Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Tehran Obesity Treatment Center, Department of Surgery, Faculty of Medicine, Shahed University, Tehran, Iran.
BMC Surg. 2022 Jul 28;22(1):290. doi: 10.1186/s12893-022-01740-7.
Obesity is a global health priority, particularly in developing countries. The preventive effect of bariatric surgery against obesity-related diseases in the developing countries of the Middle East and North Africa region, where type 2 diabetes mellitus (T2DM), hypertension (HTN), and dyslipidemia prevail, has not been examined.
Severely obese participants who underwent bariatric surgery were compared with their counterparts who underwent no intervention. These patients had been followed up in two prospective cohort studies for three years. We here determined the incidence of new-onset T2DM, HTN, and dyslipidemia and reported absolute and relative risks for the incidence of these comorbidities in the two groups.
In this study, 612 participants in the bariatric surgery group were compared with 593 participants in the control group. During the follow-up period, T2DM developed in eight (2.9%) people in the surgery group and 66 (15.0%) people in the control group (P < 0.001). New-onset HTN and dyslipidemia showed significantly lower frequencies in the surgery group compared to the control group (4 (1.8%) vs. 70 (20.4%) and 33 (14.3%) vs. 93 (31.5%), respectively). Regarding a less favorable metabolic profile in the surgery group at the baseline, the relative risk reductions associated with bariatric surgery were 94, 93, and 55% for the development of T2DM, HTN, and dyslipidemia, respectively.
The risk reduction of obesity-related comorbidities after bariatric surgery should be considered in the decision-making process for public health in the region, which bariatric surgery could result in the prevention of comorbidities.
肥胖是全球健康的重点关注问题,尤其在发展中国家。在中东和北非地区,2 型糖尿病(T2DM)、高血压(HTN)和血脂异常等肥胖相关疾病较为普遍,尚未对减重手术预防肥胖相关疾病的效果进行评估。
对接受减重手术的重度肥胖患者与未接受任何干预的患者进行比较。这些患者参加了两项前瞻性队列研究,随访时间为 3 年。我们在此确定了新发 T2DM、HTN 和血脂异常的发生率,并报告了两组患者发生这些合并症的绝对风险和相对风险。
本研究比较了 612 例接受减重手术的患者和 593 例接受对照组患者。在随访期间,手术组有 8 人(2.9%)发生 T2DM,对照组有 66 人(15.0%)发生 T2DM(P<0.001)。与对照组相比,手术组新发 HTN 和血脂异常的频率明显较低(4 例[1.8%] vs. 70 例[20.4%]和 33 例[14.3%] vs. 93 例[31.5%])。基线时手术组代谢情况较差,与减重手术相关的 T2DM、HTN 和血脂异常发展的相对风险降低分别为 94%、93%和 55%。
在该地区公共卫生决策过程中应考虑减重手术后肥胖相关合并症风险降低的因素,减重手术可能有助于预防合并症。