代谢和减重手术后心血管风险降低。

Cardiovascular Risk Reduction Following Metabolic and Bariatric Surgery.

机构信息

Department of General Surgery, Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA.

Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.

出版信息

Surg Clin North Am. 2021 Apr;101(2):269-294. doi: 10.1016/j.suc.2020.12.012.

DOI:10.1016/j.suc.2020.12.012

PMID:33743969

Abstract

Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality in developed countries, with worsening pandemics of type 2 diabetes mellitus and obesity as major cardiovascular (CV) risk factors. Clinical trials of nonsurgical obesity treatments have not shown benefits in CVD, although recent diabetes trials have demonstrated major CV benefits. In many retrospective and prospective cohort studies, however, metabolic (bariatric) surgery is associated with substantial and reproducible CVD benefits. Despite a lack of prospective, randomized clinical trials, data suggest metabolic surgery may be the most effective modality for CVD risk reduction, likely through weight loss and weight loss-independent mechanisms.

摘要

心血管疾病（CVD）仍然是发达国家发病率和死亡率的主要原因，随着 2 型糖尿病和肥胖等主要心血管（CV）危险因素的流行情况恶化。非手术性肥胖治疗的临床试验并未显示对 CVD 有益，尽管最近的糖尿病试验显示出主要的 CV 益处。然而，在许多回顾性和前瞻性队列研究中，代谢（减重）手术与 CVD 益处显著且可重复相关。尽管缺乏前瞻性、随机临床试验，但数据表明代谢手术可能是降低 CVD 风险最有效的方式，可能通过体重减轻和体重减轻以外的机制。