The Complications of Bariatric Surgery Patients with Type 2 Diabetes in the World: A Systematic Review and Meta-Analysis

Kabir, Ali; Mousavi, Sara Ebrahimi; Pazouki, Abdolreza

doi:10.2174/1573399814666180403164529

Cited by 10 publications

(7 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Obesity is a medical condition associated with the accumulation of excess body fat, triggering metabolic disorders, such as type 2 diabetes (32). Perturbation of fatty acid metabolism is a major factor contributing to whole-body insulin resistance.…”

Section: Discussionmentioning

confidence: 99%

Sonic hedgehog signaling instigates high-fat diet–induced insulin resistance by targeting PPARγ stability

Yao

Liu

Xiao

et al. 2019

Journal of Biological Chemistry

View full text Add to dashboard Cite

Obesity is a major risk for patients with chronic metabolic disorders including type 2 diabetes. Sonic hedgehog (Shh) is a morphogen that regulates the pancreas and adipose tissue formation during embryonic development. Peroxisome proliferator-activated receptor ␥ (PPAR␥) is a member of the nuclear receptor superfamily and one of the most important regulators of insulin action. Here, we evaluated the role and mechanism of Shh signaling in obesity-associated insulin resistance and characterized its effect on PPAR␥. We showed that Shh expression was up-regulated in subcutaneous fat from obese mice. In differentiated 3T3-L1 and primary cultured adipocytes from rats, recombinant Shh protein and SAG (an agonist of Shh signaling) activated an extracellular signal-regulated kinase (ERK)-dependent noncanonical pathway and induced PPAR␥ phosphorylation at serine 112, which decreased PPAR␥ activity. Meanwhile, Shh signaling degraded PPAR␥ protein via binding of PPAR␥ to neural precursor cell-expressed developmentally down-regulated protein 4-1 (NEDD4-1). Furthermore, vismodegib, an inhibitor of Shh signaling, attenuated ERK phosphorylation induced by a high fat diet (HFD) and restored PPAR␥ protein level, thus ameliorating glucose intolerance and insulin resistance in obese mice. Our finding suggests that Shh in subcutaneous fat decreases PPAR␥ activity and stability via activation of an ERK-dependent noncanonical pathway, resulting in impaired insulin action. Inhibition of Shh may serve as a potential therapeutic approach to treat obesity-related diabetes.

show abstract

Section: Discussionmentioning

confidence: 99%

Sonic hedgehog signaling instigates high-fat diet–induced insulin resistance by targeting PPARγ stability

Yao

Liu

Xiao

et al. 2019

Journal of Biological Chemistry

View full text Add to dashboard Cite

show abstract

“…Besides common postoperative complications such as infections, hemorrhage, and high reoperation rates (56), long-term complications such as postprandial hypoglycemia may surface more than a decade later (57). Furthermore, T2DM patients have been shown to be more susceptible to postsurgical complications compared with non-T2DM patients (58). Nevertheless, with current high-quality data, the American Society for Metabolic and Bariatric Surgery (ASMBS) has recommended bariatric surgery (particularly, RYGB) in class I obesity for T2DM patients (34).…”

Section: Discussionmentioning

confidence: 99%

Comparison of mechanistic pathways of bariatric surgery in patients with diabetes mellitus: A Bayesian network meta‐analysis

Lin

Yeong

Lim

et al. 2022

Obesity

View full text Add to dashboard Cite

Objective: Metabolic bariatric procedures are potentially efficacious treatment options in patients with type 2 diabetes mellitus (T2DM). Previous meta-analyses focused on individual operative approaches rather than the mechanistic pathways behind different bariatric procedures. This updated network meta-analysis aimed to synthesize new evidence and comparatively evaluate the efficacy of metabolic surgery against restrictive procedures and standard first-line treatment for patients with T2DM.Methods: Embase, MEDLINE, and trial registries were searched for randomized controlled trials on bariatric surgeries in patients with T2DM on September 3, 2021.A Bayesian network meta-analysis was conducted. The primary outcome was T2DM remission. Secondary outcomes included changes in BMI, lipoprotein levels, and blood pressure.Results: Thirty-two articles were included. Metabolic surgery was statistically superior to restrictive procedures (risk ratio [RR]: 2.57, 95% credibility intervals [CrI]:

show abstract

“…Eligible centers had to meet the criteria listed in Table 1. [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] The final collaborative consortium included 19 centers: 12 from Europe (Arnhem, Basel, Brussels/Dendermonde, Bristol, Bruges, Gothenburg, Madrid, Nice, Offenbach, Taunton, Wien, and Zurich), 3 from USA (Fresno, Providence, Weston), and 4 from South America (Santiago de Chile, São Paulo [2 centers in each city]).…”

Section: Methodsmentioning

confidence: 99%

“…Cardiovascular disease (eg, cardiac arrhythmia, stroke, coronary artery disease) 22 Available prospective bariatric database Preoperative BMI 50 kg/m 2 26,27 History of thromboembolic events and/or therapeutic anticoagulation 27 Interest in bariatric outcomes, documented by !1 publication(s) on bariatric surgery Laparoscopic primary Roux-en-Y gastric bypass or sleeve gastrectomy 24 Diabetes mellitus (Type 1 and Type 2, as defined by the American Diabetes Association) 28 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.…”

Section: Outcome Variables Of Interestmentioning

confidence: 99%

Defining Global Benchmarks in Bariatric Surgery

et al. 2019

View full text Add to dashboard Cite

OBJECTIVE To define "best possible" outcomes for bariatric surgery (BS)(Roux-en-Y gastric bypass [RYGB] and sleeve gastrectomy [SG]). BACKGROUND Reference values for optimal surgical outcomes in well-defined low-risk bariatric patients have not been established so far. Consequently, outcome comparison across centers and over time is impeded by heterogeneity in case-mix. METHODS Out of 39,424 elective BS performed in 19 high-volume academic centers from 3 continents between June 2012 and May 2017, we identified 4120 RYGB and 1457 SG low-risk cases defined by absence of previous abdominal surgery, concomitant procedures, diabetes mellitus, sleep apnea, cardiopathy, renal insufficiency, inflammatory bowel disease, immunosuppression, anticoagulation, BMI>50 kg/m and age>65 years. We chose clinically relevant endpoints covering the intra-and postoperative course. Complications were graded by severity using the comprehensive complication index. Benchmark values were defined as the 75th percentile of the participating centers' median values for respective quality indicators. RE-SULTS Patients were mainly females (78%), aged 38±11 years, with a baseline BMI 40.8 ± 5.8 kg/m. Over 90 days, 7.2% of RYGB and 6.2% of SG patients presented at least 1 complication and no patients died (mortality in nonbenchmark cases: 0.06%). The most frequent reasons for readmission after 90days following both procedures were symptomatic cholelithiasis and abdominal pain of unknown origin. Benchmark values for both RYGB and SG at 90-days postoperatively were 5.5% Clavien-Dindo grade IIIa complication rate, 5.5% readmission rate, and comprehensive complication index 33.73 in the subgroup of patients presenting at least 1 grade II complication. CONCLUSION Benchmark cutoffs targeting perioperative outcomes in BS offer a new tool in surgical quality-metrics and may be implemented in quality-improvement cycle.ClinicalTrials.gov Identifier NCT03440138.

show abstract

The Complications of Bariatric Surgery Patients with Type 2 Diabetes in the World: A Systematic Review and Meta-Analysis

Abstract: As our study showed, most of the complications are not necessarily higher in diabetic population but dependent on the method of surgery.

Cited by 10 publications

References 28 publications

Sonic hedgehog signaling instigates high-fat diet–induced insulin resistance by targeting PPARγ stability

Sonic hedgehog signaling instigates high-fat diet–induced insulin resistance by targeting PPARγ stability

Comparison of mechanistic pathways of bariatric surgery in patients with diabetes mellitus: A Bayesian network meta‐analysis

Defining Global Benchmarks in Bariatric Surgery

Contact Info

Product

Resources

About