Major Adverse Cardiovascular Events Among Obese Patients with Diabetes After Metabolic and Bariatric Surgery: a Meta-analysis of Matched Cohort and Prospective Controlled Studies with 122,361 Participates

Yang, Wenxing; Zhan, Meng‐jun; Li, Zhuo; X, Sun; Zhang, Kui

doi:10.1007/s11695-023-06634-y

Cited by 5 publications

(4 citation statements)

References 68 publications

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“…Numerous studies have demonstrated that MBS is significantly more effective than dietary and lifestyle changes alone at inducing weight loss, reducing complications, comorbidities, and mortality, and improving patients’ overall quality of life [ 6 , 8 , 10 , 11 , 22 – 24 ]. Such reductions in complications and comorbidities include improvements in existing conditions and their prevention, including the prevention of various cardiometabolic diseases and cancers demonstrated also in multiple meta-analyses [ 25 – 34 ]. But questions persist as to when MBS might be contraindicated and which procedure to select in different situations.…”

Section: Discussionmentioning

confidence: 99%

IFSO Consensus on Definitions and Clinical Practice Guidelines for Obesity Management—an International Delphi Study

Salminen,

Kow,

Aminian

et al. 2023

OBES SURG

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Introduction This survey of international experts in obesity management was conducted to achieve consensus on standardized definitions and to identify areas of consensus and non-consensus in metabolic bariatric surgery (MBS) to assist in an algorithm of clinical practice guidelines for the management of obesity. Methods A three-round Delphi survey with 136 statements was conducted by 43 experts in obesity management comprising 26 bariatric surgeons, 4 endoscopists, 8 endocrinologists, 2 nutritionists, 2 counsellors, an internist, and a pediatrician spanning six continents over a 2-day meeting in Hamburg, Germany. To reduce bias, voting was unanimous, and the statements were neither favorable nor unfavorable to the issue voted or evenly balanced between favorable and unfavorable. Consensus was defined as ≥ 70% inter-voter agreement. Results Consensus was reached on all 15 essential definitional and reporting statements, including initial suboptimal clinical response, baseline weight, recurrent weight gain, conversion, and revision surgery. Consensus was reached on 95/121 statements on the type of surgical procedures favoring Roux-en-Y gastric bypass, sleeve gastrectomy, and endoscopic sleeve gastroplasty. Moderate consensus was reached for sleeve gastrectomy single-anastomosis duodenoileostomy and none on the role of intra-gastric balloons. Consensus was reached for MBS in patients > 65 and < 18 years old, with a BMI > 50 kg/m2, and with various obesity-related complications such as type 2 diabetes, liver, and kidney disease. Conclusions In this survey of 43 multi-disciplinary experts, consensus was reached on standardized definitions and reporting standards applicable to the whole medical community. An algorithm for treating patients with obesity was explored utilizing a thoughtful multimodal approach. Graphical Abstract

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Section: Discussionmentioning

confidence: 99%

IFSO Consensus on Definitions and Clinical Practice Guidelines for Obesity Management—an International Delphi Study

Salminen,

Kow,

Aminian

et al. 2023

OBES SURG

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“…This extensive body fat depletion, especially in the ectopic and visceral depots, may contribute to the prevention of major complications of T2DM [ 43 ]. Observational studies suggest that MACE was significantly lower (OR = 0.49) in patients with T2DM receiving metabolic surgery [ 44 ]. Risks for heart failure and atrial fibrillation may also be reduced, though the results were less conclusive [ 44 ].…”

Section: Metabolic Surgerymentioning

confidence: 99%

“…Observational studies suggest that MACE was significantly lower (OR = 0.49) in patients with T2DM receiving metabolic surgery [ 44 ]. Risks for heart failure and atrial fibrillation may also be reduced, though the results were less conclusive [ 44 ]. Furthermore, preclinical and clinical studies suggest that metabolic surgery may prevent the progression of chronic kidney disease and improve renal outcomes in T2DM [ 45 ].…”

Section: Metabolic Surgerymentioning

confidence: 99%

Body Fat Depletion: the Yin Paradigm for Treating Type 2 Diabetes

Zhu,

Wilding

2023

Curr Atheroscler Rep

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Purpose of Review To highlight that body fat depletion (the Yin paradigm) with glucose-lowering treatments (the Yang paradigm) are associated with metabolic benefits for patients with type 2 diabetes mellitus (T2DM). Recent Findings The sodium-glucose cotransporter-2 inhibitor-mediated sodium/glucose deprivation can directly improve glycemic control and kidney outcome in patients with T2DM. The glucose deprivation might also promote systemic fatty acid β-oxidation to deplete ectopic/visceral fat and thereby contribute to the prevention of cardiovascular diseases. As with metabolic surgery, bioengineered incretin-based medications with potent anorexigenic and insulinotropic efficacy can significantly reduce blood glucose as well as body weight (especially in the ectopic/visceral fat depots). The latter effects could be a key contributor to their cardiovascular-renal protective effects. Summary In addition to a healthy diet, the newer glucose-lowering medications, with body fat reduction effects, should be prioritized when treating patients with T2DM, especially for those with established cardiovascular/renal risks or diseases.

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“…19 It is remarkable that BMS is associated with a lower risk of all-cause mortality, incident heart failure, myocardial infarction, and stroke. [20][21][22] Shobini Jayaraman et al have shown that the modifications in lowdensity lipoprotein (LDL) play a pivotal role in the accelerated development of cardiovascular diseases (CVD) in obesity. Subsequent to bariatric surgery, weight loss exhibits the potential to partially rectify these LDL alterations by alleviating systemic inflammation associated with obesity.…”

Section: Introductionmentioning

confidence: 99%

Analysis Using Various Models on the Effect of Metabolic Surgery on Cardiovascular Disease Risk in the Chinese Population with Obesity

Wang,

Xu,

Chen

et al. 2024

DMSO

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Major Adverse Cardiovascular Events Among Obese Patients with Diabetes After Metabolic and Bariatric Surgery: a Meta-analysis of Matched Cohort and Prospective Controlled Studies with 122,361 Participates

Cited by 5 publications

References 68 publications

IFSO Consensus on Definitions and Clinical Practice Guidelines for Obesity Management—an International Delphi Study

IFSO Consensus on Definitions and Clinical Practice Guidelines for Obesity Management—an International Delphi Study

Body Fat Depletion: the Yin Paradigm for Treating Type 2 Diabetes

Analysis Using Various Models on the Effect of Metabolic Surgery on Cardiovascular Disease Risk in the Chinese Population with Obesity

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