National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
Obes Surg. 2022 Nov;32(11):3523-3532. doi: 10.1007/s11695-022-06244-0. Epub 2022 Sep 21.
To perform a meta-analysis of the literature to evaluate the prevalence of cerebrovascular comorbidities between patients undergoing bariatric surgery and those not undergoing bariatric surgery.
Studies about the risk of cerebrovascular disease both before and after bariatric surgery were systematically explored in multiple electronic databases, including PubMed, Web of Science, Cochrane Library, and Embase, from the time of database construction to May 2022.
Seventeen studies with 3,124,063 patients were finally included in the meta-analysis. There was a statistically significant reduction in cerebrovascular event risk following bariatric surgery (OR 0.68; 95% CI 0.58 to 0.78; I = 87.9%). The results of our meta-analysis showed that bariatric surgery was associated with decreased cerebrovascular event risk in the USA, Sweden, the UK, and Germany but not in China or Finland. There was no significant difference in the incidence of cerebrovascular events among bariatric surgery patients compared to non-surgical patients for greater than or equal to 5 years, but the incidence of cerebrovascular events less than 5 years after bariatric surgery was significantly lower in the surgical patients compared to non-surgical patients in the USA population.
Our meta-analysis suggested that bariatric surgery for severe obesity was associated with a reduced risk of cerebrovascular events in the USA, Sweden, the UK, and Germany. Bariatric surgery significantly reduced the risk of cerebrovascular events within 5 years, but there was no significant difference in the risk of cerebrovascular events for 5 or more years after bariatric surgery in the USA.
对文献进行荟萃分析，评估接受减重手术和未接受减重手术的患者发生脑血管合并症的患病率。
系统检索了多个电子数据库，包括 PubMed、Web of Science、Cochrane 图书馆和 Embase，从数据库建立时间到 2022 年 5 月，以评估减重手术前后脑血管疾病风险的研究。
最终纳入了 17 项研究，共 3124063 例患者。减重手术后脑血管事件风险显著降低（OR 0.68；95%CI 0.58 至 0.78；I=87.9%）。我们的荟萃分析结果表明，减重手术与美国、瑞典、英国和德国的脑血管事件风险降低相关，但与中国或芬兰无关。对于大于或等于 5 年的患者，减重手术患者与非手术患者的脑血管事件发生率没有显著差异，但在美国人群中，减重手术患者的脑血管事件发生率在手术后 5 年内显著低于非手术患者。
我们的荟萃分析表明，严重肥胖的减重手术与美国、瑞典、英国和德国的脑血管事件风险降低相关。减重手术显著降低了 5 年内的脑血管事件风险，但在美国，减重手术后 5 年以上的脑血管事件风险无显著差异。
