others in terms of weight loss obtained following this diet. Further studies investigating whether this is specific to this diet or to any caloric restriction are warranted.

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“…As previously reported about the sex-specific difference in bone mass after sleeve gastrectomy, baseline BMD was higher in males than in females, and males had greater weight loss ( Yang et al, 2022 ). Furthermore, males showed a significant decrease in BMD of the total proximal femur and femoral neck as assessed by DXA compared with females after sleeve surgery, although the BMD of the lumbar spine remained unchanged ( Risi et al, 2022 ). The results of the present study are generally consistent with these findings.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of bone density and skeletal muscle mass after sleeve gastrectomy using computed tomography method

Kai¹,

Fujiwara²,

Nagao³

et al. 2023

Bone Reports

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Sex difference in the safety and efficacy of bariatric procedures: a systematic review and meta-analysis

Cited by 21 publications

References 63 publications

Obesity and Cardiovascular Risk: Systematic Intervention Is the Key for Prevention

Obesity and Cardiovascular Risk: Systematic Intervention Is the Key for Prevention

Predictors of weight loss in patients with obesity treated with a Very Low-Calorie Ketogenic Diet

Evaluation of bone density and skeletal muscle mass after sleeve gastrectomy using computed tomography method

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