Cardiovascular Risk Profile in Mediterranean Patients Submitted to Bariatric Surgery and Intensive Lifestyle Intervention: Impact of Both Interventions After 1 Year of Follow-Up
详细信息 查看全文
- 作者：Pilar Sanchis ; Carla Frances ; Joana Nicolau ; Rosmeri Rivera…
- 关键词：Cardiovascular risk profile ; Bariatric surgery ; Lifestyle intervention ; Morbid obesity ; Type II diabetes ; Hypercholesterolemia
- 刊名：Obesity Surgery
- 出版年：2015
- 出版时间：January 2015
- 年：2015
- 卷：25
- 期：1
- 页码：97-108
- 全文大小：549 KB
- 参考文献：1. Adams KF, Schatzkin A, Harris TB, et al. Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. N Engl J Med. 2006;355(8):763-8. CrossRef
2. Vest AR, Heneghan HM, Schauer PR, et al. Surgical management of obesity and the relationship to cardiovascular disease. Circulation. 2013;127(8):945-9. doi:10.1161/CIRCULATIONAHA.112.103275 . CrossRef
3. Jiang J, Ahn J, Huang WY, et al. Association of obesity with cardiovascular disease mortality in the PLCO trial. Prev Med. 2013;57(1):60-. doi:10.1016/j.ypmed.2013.04.014 . CrossRef
4. The Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration BMI Mediated Effects). Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1.8 million participants. Lancet. 2013. doi:10.1016/S0140-6736(13)61836-X .
5. Must A, Spadano Van Gaal LF, Maggioni AP. Overweight, obesity, and outcomes: fat mass and beyond. Lancet. 2013. doi:10.1016/S0140-6736(13)62076-0 .
6. Berrington de Gonzalez A, Hartge P, Cerhan JR, et al. Body-mass index and mortality among 1.46 million white adults. N Engl J Med. 2010;363(23):2211-. doi:10.1056/NEJMoa1000367 . CrossRef
7. Hackam DG, Anand SS. Emerging risk factors for atherosclerotic vascular disease: a critical review of the evidence. JAMA. 2003;290(7):932-0. CrossRef
8. Tzotzas T, Evangelou P, Kiortsis DN. Obesity, weight loss and conditional cardiovascular risk factors. Obes Rev. 2011;12(5):e282-. doi:10.1111/j.1467-789X.2010.00807.x . CrossRef
9. Sj?str?m L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10?years after bariatric surgery. N Engl J Med. 2004;351(26):2683-3. doi:10.1056/NEJMoa035622 . CrossRef
10. Adams TD, Gress RE, Smith SC, et al. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007;357(8):753-1. doi:10.1056/NEJMoa066603 . CrossRef
11. Sj?str?m L, Peltonen M, Jacobson P, et al. Bariatric surgery and long-term cardiovascular events. JAMA. 2012;307(1):56-5. doi:10.1001/jama.2011.1914 . CrossRef
12. Dixon JB, O'Brien PE, Playfair J, et al. Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial. JAMA. 2008;299(3):316-3. doi:10.1001/jama.299.3.316 . CrossRef
13. Hofs? D, Nordstrand N, Johnson LK, et al. Obesity-related cardiovascular risk factors after weight loss: a clinical trial comparing gastric bypass surgery and intensive lifestyle intervention. Eur J Endocrinol. 2010;163(5):735-5. doi:10.1530/EJE-10-0514 . CrossRef
14. Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg. 2013;23(4):427-6. doi:10.1007/s11695-012-0864-0 . CrossRef
15. Aasheim ET, Bj?rkman S, S?vik TT, et al. Vitamin status after bariatric surgery: a randomized study of gastric bypass and duodenal switch. Am J Clin Nutr. 2009;90(1):15-2. doi:10.3945/ajcn.2009.27583 .
文摘
Background The aim was to compare obesity-related cardiovascular (CV) risk factors (classic and emerging) and the estimated CV risk at 10?years (calculated by REGICOR) in obese Mediterranean patients submitted to bariatric surgery and intensive lifestyle intervention at baseline and after 1?year of follow-up. Methods Patients submitted to bariatric surgery (n--08) and standardized program of therapeutic changes in lifestyle (n--0) were retrospectively included. Clinical history, physical examination, and laboratory analysis were routinely determined before weight loss intervention and at 1?year follow-up. Results Seventy-five percent of the surgery patients had a CV risk lower than 5?% and not one patient had a 10-year CV risk higher than 15?%. The percentage of patients with comorbidities (diabetes and sleep apnea syndrome) was higher in the surgery group. Seventeen of the surgery patients had no comorbidities. The improvement in CV risk profile was significant higher in the surgery group. CV risk benefit of both intervention groups was related to baseline higher CV risk, with type 2 diabetes with poor metabolic control and high cholesterol levels being the most important predictors for surgery patients. Neither body mass index nor excess of weight loss was related to CV risk improvement. Conclusions Mediterranean patients undergoing a weight loss intervention have a low CV risk. In comparison with lifestyle intervention, surgery induces a better improvement of CV risk. This benefit is related to estimated CV risk, presence of diabetes, and cholesterol levels at baseline. These observations should be taken into account in order to optimize health resources.