The Center of Excellence of Metabolic and Bariatric Surgery, Oswaldo Cruz Hospital, São Paulo, Brazil.
Curr Atheroscler Rep. 2013 Oct;15(10):355. doi: 10.1007/s11883-013-0355-3.
Bariatric surgery was initially developed as a tool for weight reduction only, but it is gaining increasing popularity because of its remarkable effect on glucose metabolism in morbidly obese and less obese patients. Recent publications have shown the good results of metabolic surgery, creating a new field of clinical research that is currently overflowing in the medical community with outstanding high-quality data. In morbidly obese population, there is compelling data on long term cardiovascular risk reduction and mortality, coming from longitudinal prospective studies and systematic reviews. Numbers range from 33 to 92% of decrease in fatal and nonfatal cardiovascular events . In low body mass index (BMI) diabetics, there is an increasing number of reported good outcomes after metabolic surgery with the aim to treat type 2 diabetes (T2DM). There is scarce information on cardiovascular outcomes in non-morbidly obese subjects, but the extraordinary glucose, lipid and blood pressure control in the published series are suggesting good long-term effects on cardiovascular risk profile and mortality. The papers review was comprehensive, including the available randomized controlled trials, long-term prospective series and systematic reviews.
减重手术最初仅被开发用作减肥工具，但由于其在病态肥胖和非病态肥胖患者的葡萄糖代谢方面具有显著效果，因此越来越受欢迎。最近的出版物表明代谢手术具有良好的效果，开创了一个新的临床研究领域，目前该领域在医学界涌现出大量高质量的数据。在病态肥胖人群中，来自纵向前瞻性研究和系统评价的长期心血管风险降低和死亡率的相关数据非常有说服力。致命和非致命心血管事件的发生率降低了 33%至 92%。在低体重指数（BMI）的糖尿病患者中，代谢手术后的良好结果报告数量不断增加，目的是治疗 2 型糖尿病（T2DM）。非病态肥胖患者的心血管结果信息较少，但已发表的系列研究中非凡的血糖、血脂和血压控制情况表明，其对心血管风险状况和死亡率具有良好的长期影响。这篇综述文章全面，包括了现有的随机对照试验、长期前瞻性系列研究和系统评价。
