Interference of wheight loss on cardiovascular risk and type 2 Diabetes 24 months after gastric bypass – cohort retrospective
Interferência da perda de peso no risco cardiovascular e Diabetes tipo 2 24 meses após bypass gástrico – coorte retrospective
DOI:
https://doi.org/10.34119/bjhrv5n6-049Keywords:
weight loss, dyslipidemia, obesity, cardiovascular riskAbstract
Background: Obesity has increased in prevalence and thus has become a public health crisis. The objective of this study was to evaluate the impact of weight loss on the resolution of type 2 diabetes mellitus and cardiovascular risk. Methods: This is a retrospective cohort and descriptive study, involved consulting a database, from March 2018 to March 2019. The subjects were female and male patients, ≥18 years, who had been submitted to bariatric surgery from March 2014 to March 2016. The following data were obtained from their charts: weight, height, age, sex, presence of associated morbidities (type 2 diabetes mellitus, cardiovascular risk), glycated hemoglobina and glucose. The data a presented as the mean and standard deviation, median and interquartile range, or count and percentage. The results were considered statistically significant if p-value ≤0.05. Results: The patients had maintained a substantial percentage of excesso wheight loss (%EWL) during the postoperative period, and the Hb1Ac, glucose, CVR, and metabolic alterations were also reduced. Six months after surgery, group 1 (<70% EWL) and group 2 (≥ 70%) showed reduced Hb1Ac and, glucose and only group 2 showed reduced CVR. From 12 to 18 months after surgery, group 1 showed reduced Hb1Ac. From 18 to 24 months after surgery, group 2 showed reduced CVR and group 1 showed reduced glucose. Conclusion: Bariatric surgery had a positive effect on %EWL and modified the metabolic profile and CVR of patients up to 24 months after gastric bypass, reducing associated comorbidities.
References
STROCSS 2021 guidelines apply to cohort studies as well as other observational studies (e.g. cross-sectional, case-control etc.).
Brasil. Ministério da Saúde. Secretária de Vigilância em Saúde. Plano de ações estratégicas para o enfrentamento das doenças crônicas não transmissíveis (DCNT) no Brasil 2011-2022/ Min. da Saúde, 2017.
WHO -The Asia-Pacific perspective: Redefining obesity and its treatment. World Health Organization – Western Pacific Region. International Association for the Study of Obesity. Geneve: World Health Organization; 2017.
SBEM - Diretrizes Associação Médica Brasileira e Conselho Federal de Medicina. Sobrepeso e obesidade; diagnóstico. Brasília (DF): Soc. Bras. de Endoc. e Metab. ; 2018.
Santos AX. Prevalência de Hipertensão Arterial sistêmica e Diabetes Mellitus em obesos Candidatos à cirurgia bariátrica. Rev. Bras. de Obes., Nutrição e Emagrecimento. 6; 34 (2012):184-190. [Disponível em: Wttp://www.rbone.com.br/index.php/rbone/article/view/287/278].
Bastos ECL, Barbosa EMWG, Sorlano GMS, et al. Fatores determinantes do reganho ponderal no pós-operatório de cirurgia bariátrica. ABCD, Arq. Bras. Cir. Dig. 26; 1; 2013.
Van Der Beek ESJ, Riele WT, Boerma D, et al. The impact of reconstructive procedures following bariatric surgery on patient well-being and quality of life, Obes. Surg. 20 (2014): 36–41. [https://doi.org/10.1007/s11695-009-9909-4].
G.P. Pimenta, D.N. Moura, E.T.A. Filho, T.R. Jaudy, J.E.A. Nascimento, Avaliação da qualidade de vida tardia após gastroplastia vertical, Rev. Col. Bras. Cir. 40 (2016) 453–457. https://doi.org/10.1590/S0100-69912013000600006.
Bordalo LA, Mourão DM, Bressan J. Deficiências Nutricionais após cirurgia bariátrica: Por que ocorrem?, Acta Méd. Port. 24 (4) (2016):1021–1028. [http://dx.doi.org/10.20344/amp.1564].
Santos LG, Araújo MSM. Perda de peso pré-operatória em pacientes submetidos à gastroplastia redutora com derivação gastrointestinal em Y-de-Roux: uma revisão de literatura. Com. Ciências Saúde. (2012).
Costa TMRL, Paganot, M, Radominski RB, Borba VZC. Impacto da deficiência nutricional na massa óssea após a cirurgia bariátrica. Arq. Bras. Cir. Dig. 2016; 29(1).
Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004; 292:1724–37.
Salameh JR. Bariatric surgery: past and present. Am. J. Am. Sci. 2006; 331:194–200.
Sjöström L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, et al., for the Swedish Obese Subjects Study Scientific Group*. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004; 351:2683–93.
Kelles SMB, Diniz MFHS, Machado CJ, Barreto SM. Perfil de pacientes submetidos à cirurgia bariátrica, assistidos pelo Sistema Único de Saúde do Brasil: revisão sistemática. Cad. Saúde Pública. 2015;31(8).
Framingham Heart Study, 2008. Disponível em: www.framinghamheartstudy.org.
Deitel M, Shikora SA. The development of the surgical treatment of morbid obesity, J. Am. Coll. Nutr. 21 (2014) 365-71. [https://doi.org/10.1080/07315724.2002.10719237].
SBC - Sociedade brasileira de cardiologia. [Internet]. Dislipidemias e parâmetros bioquimicos. [acesso em 3 out 2018]. Disponível em: [http://www.sbcardiologia.org.br/pdf/Consenso_SBC-2015.pdf.]
Oliveira DM, Meregui MAB, Jesus MCP. A decisão da mulher obesa pela cirurgia bariátrica à luz da fenomenologia social, Rev. Esc. Enferm. USP 48 (2014) 970–976. [http://dx.doi.org/10.1590/S0080-623420140000700002].
Carvalho LA, Pires RCCP, Rebelo TJ, et al. Qualidade de vida de pacientes submetidos à cirurgia bariátrica no Hospital Santa Casa de Misericórdia de Belo Horizonte/MG. Rev Univ Val do Rio Verde. 2013;11(1):195-205.
Sandoval D. Reviews: bariatric surgeries: beyond restriction and malabsorption. Int J Obesity. 2011;35 Suppl 3: S45–9.
Costa RC, Yamaguchi N, Santo MA, Riccioppo D, et al. Outcomes on quality of life, weight loss, and comorbidities after Roux-en-Y gastric bypass. Arq Gastroenterol. 2014;51(3):165-70.
Barros LM, Frota NM, Moreira RAN, et al. Assessment of bariatric surgery results. Rev Gaúcha Enferm. 2015;36(1):21-7.
Puzziferri N, Austrheim-Smith IT, Wolfe BM, et al. Three-year follow-up of a prospective randomized trial comparing laparoscopic versus open gastric bypass. Ann Surg. 2006;243(2):181-8.
Sanchez-Santos R, Del Barrio MJ, Gonzalez C, et al. Longterm health-related quality of life following gastric bypass: Influence of depression. Obes Surg. 2006;16(5):580-5.
Silva-Neto EF, Vázquez CMP, Soares FM, et al. Cirurgia bariátrica reverte risco metabólico em pacientes assistidos em nível ambulatorial. Arq Bras Cir Dig. 2014;27(1):38-42. doi: 10.1590/S0102-67202014000100010.
Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes--3-year outcomes. N Engl J Med. 2014;370(21):2002-13.
Mingrone G, Panunzi S, De Caetano A, et al. Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med. 2012;366(17):1577-85.
Kashyap SR, Bhatt DL, Wolski K, et al. Metabolic effects of bariatric surgery in patients with moderate obesity and type 2 diabetes: analysis of a randomized control trial comparing surgery with intensive medical treatment. Diabetes Care 2013;36(8):2175-82.
Hsu CC, Almulaifi A, Chen JC, et al. Effect of bariatric surgery vs medical treatment on type 2 diabetes in patients with body mass index lower than 35 five-year outcome. JAMA Surg. 2015;150(12):1117-24.
Parikh M, Chung M, Sheth S, et al. Randomized pilot trial of bariatric surgery versus intensive medical weight management on diabetes remission in type 2 diabetic patients who do NOT meet NIH criteria for surgery and the role of soluble RAGE as a novel biomarker of success. Ann Surg. 2014;260(4):617-22.
Carvalho PS, Moreira CLCB, Barelli MC, et al. Cirurgia bariátrica cura síndrome metabólica? Arq Bras Endocrinol Metab. 2007;51(1):79-85. doi: 10.1590/S0004-27302007000100013.
Mathew G, Agha R, for the STROCSS Group. STROCSS 2021: Strengthening the Reporting of cohort, cross-sectional and case-control studies in Surgery. International Journal of Surgery (2021) 96:106165
