Modification of cardiometabolic profile in obese diabetic patients after bariatric surgery: changes in cardiovascular risk

Abstract

Introduction and objectives: Bariatric surgery is a valuable tool for metabolic control in obese diabetic patients. The aim of this study was to determine changes in weight and carbohydrate and lipid metabolism in obese diabetic patients during the first 4 years after bariatric surgery.

Methods: A retrospective study was performed in 104 patients (71 women; mean age, 53.0 [0.9] years; mean body mass index, 46.8 [0.7]) with type 2 diabetes mellitus (median duration, 3 years) who underwent laparoscopic proximal gastric bypass.

Results: Blood glucose levels and glycated hemoglobin concentrations decreased during the first 1-3 postoperative months. Values stabilized for the rest of the study period, allowing hypoglycemic treatment to be discontinued in 80% of the patients. No significant differences were observed as a function of the body mass index, diabetes mellitus duration, or previous antidiabetic treatment. Weight decreased during the first 15-24 months and slightly increased afterward. Levels of total cholesterol, triglycerides, and low-density lipoprotein significantly decreased, and target values were reached after 12 months in 80% of the patients. No correlation was found between these reductions and weight loss. Similarly, high-density lipoprotein concentrations decreased until 12 months after surgery. Although concentrations showed a subsequent slight increase, target or lower high-density lipoprotein values were achieved at 24 months postintervention in 85% of the patients.

Conclusions: Bariatric surgery is effective for the treatment of obese diabetic patients, contributing to their metabolic control and reducing their cardiovascular risk.

Keywords: BMI; Diabetes mellitus; HDL; HbA(1c); High-density lipoprotein; Hipercolesterolemia; Hypercholesterolemia; LDL; Lipoproteínas de alta densidad; Lipoproteínas de baja densidad; Low-density lipoprotein; Obesidad; Obesity; T2DM; body mass index; glycated hemoglobin A(1c); high-density lipoprotein; low-density lipoprotein; type 2 diabetes mellitus.