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

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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.

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Acknowledgments

The second author (Mohd Shahnawaz Khan) extends appreciation to the Deanship of Scientific Research at King Saud University (KSU) for funding this work through research group project 324 number RG-215.

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Author notes

  1. Mohd Shanawaz Khan and Mohammad Chand Jamali contributed equally to this manuscript

Authors and Affiliations

  1. Department of Pharmaceutical Medicine (Division of Pharmacology), School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India

    Salman Hussain

  2. Department of Biochemistry, King Saud University, Riyadh, Saudi Arabia

    Mohd Shahnawaz Khan

  3. Department of Health and Medical Sciences, Khawarizmi International College, Abu Dhabi, United Arab Emirates

    Mohammad Chand Jamali

  4. New Delhi, India

    Ali Nasir Siddiqui

  5. Department of Pharmacology, School of Pharmacy, Suresh Gyan Vihar University, Jagatpura, Jaipur, India

    Gaurav Gupta

  6. Department of Pharmacognosy & Phytochemistry, R.V. Northland Institute of Pharmacy, Dadri, U.P, India

    Md Sarfaraj Hussain

  7. Department of Food Science and Nutrition, College of Food and Agriculture Sciences, King Saud University, Riyadh, 11451, Saudi Arabia

    Fohad Mabood Husain

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  1. Salman Hussain
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Correspondence to Mohammad Chand Jamali.

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Hussain, S., Khan, M.S., Jamali, M.C. et al. Impact of Bariatric Surgery in Reducing Macrovascular Complications in Severely Obese T2DM Patients. OBES SURG 31, 1929–1936 (2021). https://doi.org/10.1007/s11695-020-05155-2

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