Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 May;31(5):1929-1936.
doi: 10.1007/s11695-020-05155-2. Epub 2021 Jan 7.

Impact of Bariatric Surgery in Reducing Macrovascular Complications in Severely Obese T2DM Patients

Salman Hussain  1 , Mohd Shahnawaz Khan  2 , Mohammad Chand Jamali  3 , Ali Nasir Siddiqui  4 , Gaurav Gupta  5 , Md Sarfaraj Hussain  6 , Fohad Mabood Husain  7
Affiliations
Meta-Analysis

Impact of Bariatric Surgery in Reducing Macrovascular Complications in Severely Obese T2DM Patients

Salman Hussain et al. Obes Surg. 2021 May.

Abstract

Background: Evidence from real-world studies have suggested a reduced rate of macrovascular complications following bariatric surgery. We undertook this meta-analysis to investigate the impact of bariatric surgery on macrovascular disease outcomes in severely obese type 2 diabetes mellitus (T2DM) patients.

Methods: An extensive literature search was performed in PubMed from inception until March 2020. All cohort studies assessing the association between bariatric surgery and macrovascular complications in severely obese T2DM patients were included. Two independent reviewers screened the articles, extracted data, and assessed the quality using the Newcastle-Ottawa Scale. The primary outcome was to assess the impact of bariatric surgery and the risk of macrovascular complications. Statistical analysis was performed using Review Manager 5.3.

Results: This meta-analysis comprised of five studies including 49,211 participants (75% female), of which 14,434 underwent bariatric surgery and 34,777 underwent usual care. Participants who underwent bariatric surgery had a significantly lower risk of macrovascular complications as compared to those with non-surgical interventions (RR: 0.50 [95% CI: 0.35-0.73], p = 0.0003). In the subgroup analysis, based on the geographical regions, studies conducted in the USA showed a higher reduction (RR: 0.41 [95% CI: 0.32-0.53], p < 0.00001) in macrovascular complications as compared to other parts of the world. The risk of all-cause mortality was also significantly lower in patients with bariatric surgery (RR 0.39 [95% CI: 0.30-0.50], p < 0.00001).

Conclusion: Bariatric surgery was associated with a 50% reduction in macrovascular complications along with 61% reduction in risk of all-cause mortality in morbidly obese T2DM patients.

Keywords: Bariatric surgery; Diabetes complications; Macrovascular complications; Meta-analysis; Obesity; T2DM.

PubMed Disclaimer

Comment in

References

    1. Zimmet PZ. Diabetes and its drivers: the largest epidemic in human history? Clin Diabetes Endocrinol. 2017;3:1–8. - DOI
    1. World Health Organization. Obesity and overweight. Available at: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight . Accessed 10th March 2020.
    1. IDF Diabetes Atlas Ninth Edition 2019. Available at: https://www.idf.org/e-library/epidemiology-research/diabetes-atlas.html . Accessed on 10th March 2020.
    1. Damian DJ, Kimaro K, Mselle G, et al. Prevalence of overweight and obesity among type 2 diabetic patients attending diabetes clinics in northern Tanzania. BMC Res Notes. 2017;10:515. - DOI
    1. Adult obesity and type 2 diabetes. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploa... . Accessed on 10th March 2020.

Publication types

LinkOut - more resources