Risk prediction of complications of metabolic syndrome before and 6 years after gastric bypass
Abstract 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...
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| Veröffentlicht in: | Surgery for obesity and related diseases 2014-07, Vol.10 (4), p.576-582 |
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| creator | Aminian, Ali, M.D Daigle, Christopher R., M.D Romero-Talamás, Héctor, M.D Kashyap, Sangeeta R., M.D Kirwan, John P., Ph.D Brethauer, Stacy A., M.D Schauer, Philip R., M.D |
| description | Abstract 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 |
| doi_str_mv | 10.1016/j.soard.2014.01.025 |
| format | Article |
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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.</description><identifier>ISSN: 1550-7289</identifier><identifier>EISSN: 1878-7533</identifier><identifier>DOI: 10.1016/j.soard.2014.01.025</identifier><identifier>PMID: 24837561</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Bariatric ; Cardiovascular ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - prevention & control ; Diabetes ; Diabetic Retinopathy - epidemiology ; Diabetic Retinopathy - prevention & control ; Female ; Follow-Up Studies ; Framingham ; Gastric Bypass ; Gastroenterology and Hepatology ; Humans ; Kidney Diseases - epidemiology ; Kidney Diseases - prevention & control ; Male ; Metabolic ; Metabolic Syndrome - complications ; Metabolic Syndrome - mortality ; Metabolic Syndrome - surgery ; Middle Aged ; Morbid obesity ; Mortality ; Nephropathy ; Obesity, Morbid - complications ; Obesity, Morbid - mortality ; Obesity, Morbid - surgery ; Retinopathy ; Retrospective Studies ; Risk ; Risk Factors ; Roux-en-Y gastric bypass ; Stroke ; Surgery ; Time Factors ; Treatment Outcome ; Weight Loss ; Young Adult</subject><ispartof>Surgery for obesity and related diseases, 2014-07, Vol.10 (4), p.576-582</ispartof><rights>American Society for Bariatric Surgery</rights><rights>2014 American Society for Bariatric Surgery</rights><rights>Copyright © 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c484t-890202f31502d356bb287cabc90c2921ef8f7b6600c8994ec3334ca9a9c2b04c3</citedby><cites>FETCH-LOGICAL-c484t-890202f31502d356bb287cabc90c2921ef8f7b6600c8994ec3334ca9a9c2b04c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.soard.2014.01.025$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24837561$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aminian, Ali, M.D</creatorcontrib><creatorcontrib>Daigle, Christopher R., M.D</creatorcontrib><creatorcontrib>Romero-Talamás, Héctor, M.D</creatorcontrib><creatorcontrib>Kashyap, Sangeeta R., M.D</creatorcontrib><creatorcontrib>Kirwan, John P., Ph.D</creatorcontrib><creatorcontrib>Brethauer, Stacy A., M.D</creatorcontrib><creatorcontrib>Schauer, Philip R., M.D</creatorcontrib><title>Risk prediction of complications of metabolic syndrome before and 6 years after gastric bypass</title><title>Surgery for obesity and related diseases</title><addtitle>Surg Obes Relat Dis</addtitle><description>Abstract 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.</description><subject>Adult</subject><subject>Aged</subject><subject>Bariatric</subject><subject>Cardiovascular</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - prevention & control</subject><subject>Diabetes</subject><subject>Diabetic Retinopathy - epidemiology</subject><subject>Diabetic Retinopathy - prevention & control</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Framingham</subject><subject>Gastric Bypass</subject><subject>Gastroenterology and Hepatology</subject><subject>Humans</subject><subject>Kidney Diseases - epidemiology</subject><subject>Kidney Diseases - prevention & control</subject><subject>Male</subject><subject>Metabolic</subject><subject>Metabolic Syndrome - complications</subject><subject>Metabolic Syndrome - mortality</subject><subject>Metabolic Syndrome - surgery</subject><subject>Middle Aged</subject><subject>Morbid obesity</subject><subject>Mortality</subject><subject>Nephropathy</subject><subject>Obesity, Morbid - complications</subject><subject>Obesity, Morbid - mortality</subject><subject>Obesity, Morbid - surgery</subject><subject>Retinopathy</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Risk Factors</subject><subject>Roux-en-Y gastric bypass</subject><subject>Stroke</subject><subject>Surgery</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Weight Loss</subject><subject>Young Adult</subject><issn>1550-7289</issn><issn>1878-7533</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU-L1jAQxoO4uOvqJxAkRy-tk6RN2oOCLP6DhYVVr4Y0nUrebZua6Sv025v6rh687CmT4XlmmN_D2AsBpQChXx9Kii71pQRRlSBKkPUjdiEa0xSmVupxrusaCiOb9pw9JToAKF0b-YSdy6pRptbign2_DXTHl4R98GuIM48D93FaxuDd_qe9MeHquphbnLa5T3FC3uEQE3I391zzDV0i7oYVE__haE1Z2W2LI3rGzgY3Ej6_fy_Ztw_vv159Kq5vPn6-endd-Kqp1qJpQYIclKhB9qrWXScb413nW_CylQKHZjCd1gC-adsKvVKq8q51rZcdVF5dslenuUuKP49Iq50CeRxHN2M8khW1lloLMCZL1UnqUyRKONglhcmlzQqwO1h7sH_A2h2sBWEz2Ox6eb_g2E3Y__P8JZkFb04CzGf-Cpgs-YCzz2AT-tX2MTyw4O1_fj-GOacw3uGGdIjHNGeCVliSFuyXPds9WlHBnqtRvwEPU5-c</recordid><startdate>20140701</startdate><enddate>20140701</enddate><creator>Aminian, Ali, M.D</creator><creator>Daigle, Christopher R., M.D</creator><creator>Romero-Talamás, Héctor, M.D</creator><creator>Kashyap, Sangeeta R., M.D</creator><creator>Kirwan, John P., Ph.D</creator><creator>Brethauer, Stacy A., M.D</creator><creator>Schauer, Philip R., M.D</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140701</creationdate><title>Risk prediction of complications of metabolic syndrome before and 6 years after gastric bypass</title><author>Aminian, Ali, M.D ; Daigle, Christopher R., M.D ; Romero-Talamás, Héctor, M.D ; Kashyap, Sangeeta R., M.D ; Kirwan, John P., Ph.D ; Brethauer, Stacy A., M.D ; Schauer, Philip R., M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c484t-890202f31502d356bb287cabc90c2921ef8f7b6600c8994ec3334ca9a9c2b04c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Bariatric</topic><topic>Cardiovascular</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Cardiovascular Diseases - prevention & control</topic><topic>Diabetes</topic><topic>Diabetic Retinopathy - epidemiology</topic><topic>Diabetic Retinopathy - prevention & control</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Framingham</topic><topic>Gastric Bypass</topic><topic>Gastroenterology and Hepatology</topic><topic>Humans</topic><topic>Kidney Diseases - epidemiology</topic><topic>Kidney Diseases - prevention & control</topic><topic>Male</topic><topic>Metabolic</topic><topic>Metabolic Syndrome - complications</topic><topic>Metabolic Syndrome - mortality</topic><topic>Metabolic Syndrome - surgery</topic><topic>Middle Aged</topic><topic>Morbid obesity</topic><topic>Mortality</topic><topic>Nephropathy</topic><topic>Obesity, Morbid - complications</topic><topic>Obesity, Morbid - mortality</topic><topic>Obesity, Morbid - surgery</topic><topic>Retinopathy</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>Risk Factors</topic><topic>Roux-en-Y gastric bypass</topic><topic>Stroke</topic><topic>Surgery</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Weight Loss</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aminian, Ali, M.D</creatorcontrib><creatorcontrib>Daigle, Christopher R., M.D</creatorcontrib><creatorcontrib>Romero-Talamás, Héctor, M.D</creatorcontrib><creatorcontrib>Kashyap, Sangeeta R., M.D</creatorcontrib><creatorcontrib>Kirwan, John P., Ph.D</creatorcontrib><creatorcontrib>Brethauer, Stacy A., M.D</creatorcontrib><creatorcontrib>Schauer, Philip R., M.D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery for obesity and related diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aminian, Ali, M.D</au><au>Daigle, Christopher R., M.D</au><au>Romero-Talamás, Héctor, M.D</au><au>Kashyap, Sangeeta R., M.D</au><au>Kirwan, John P., Ph.D</au><au>Brethauer, Stacy A., M.D</au><au>Schauer, Philip R., M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk prediction of complications of metabolic syndrome before and 6 years after gastric bypass</atitle><jtitle>Surgery for obesity and related diseases</jtitle><addtitle>Surg Obes Relat Dis</addtitle><date>2014-07-01</date><risdate>2014</risdate><volume>10</volume><issue>4</issue><spage>576</spage><epage>582</epage><pages>576-582</pages><issn>1550-7289</issn><eissn>1878-7533</eissn><abstract>Abstract 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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>24837561</pmid><doi>10.1016/j.soard.2014.01.025</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Aged Bariatric Cardiovascular Cardiovascular Diseases - epidemiology Cardiovascular Diseases - prevention & control Diabetes Diabetic Retinopathy - epidemiology Diabetic Retinopathy - prevention & control Female Follow-Up Studies Framingham Gastric Bypass Gastroenterology and Hepatology Humans Kidney Diseases - epidemiology Kidney Diseases - prevention & control Male Metabolic Metabolic Syndrome - complications Metabolic Syndrome - mortality Metabolic Syndrome - surgery Middle Aged Morbid obesity Mortality Nephropathy Obesity, Morbid - complications Obesity, Morbid - mortality Obesity, Morbid - surgery Retinopathy Retrospective Studies Risk Risk Factors Roux-en-Y gastric bypass Stroke Surgery Time Factors Treatment Outcome Weight Loss Young Adult |
| title | Risk prediction of complications of metabolic syndrome before and 6 years after gastric bypass |
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