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Effect of Bariatric Surgery on Metabolic Syndrome in Chinese Patients with Low Body Mass Index: a Propensity Score Matching Study

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Abstract

Background

Bariatric surgery (BS) is known to improve the components of metabolic syndrome (MS) in patients with obesity. However, few studies have evaluated the effect of BS on patients with MS at low BMI levels. The study aims to assess the effect of BS on MS in patients with low BMI by comparing BS with medical therapy (MT).

Methods

A total of 271 patients with MS who underwent BS and MT at a single institution were reviewed in this retrospective cohort study. A 1:1 propensity score matching was performed for the BS and MT groups with BMI<35 kg/m2. We analyzed the 5 years effect of BS versus MT on the remission of MS, its components, atherosclerotic cardiovascular disease (ASCVD) risk, and medication used.

Results

Patients in the MT group showed a decrease in the prevalence of MS to 62% at the 1st year and 10% at the 5th year. In the BS group, MS prevalence in patients with BMI<35 kg/m2 decreased to 30% and 9% at the 1st and 5th year, whereas in patients with BMI≥35 kg/m2 was 26% and 7%, respectively. The 10-year ASCVD risk and the lifetime ASCVD were significantly decreased 5 years after BS in patients with BMI<35 kg/m2. The number and daily drug dose of hypoglycemic drugs, antihypertensive medications, and lipid-lowering drugs were reduced from baseline in both BS and MT groups.

Conclusion

Bariatric surgery significantly improves MS remission rates and long-term cardiovascular risk in Chinese patients with metabolic syndrome and a BMI <35 kg/m2.

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Funding

This work was supported by the National Key R&D Program (2018YFA0800601 to Z. Zhu), Science and Technology Innovation Enhancement Project of Army Medical University (2019XLC3047 to M.Zhou) and the National Natural Science Foundation of China (81920108010 and 81721001 to Z. Zhu).

Author information

Author notes

  1. Xunmei Zhou, Zhigang Ke contributed equally to this work.

Authors and Affiliations

  1. Department of Endocrinology, University-Town Hospital of Chongqing Medical University, Chongqing, 401331, China

    Xunmei Zhou

  2. Department of Hypertension and Endocrinology, Center for Hypertension and Metabolic Diseases, Daping Hospital, Army Medical University, Chongqing Institute of Hypertension, Chongqing, 400042, China

    Xunmei Zhou, Fang Sun & Zhiming Zhu

  3. Department of General Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China

    Zhigang Ke, Fan Li, Yu Gao & Weidong Tong

  4. Department of General Medicine, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China

    Zaichun You

  5. Department of General Medicine, Xinmiao Central Hospital, Fuling District, Chongqing, 408114, China

    Jian Zhang

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  1. Xunmei Zhou
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Corresponding authors

Correspondence to Zhiming Zhu or Weidong Tong.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Key Points

1. Bariatric surgery has advantages in treating metabolic syndrome patients with a BMI<35 kg/m2

2. Bariatric surgery is more effective than medical therapy for the risk of ASCVD in MS patients with a BMI<35 kg/m2

3. Bariatric surgery reduces medication used in patients with MS and BMI<35 kg/m2

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Zhou, X., Ke, Z., Sun, F. et al. Effect of Bariatric Surgery on Metabolic Syndrome in Chinese Patients with Low Body Mass Index: a Propensity Score Matching Study. OBES SURG 33, 3051–3061 (2023). https://doi.org/10.1007/s11695-023-06765-2

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  • DOI: https://doi.org/10.1007/s11695-023-06765-2

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