Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Surgery
Published in: BMC Surgery 1/2022

Open Access 01-12-2022 | Obesity | Research

The effect of bariatric surgery in comparison with the control group on the prevention of comorbidities in people with severe obesity: a prospective cohort study

Authors: Amir Ebadinejad, Maryam Barzin, Behnaz Abiri, Maryam Mahdavi, Alireza Khalaj, Danial Ebrahimi, Farhad Hosseinpanah, Majid Valizadeh

Published in: BMC Surgery | Issue 1/2022

Login to get access

Abstract

Background

Obesity is a global health priority, particularly in developing countries. The preventive effect of bariatric surgery against obesity-related diseases in the developing countries of the Middle East and North Africa region, where type 2 diabetes mellitus (T2DM), hypertension (HTN), and dyslipidemia prevail, has not been examined.

Method

Severely obese participants who underwent bariatric surgery were compared with their counterparts who underwent no intervention. These patients had been followed up in two prospective cohort studies for three years. We here determined the incidence of new-onset T2DM, HTN, and dyslipidemia and reported absolute and relative risks for the incidence of these comorbidities in the two groups.

Results

In this study, 612 participants in the bariatric surgery group were compared with 593 participants in the control group. During the follow-up period, T2DM developed in eight (2.9%) people in the surgery group and 66 (15.0%) people in the control group (P < 0.001). New-onset HTN and dyslipidemia showed significantly lower frequencies in the surgery group compared to the control group (4 (1.8%) vs. 70 (20.4%) and 33 (14.3%) vs. 93 (31.5%), respectively). Regarding a less favorable metabolic profile in the surgery group at the baseline, the relative risk reductions associated with bariatric surgery were 94, 93, and 55% for the development of T2DM, HTN, and dyslipidemia, respectively.

Conclusion

The risk reduction of obesity-related comorbidities after bariatric surgery should be considered in the decision-making process for public health in the region, which bariatric surgery could result in the prevention of comorbidities.
Appendix
Available only for authorised users
Literature
1.
Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA. 2004;291(10):1238–45.PubMedCrossRef
2.
3.
Amin R, Kolahi AA, Sohrabi MR. Disparities in obesity prevalence in iranian adults: cross-sectional study using data from the 2016 STEPS Survey. Obes Facts. 2021;14(3):298–305.PubMedPubMedCentralCrossRef
4.
Mousapour P, Valizadeh M, Mahdavi M, Saadat N, Barzin M, Azizi F, et al. Trends in the prevalence of severe obesity among tehranian adults: tehran lipid and glucose study, 1999–2017. Arch Iran Med. 2020;23(6):378–85.PubMedCrossRef
5.
Lavie CJ, De Schutter A, Parto P, Jahangir E, Kokkinos P, Ortega FB, et al. Obesity and prevalence of cardiovascular diseases and prognosis-the obesity paradox updated. Prog Cardiovasc Dis. 2016;58(5):537–47.PubMedCrossRef
6.
Whitlock G, Lewington S, Sherliker P, Clarke R, Emberson J, Halsey J, et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet (London, England). 2009;373(9669):1083–96.CrossRef
7.
Ryan D, Heaner M. Guidelines (2013) for managing overweight and obesity in adults. Preface to the full report. Obesity (Silver Spring, Md). 2014;22(Suppl 2):S1-3.CrossRef
8.
Gloy VL, Briel M, Bhatt DL, Kashyap SR, Schauer PR, Mingrone G, et al. Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ (Clin Res Ed). 2013;347: f5934.
9.
Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384(11):989–1002.PubMedCrossRef
10.
Rubino D, Abrahamsson N, Davies M, Hesse D, Greenway FL, Jensen C, et al. Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance in adults with overweight or obesity: the STEP 4 randomized clinical trial. JAMA. 2021;325(14):1414–25.PubMedCrossRef
11.
Davies M, Færch L, Jeppesen OK, Pakseresht A, Pedersen SD, Perreault L, et al. Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet (London, England). 2021;397(10278):971–84.CrossRef
12.
O’Brien PE, Hindle A, Brennan L, Skinner S, Burton P, Smith A, et al. Long-term outcomes after bariatric surgery: a systematic review and meta-analysis of weight loss at 10 or more years for all bariatric procedures and a single-centre review of 20-year outcomes after adjustable gastric banding. Obes Surg. 2019;29(1):3–14.PubMedCrossRef
13.
Vitiello A, Angrisani L, Santonicola A, Iovino P, Pilone V, Forestieri P. Bariatric surgery versus lifestyle intervention in class I obesity: 7–10-year results of a retrospective study. World J Surg. 2019;43(3):758–62.PubMedCrossRef
14.
Jakobsen GS, Småstuen MC, Sandbu R, Nordstrand N, Hofsø D, Lindberg M, et al. Association of bariatric surgery vs medical obesity treatment with long-term medical complications and obesity-related comorbidities. JAMA. 2018;319(3):291–301.PubMedPubMedCentralCrossRef
15.
Wiggins T, Guidozzi N, Welbourn R, Ahmed AR, Markar SR. Association of bariatric surgery with all-cause mortality and incidence of obesity-related disease at a population level: a systematic review and meta-analysis. PLoS Med. 2020;17(7): e1003206.PubMedPubMedCentralCrossRef
16.
Azizi F, Hadaegh F, Hosseinpanah F, Mirmiran P, Amouzegar A, Abdi H, et al. Metabolic health in the Middle East and north Africa. Lancet Diabetes Endocrinol. 2019;7(11):866–79.PubMedCrossRef
17.
Welbourn R, Hollyman M, Kinsman R, Dixon J, Liem R, Ottosson J, et al. Bariatric surgery worldwide: baseline demographic description and one-year outcomes from the fourth IFSO Global Registry Report 2018. Obes Surg. 2019;29(3):782–95.PubMedCrossRef
18.
Azizi F, Ghanbarian A, Momenan AA, Hadaegh F, Mirmiran P, Hedayati M, et al. Prevention of non-communicable disease in a population in nutrition transition: Tehran lipid and glucose study phase II. Trials. 2009;10:5.PubMedPubMedCentralCrossRef
19.
Barzin M, Hosseinpanah F, Motamedi MA, Shapoori P, Arian P, Daneshpour MA, et al. Bariatric surgery for morbid obesity: Tehran Obesity Treatment Study (TOTS) rationale and study design. JMIR Res Protocols. 2016;5(1): e8.CrossRef
20.
Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2003;26(Suppl 1):S5–20.
21.
Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2007;25(6):1105–87.PubMedCrossRef
22.
Singh P, Subramanian A, Adderley N, Gokhale K, Singhal R, Bellary S, et al. Impact of bariatric surgery on cardiovascular outcomes and mortality: a population-based cohort study. Br J Surg. 2020;107(4):432–42.PubMedCrossRef
23.
Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas. Diabetes Res Clin Pract. 2019;157: 107843.PubMedCrossRef
24.
Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet (London, England). 2016;387(10027):1513–30.
25.
Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants. Lancet (London, England). 2017;389(10064):37–55.
26.
Pontiroli AE, Zakaria AS, Fanchini M, Osio C, Tagliabue E, Micheletto G, et al. A 23-year study of mortality and development of co-morbidities in patients with obesity undergoing bariatric surgery (laparoscopic gastric banding) in comparison with medical treatment of obesity. Cardiovasc Diabetol. 2018;17(1):161.PubMedPubMedCentralCrossRef
27.
Thereaux J, Lesuffleur T, Czernichow S, Basdevant A, Msika S, Nocca D, et al. Association between bariatric surgery and rates of continuation, discontinuation, or initiation of antidiabetes treatment 6 years later. JAMA Surg. 2018;153(6):526–33.PubMedPubMedCentralCrossRef
28.
Bailly L, Schiavo L, Sebastianelli L, Fabre R, Morisot A, Pradier C, et al. Preventive effect of bariatric surgery on type 2 diabetes onset in morbidly obese inpatients: a national French survey between 2008 and 2016 on 328,509 morbidly obese patients. Surg Obes Rel. 2019;15(3):478–87.CrossRef
29.
Sjöström L. Review of the key results from the Swedish Obese Subjects (SOS) trial—a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013;273(3):219–34.PubMedCrossRef
30.
Carlsson LM, Peltonen M, Ahlin S, Anveden Å, Bouchard C, Carlsson B, et al. Bariatric surgery and prevention of type 2 diabetes in Swedish obese subjects. N Engl J Med. 2012;367(8):695–704.PubMedCrossRef
31.
Thereaux J, Lesuffleur T, Czernichow S, Basdevant A, Msika S, Nocca D, et al. Multicentre cohort study of antihypertensive and lipid-lowering therapy cessation after bariatric surgery. Br J Surg. 2019;106(3):286–95.PubMedCrossRef
32.
Reges O, Greenland P, Dicker D, Leibowitz M, Hoshen M, Gofer I, et al. Association of bariatric surgery using laparoscopic banding, Roux-en-Y Gastric bypass, or laparoscopic sleeve gastrectomy vs usual care obesity management with all-cause mortality. JAMA. 2018;319(3):279–90.PubMedPubMedCentralCrossRef
33.
Rubino DM, Greenway FL, Khalid U, O’Neil PM, Rosenstock J, Sørrig R, et al. Effect of weekly subcutaneous semaglutide vs daily liraglutide on body weight in adults with overweight or obesity without diabetes: the STEP 8 randomized clinical trial. JAMA. 2022;327(2):138–50.PubMedPubMedCentralCrossRef
34.
Wadden TA, Bailey TS, Billings LK, Davies M, Frias JP, Koroleva A, et al. Effect of subcutaneous semaglutide vs placebo as an adjunct to intensive behavioral therapy on body weight in adults with overweight or obesity: the STEP 3 randomized clinical trial. JAMA. 2021;325(14):1403–13.PubMedCrossRef
35.
Nosso G, Griffo E, Cotugno M, Saldalamacchia G, Lupoli R, Pacini G, et al. Comparative effects of Roux-en-Y gastric bypass and sleeve gastrectomy on glucose homeostasis and incretin hormones in obese type 2 diabetic patients: a one-year prospective study. Hormone Metab Res. 2016;48(5):312–7.CrossRef
36.
Umeda LM, Silva EA, Carneiro G, Arasaki CH, Geloneze B, Zanella MT. Early improvement in glycemic control after bariatric surgery and its relationships with insulin, GLP-1, and glucagon secretion in type 2 diabetic patients. Obes Surg. 2011;21(7):896–901.PubMedCrossRef
37.
Immonen H, Hannukainen JC, Iozzo P, Soinio M, Salminen P, Saunavaara V, et al. Effect of bariatric surgery on liver glucose metabolism in morbidly obese diabetic and non-diabetic patients. J Hepatol. 2014;60(2):377–83.PubMedCrossRef
38.
Honka H, Koffert J, Hannukainen JC, Tuulari JJ, Karlsson HK, Immonen H, et al. The effects of bariatric surgery on pancreatic lipid metabolism and blood flow. J Clin Endocrinol Metab. 2015;100(5):2015–23.PubMedCrossRef
39.
Russel SM, Valle V, Spagni G, Hamilton S, Patel T, Abdukadyrov N, et al. Physiologic mechanisms of type II diabetes mellitus remission following bariatric surgery: a meta-analysis and clinical implications. J Gastrointest Surg. 2020;24(3):728–41.PubMedCrossRef
40.
Clemente-Postigo M, Roca-Rodriguez Mdel M, Camargo A, Ocaña-Wilhelmi L, Cardona F, Tinahones FJ. Lipopolysaccharide and lipopolysaccharide-binding protein levels and their relationship to early metabolic improvement after bariatric surgery. Surg Obes Rel Dis. 2015;11(4):933–9.CrossRef
41.
Adams ST, Salhab M, Hussain ZI, Miller GV, Leveson SH. Obesity-related hypertension and its remission following gastric bypass surgery—a review of the mechanisms and predictive factors. Blood Press. 2013;22(3):131–7.PubMedCrossRef
42.
Sledzinski T, Sledzinski M, Smolenski RT, Swierczynski J. Increased serum nitric oxide concentration after bariatric surgery—a potential mechanism for cardiovascular benefit. Obes Surg. 2010;20(2):204–10.PubMedCrossRef
43.
Gokce N, Vita JA, McDonnell M, Forse AR, Istfan N, Stoeckl M, et al. Effect of medical and surgical weight loss on endothelial vasomotor function in obese patients. Am J Cardiol. 2005;95(2):266–8.PubMedCrossRef
44.
Ikonomidis I, Mazarakis A, Papadopoulos C, Patsouras N, Kalfarentzos F, Lekakis J, et al. Weight loss after bariatric surgery improves aortic elastic properties and left ventricular function in individuals with morbid obesity: a 3-year follow-up study. J Hypertens. 2007;25(2):439–47.PubMedCrossRef
Metadata
Title
The effect of bariatric surgery in comparison with the control group on the prevention of comorbidities in people with severe obesity: a prospective cohort study
Authors
Amir Ebadinejad
Maryam Barzin
Behnaz Abiri
Maryam Mahdavi
Alireza Khalaj
Danial Ebrahimi
Farhad Hosseinpanah
Majid Valizadeh
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2022
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-022-01740-7

Other articles of this Issue 1/2022

BMC Surgery 1/2022 Go to the issue

Research

Factors influencing outcomes in selective neck dissection in 661 patients with head and neck squamous cell carcinoma

Research

The impact of tumor burden at the initial hepatectomy on the recurrence-to-death survival after repeat surgical resection/radiofrequency ablation: a retrospective study

Research

Laparoscopic surgery does not reduce the need for red blood cell transfusion after resection for colorectal tumour: a propensity score match study on 728 patients

Research

Comparison of transfacet and pedicle screws in oblique lateral interbody fusion for single-level degenerative lumbar spine diseases: a retrospective propensity score-matched analysis

Review

Human albumin and 6% hydroxyethyl starches (130/0.4) in cardiac surgery: a meta-analysis revisited

Research

Analysis of the therapeutic effect of artificial leather embedding combined with fascial sleeve flap transplantation on chronic wounds of lower limbs with bone and plate exposure