Short-term cardiometabolic risk reduction after bariatric surgery

Hellenic J Cardiol. 2015 Jan-Feb;56(1):61-5.

Abstract

Introduction: Clinically severe obesity, defined as a body mass index (BMI) 40 kg/m2, increases cardiovascular risk and results in elevated mortality. The objective of this study was to examine the short-term health benefits after bariatric surgery. Using commonly recognized scoring systems, we assessed the shortterm reduction of calculated cardiometabolic risk following bariatric surgery.

Methods: Short-term cardiovascular risk reduction was assessed prospectively in 50 consecutive, morbidly obese patients (45 women, 5 men, age 39.3 ± 8.97 years, BMI 50.67 ± 12.25 kg/m²) using the following scales: the Finnish Diabetes Risk Score, Reynolds Risk Score, Italian "Progetto Cuore" score, SCORE. The follow-up data at baseline and six months were recorded in all studied patients. Patients who did not meet the inclusion criteria of particular score systems were not included in the analysis. There were no revisions, surgical failures or deaths in the study group.

Results: The average weight loss six months after bariatric surgery was 35.8 ± 10.59 kg (mean BMI 36.54 ± 5.92 kg/m²). The most interesting result was that the median value of a 10-year risk of developing type 2 diabetes according to the FINDRISC score was 15 (IQR 15-15) at baseline vs. 13 (IQR 13-13) following surgery, p<0.001. We observed a reduction of 2 points in the majority of patients. In addition, in 29 patients it was possible to calculate the 10-year probability of developing the first major cardiovascular event using the Italian "Progetto Cuore" score; the median score decreased from 2.0 to 0.8 (p<0.001).

Conclusions: Weight loss at 6 months, as a result of bariatric surgery in this group of clinically severely obese patients at a very high risk, was especially effective as concerns the reduction of the calculated risk of diabetes, cardiovascular diseases, and related mortality.

MeSH terms

  • Adult
  • Bariatric Surgery / methods*
  • Body Mass Index
  • Cardiovascular Diseases / mortality
  • Cardiovascular Diseases / prevention & control*
  • Diabetes Mellitus, Type 2 / mortality
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Obesity, Morbid* / diagnosis
  • Obesity, Morbid* / psychology
  • Obesity, Morbid* / surgery
  • Outcome Assessment, Health Care
  • Poland
  • Risk Assessment
  • Risk Factors
  • Risk Reduction Behavior