BACKGROUND: Roux-en-Y gastric bypass (RYGB) surgery has been shown to have favorable effects on components of metabolic syndrome. However, the long-term effect of RYGB on predicted risk of end-organ complications is less clear. The objective of this study was to examine long-term changes in predicted risk of metabolic syndrome-related complications after RYGB. METHODS: The predicted risk of metabolic syndrome-related complications in a cohort of 131 diabetic patients was compared between baseline and last follow-up points after RYGB using validated risk assessment tools. RESULTS: After a median postsurgical follow-up time of 6 years (range, 5-9), a mean percent excess weight loss of 60.7 ± 25.1% was associated with a diabetes remission rate of 61%. At long-term follow-up, the levels of glycated hemoglobin, low-density lipoprotein, and blood pressure were within the recommended American Diabetes Association's goals in 85%, 73%, and 63% of patients, respectively (P<.001). RYGB was associated with a relative risk reduction of 27% for 10-year overall risk of coronary heart disease (CHD), stroke, and peripheral vascular disease; 20% for 10-year risk of CHD; 40% for 10-year risk of myocardial infarction; 42% for 10-year risk of stroke; 47% for 4-year risk of intermittent claudication; 45% for 5-year risk of moderate-severe kidney disease; and 18% for 5-year risk of cardiovascular mortality. Four-year risk of diabetic retinopathy was also significantly decreased. CONCLUSION: RYGB in diabetic patients results in remarkable control of diabetes, dyslipidemia, and hypertension, and is associated with a significant reduction in predicted risk of major complications including nephropathy, retinopathy, and cardiovascular disease and mortality in the range of 18-47% at long-term follow-up.
BACKGROUND: Roux-en-Y gastric bypass (RYGB) surgery has been shown to have favorable effects on components of metabolic syndrome. However, the long-term effect of RYGB on predicted risk of end-organ complications is less clear. The objective of this study was to examine long-term changes in predicted risk of metabolic syndrome-related complications after RYGB. METHODS: The predicted risk of metabolic syndrome-related complications in a cohort of 131 diabeticpatients was compared between baseline and last follow-up points after RYGB using validated risk assessment tools. RESULTS: After a median postsurgical follow-up time of 6 years (range, 5-9), a mean percent excess weight loss of 60.7 ± 25.1% was associated with a diabetes remission rate of 61%. At long-term follow-up, the levels of glycated hemoglobin, low-density lipoprotein, and blood pressure were within the recommended American Diabetes Association's goals in 85%, 73%, and 63% of patients, respectively (P<.001). RYGB was associated with a relative risk reduction of 27% for 10-year overall risk of coronary heart disease (CHD), stroke, and peripheral vascular disease; 20% for 10-year risk of CHD; 40% for 10-year risk of myocardial infarction; 42% for 10-year risk of stroke; 47% for 4-year risk of intermittent claudication; 45% for 5-year risk of moderate-severe kidney disease; and 18% for 5-year risk of cardiovascular mortality. Four-year risk of diabetic retinopathy was also significantly decreased. CONCLUSION: RYGB in diabeticpatients results in remarkable control of diabetes, dyslipidemia, and hypertension, and is associated with a significant reduction in predicted risk of major complications including nephropathy, retinopathy, and cardiovascular disease and mortality in the range of 18-47% at long-term follow-up.
Authors: Ali Aminian; Amin Andalib; Maria R Ver; Ricard Corcelles; Philip R Schauer; Stacy A Brethauer Journal: Obes Surg Date: 2016-06 Impact factor: 4.129
Authors: Zhamak Khorgami; Amin Andalib; Ali Aminian; Matthew D Kroh; Philip R Schauer; Stacy A Brethauer Journal: Surg Endosc Date: 2015-08-26 Impact factor: 4.584
Authors: Suriya Punchai; Zubaidah Nor Hanipah; Katherine M Meister; Philip R Schauer; Stacy A Brethauer; Ali Aminian Journal: Obes Surg Date: 2017-08 Impact factor: 4.129
Authors: Ali Aminian; Mohammad Jamal; Toms Augustin; Ricard Corcelles; John P Kirwan; Philip R Schauer; Stacy A Brethauer Journal: Diabetes Technol Ther Date: 2015-07-15 Impact factor: 6.118
Authors: Zubaidah Nor Hanipah; Suriya Punchai; Linden A Karas; Samuel Szomstein; Rahul J Rosenthal; Stacy A Brethauer; Ali Aminian; Philip R Schauer Journal: Obes Surg Date: 2018-06 Impact factor: 4.129