Incidence of Diabetes Mellitus, Cardiovascular Diseases, and Cancer in Patients Undergoing Malabsorptive Surgery (Biliopancreatic Diversion and Biliointestinal Bypass) vs Medical Treatment.

Autor: Pontiroli AE; Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy. antonio.pontiroli@unimi.it.; ASST Santi Paolo e Carlo, Milan, Italy. antonio.pontiroli@unimi.it.; Ospedale San Paolo, Via Antonio di Rudinì 8, 20142, Milan, Italy. antonio.pontiroli@unimi.it., Ceriani V; IRCCS Multimedica, Milan, Italy., Sarro G; Ospedale Civile, Magenta, Milan, Italy., Micheletto G; INCO e Dipartimento di Chirurgia Generale, Istituto Clinico Sant'Ambrogio, Milan, Italy., Giovanelli A; INCO e Dipartimento di Chirurgia Generale, Istituto Clinico Sant'Ambrogio, Milan, Italy., Zakaria AS; ASST Santi Paolo e Carlo, Milan, Italy., Fanchini M; ASST Santi Paolo e Carlo, Milan, Italy., Osio C; IRCCS Multimedica, Milan, Italy., Nosari I; Istituto Humanitas Gavazzeni, Bergamo, Italy., Veronelli AM; ASST Santi Paolo e Carlo, Milan, Italy.; Ospedale San Paolo, Via Antonio di Rudinì 8, 20142, Milan, Italy., Folli F; Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy.; ASST Santi Paolo e Carlo, Milan, Italy.
Jazyk: angličtina
Zdroj: Obesity surgery [Obes Surg] 2019 Mar; Vol. 29 (3), pp. 935-942.
DOI: 10.1007/s11695-018-3601-5
Abstrakt: Background and Aims: Bariatric surgeries such as gastric banding (LAGB), gastric bypass (RYGB), vertical banded gastroplasty (VBG), and sleeve gastrectomy (LSG) decrease body weight in morbid obesity, leading to the resolution of coexisting diabetes mellitus and arterial hypertension in the majority of cases as well as improvements of renal function and liver steatosis. BS (LAGB, RYGB, VBG, and LSG) also reduce incident cases of diabetes, of cardiovascular diseases, and of cancer; these therapeutic and preventive effects on comorbidities of obesity have not been analyzed for malabsorptive surgeries such as biliopancreatic diversion (BPD) or biliointestinal bypass (BIBP). The aim of this study was to analyze the incidence of comorbidities, i.e., diabetes, cardiovascular diseases, and cancer, in obese subjects undergoing BPD and BIBP, in comparison with standard medical treatment of obesity.
Patients and Methods: Medical records of 1983 obese patients (body mass index (BMI) > 35 kg/m 2 , aged 18-65 years, undergoing surgery (n = 472, of which 111 with diabetes) or medical treatment (n = 1511, of which 422 with diabetes), during the period 1999-2008 (visit 1)) were collected; incident cases of comorbidities were ascertained through December 31, 2016.
Results: Observation period was 12.0 ± 3.48 years (mean ± SD). Compared to non-surgical patients matched for age, body mass index, and blood pressure, malabsorptive surgeries were associated with reduced new incident cases of diabetes (p = 0.001), cardiovascular diseases (p = 0.001), hyperlipidemia (p = 0.001), oculopathy (p = 0.021), and cancer (p = 0.001). The preventive effect of BS was similar in both nondiabetic and diabetic patients for cardiovascular diseases and hyperlipidemia (both p = 0.001). The preventive effect was significant in nondiabetic subjects for coronary heart disease and for cancer, not significant in diabetic subjects.
Conclusion: Patients undergoing malabsorptive bariatric surgery show less incident cases of diabetes, cardiovascular diseases, hyperlipidemia, oculopathy, and cancer than controls receiving medical treatment.
Databáze: MEDLINE
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