The Effect of Bariatric Surgery on Peripheral Polyneuropathy: a Systematic Review and Meta-analysis

Aghili, Rokhsareh; Malek, Mojtaba; Tanha, Kiarash; Mottaghi, Azadeh

doi:10.1007/s11695-019-04004-1

Cited by 23 publications

(11 citation statements)

References 29 publications

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“…Metabolic surgery can result in neuropathy, even in the absence of diabetes (63). The etiology of neuropathy after surgery varies, but can be related to deficiencies in micronutrients such as vitamin B12.…”

Section: Unanswered Questions In Neuropathy and Diabetic Foot Diseasementioning

confidence: 99%

The Effect of Metabolic Surgery on the Complications of Diabetes: What Are the Unanswered Questions?

Neff

Roux

2020

Front. Endocrinol.

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Section: Unanswered Questions In Neuropathy and Diabetic Foot Diseasementioning

confidence: 99%

The Effect of Metabolic Surgery on the Complications of Diabetes: What Are the Unanswered Questions?

Neff

Roux

2020

Front. Endocrinol.

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“…9 Indeed, a recent systematic review and meta-analysis of four studies has shown an improvement in the neuropathy symptom score and NDS, particularly in diabetic patients with a BMI < 35 following bariatric surgery. 40 However, Miras et al 41 found no improvement in nerve conduction studies 12 months after Roux-en-Y bypass. Previously, we have also shown that bariatric surgery was associated with an improvement in corneal nerves and neuropathic symptoms with no change in quantitative sensory testing or nerve conduction studies after 12 months.…”

Section: Discussionmentioning

confidence: 99%

Corneal Keratocyte Density and Corneal Nerves Are Reduced in Patients With Severe Obesity and Improve After Bariatric Surgery

Iqbal

Kalteniece

Ferdousi

et al. 2021

Invest. Ophthalmol. Vis. Sci.

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PURPOSE.Obesity is associated with peripheral neuropathy, which bariatric surgery may ameliorate. The aim of this study was to assess whether corneal confocal microscopy can show a change in corneal nerve morphology and keratocyte density in subjects with severe obesity after bariatric surgery. METHODS.Twenty obese patients with diabetes (n = 13) and without diabetes (n = 7) underwent assessment of hemoglobin A1c (HbA1c), lipids, IL-6, highly sensitive C-reactive protein (hsCRP), and corneal confocal microscopy before and 12 months after bariatric surgery. Corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD), corneal nerve fiber length (CNFL), and keratocyte density (KD) from the anterior, middle, and posterior stroma were quantified. Twenty-two controls underwent assessment at baseline only.RESULTS. CNFL (P < 0.001), CNBD (P < 0.05), and anterior (P < 0.001), middle (P < 0.001), and posterior (P < 0.001) keratocyte densities were significantly lower in obese patients compared to controls, and anterior keratocyte density (AKD) correlated with CNFL. Twelve months after bariatric surgery, there were significant improvements in body mass index (BMI; P < 0.001), HDL cholesterol (P < 0.05), hsCRP (P < 0.001), and IL-6 (P < 0.01). There were significant increases in CNFD (P < 0.05), CNBD (P < 0.05), CNFL (P < 0.05), and anterior (P < 0.05) and middle (P < 0.001) keratocyte densities. The increase in AKD correlated with a decrease in BMI (r = -0.55, P < 0.05) and triglycerides (r = -0.85, P < 0.001). There were no significant correlations between the change in keratocyte densities and corneal nerve fiber or other neuropathy measures. CONCLUSIONS.Corneal confocal microscopy demonstrates early small fiber damage and reduced keratocyte density in obese patients. Bariatric surgery leads to weight reduction and improvement in lipids and inflammation and an improvement in keratocyte density and corneal nerve regeneration.

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“…Historically, there have been concerns regarding the development of neuropathy as a complication of bariatric surgery. However, recent evidence suggests that bariatric surgery has a positive effect on peripheral neuropathy [ 77 ]. Further encouraging evidence for improvements in microvascular complications have been noted in a large retrospective, matched-cohort analysis, which demonstrated a lower cumulative risk of peripheral neuropathy over approximately 4 years in 4024 people who underwent bariatric surgery, compared to 11,059 who were managed non-surgically [ 78 ].…”

Section: Metabolic Peripheral Neuropathymentioning

confidence: 99%

Current and Emerging Pharmacotherapeutic Interventions for the Treatment of Peripheral Nerve Disorders

et al. 2022

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Peripheral nerve disorders are caused by a range of different aetiologies. The range of causes include metabolic conditions such as diabetes, obesity and chronic kidney disease. Diabetic neuropathy may be associated with severe weakness and the loss of sensation, leading to gangrene and amputation in advanced cases. Recent studies have indicated a high prevalence of neuropathy in patients with chronic kidney disease, also known as uraemic neuropathy. Immune-mediated neuropathies including Guillain-Barré syndrome and chronic inflammatory demyelinating polyradiculoneuropathy may cause significant physical disability. As survival rates continue to improve in cancer, the prevalence of treatment complications, such as chemotherapy-induced peripheral neuropathy, has also increased in treated patients and survivors. Notably, peripheral neuropathy associated with these conditions may be chronic and long-lasting, drastically affecting the quality of life of affected individuals, and leading to a large socioeconomic burden. This review article explores some of the major emerging clinical and experimental therapeutic agents that have been investigated for the treatment of peripheral neuropathy due to metabolic, toxic and immune aetiologies.

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The Effect of Bariatric Surgery on Peripheral Polyneuropathy: a Systematic Review and Meta-analysis

Cited by 23 publications

References 29 publications

The Effect of Metabolic Surgery on the Complications of Diabetes: What Are the Unanswered Questions?

The Effect of Metabolic Surgery on the Complications of Diabetes: What Are the Unanswered Questions?

Corneal Keratocyte Density and Corneal Nerves Are Reduced in Patients With Severe Obesity and Improve After Bariatric Surgery

Current and Emerging Pharmacotherapeutic Interventions for the Treatment of Peripheral Nerve Disorders

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