Felipe M Kristensson1, Johanna C Andersson-Assarsson2, Per-Arne Svensson1,3, Björn Carlsson1,4, Markku Peltonen5, Lena M S Carlsson1. 1. Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden. 2. Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden johanna.andersson@medic.gu.se. 3. Institute of Health and Care Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden. 4. Research and Early Clinical Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden. 5. National Institute for Health and Welfare, Helsinki, Finland.
Abstract
OBJECTIVE: Bariatric surgery is an effective treatment for obesity, but it is unknown if outcomes differ between adults with early- versus adult-onset obesity. We investigated how obesity status at 20 years of age affects outcomes after bariatric surgery later in life. RESEARCH DESIGN AND METHODS: The Swedish Obese Subjects study is a prospective matched study performed at 25 surgical departments and 480 primary health care centers. Participants aged 37-60 years with BMI ≥34 kg/m2 (men) or ≥38 kg/m2 (women) were recruited between 1987 and 2001; 2,007 participants received bariatric surgery and 2,040 usual care. Self-reported body weight at 20 years of age was used to stratify patients into subgroups with normal BMI (<25 kg/m2), overweight (BMI 25-29.9 kg/m2), or obesity (BMI ≥30 kg/m2). Body weight, energy intake, and type 2 diabetes status were examined over 10 years, and incidence of cardiovascular and microvascular disease was determined over up to 26 years using data from health registers. RESULTS: There were small but statistically significant differences in reduction of body weight among the subgroups after bariatric surgery (interaction P = 0.032), with the largest reductions among those with obesity aged 20 years. Bariatric surgery increased type 2 diabetes remission (odds ratios 4.51, 4.90, and 5.58 in subgroups with normal BMI, overweight, or obesity at 20 years of age, respectively; interaction P = 0.951), reduced type 2 diabetes incidence (odds ratios 0.15, 0.13, and 0.15, respectively; interaction P = 0.972), and reduced microvascular complications independent of obesity status at 20 years of age (interaction P = 0.650). The association between bariatric surgery and cardiovascular disease was similar in the subgroups (interaction P = 0.674). Surgical complications were similar in the subgroups. CONCLUSIONS: The treatment benefits of bariatric surgery in adults are similar regardless of obesity status at 20 years of age.
OBJECTIVE: Bariatric surgery is an effective treatment for obesity, but it is unknown if outcomes differ between adults with early- versus adult-onset obesity. We investigated how obesity status at 20 years of age affects outcomes after bariatric surgery later in life. RESEARCH DESIGN AND METHODS: The Swedish Obese Subjects study is a prospective matched study performed at 25 surgical departments and 480 primary health care centers. Participants aged 37-60 years with BMI ≥34 kg/m2 (men) or ≥38 kg/m2 (women) were recruited between 1987 and 2001; 2,007 participants received bariatric surgery and 2,040 usual care. Self-reported body weight at 20 years of age was used to stratify patients into subgroups with normal BMI (<25 kg/m2), overweight (BMI 25-29.9 kg/m2), or obesity (BMI ≥30 kg/m2). Body weight, energy intake, and type 2 diabetes status were examined over 10 years, and incidence of cardiovascular and microvascular disease was determined over up to 26 years using data from health registers. RESULTS: There were small but statistically significant differences in reduction of body weight among the subgroups after bariatric surgery (interaction P = 0.032), with the largest reductions among those with obesity aged 20 years. Bariatric surgery increased type 2 diabetes remission (odds ratios 4.51, 4.90, and 5.58 in subgroups with normal BMI, overweight, or obesity at 20 years of age, respectively; interaction P = 0.951), reduced type 2 diabetes incidence (odds ratios 0.15, 0.13, and 0.15, respectively; interaction P = 0.972), and reduced microvascular complications independent of obesity status at 20 years of age (interaction P = 0.650). The association between bariatric surgery and cardiovascular disease was similar in the subgroups (interaction P = 0.674). Surgical complications were similar in the subgroups. CONCLUSIONS: The treatment benefits of bariatric surgery in adults are similar regardless of obesity status at 20 years of age.
Authors: Lars Sjöström; Markku Peltonen; Peter Jacobson; C David Sjöström; Kristjan Karason; Hans Wedel; Sofie Ahlin; Åsa Anveden; Calle Bengtsson; Gerd Bergmark; Claude Bouchard; Björn Carlsson; Sven Dahlgren; Jan Karlsson; Anna-Karin Lindroos; Hans Lönroth; Kristina Narbro; Ingmar Näslund; Torsten Olbers; Per-Arne Svensson; Lena M S Carlsson Journal: JAMA Date: 2012-01-04 Impact factor: 56.272
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Authors: Francesco Rubino; David M Nathan; Robert H Eckel; Philip R Schauer; K George M M Alberti; Paul Z Zimmet; Stefano Del Prato; Linong Ji; Shaukat M Sadikot; William H Herman; Stephanie A Amiel; Lee M Kaplan; Gaspar Taroncher-Oldenburg; David E Cummings Journal: Diabetes Care Date: 2016-06 Impact factor: 19.112
Authors: Lena M S Carlsson; Kajsa Sjöholm; Cecilia Karlsson; Peter Jacobson; Johanna C Andersson-Assarsson; Per-Arne Svensson; Ingrid Larsson; Stephan Hjorth; Martin Neovius; Magdalena Taube; Björn Carlsson; Markku Peltonen Journal: Lancet Diabetes Endocrinol Date: 2017-02-23 Impact factor: 32.069