de Souza Kevlin, Defante Maria L R, Franco Matheus Dos S, Mendes Beatriz Ximenes, Monteiro Sarah O N, Castro Gustavo Carvalhal, Tavares Jehovah G, Tavares Douglas G
Faculdade Redentor, Itaperuna, Brazil.
Rio de Janeiro State University, Rio de Janeiro, Brazil.
Obes Surg. 2025 Feb;35(2):624-634. doi: 10.1007/s11695-024-07652-0. Epub 2025 Jan 2.
Metabolic and bariatric surgery (MBS) has been associated with weight reduction and obesity complications improvement. However, there is no clear evidence of the extent and consistency of the effects of this procedure on rheumatic diseases. This study aims to conduct a meta-analysis to address the impact of MBS on rheumatic diseases. We searched PubMed, Cochrane, and Embase for studies reporting the prevalence of rheumatic diseases, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the medication use after MBS. We conducted a random-effects meta-analysis using odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CI). P-values < 0.05 were considered statistically significant. We included 28 studies comprising 43,421 patients, with 13,347 patients with rheumatic diseases. The prevalence of osteoarthritis (OA), rheumatoid arthritis, and psoriatic arthritis was significantly reduced after MBS (OR 0.20; 95% CI 0.12 to 0.33; P = 0.01). The WOMAC index for patients with OA had a statistically significant overall reduction after MBS at 6 months (MD - 20.60 points; 95% CI - 28.73 to - 12.47; P < 0.01) and at 12 months (MD - 15.88 points; 95% CI - 19.09 to - 12.66; P < 0.01). Medication use significantly decreased after MBS, both at the follow-up beyond 2 years (OR 0.49; 95% CI 0.35 to 0.69; P < 0.01) and up to 2 years (OR 0.32; 95% CI 0.15 to 0.69; P < 0.01). In this meta-analysis, we found a significant decrease in the prevalence of rheumatic diseases, improvements in the WOMAC index, and reduced medication use among patients undergoing MBS.
代谢与减重手术（MBS）与体重减轻及肥胖并发症改善相关。然而，尚无明确证据表明该手术对风湿性疾病影响的程度及一致性。本研究旨在进行一项荟萃分析，以探讨MBS对风湿性疾病的影响。我们在PubMed、Cochrane和Embase数据库中检索了报告风湿性疾病患病率、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）以及MBS术后用药情况的研究。我们采用比值比（OR）和均数差（MD）并结合95%置信区间（CI）进行随机效应荟萃分析。P值<0.05被认为具有统计学意义。我们纳入了28项研究，共43421例患者，其中13347例患有风湿性疾病。MBS术后骨关节炎（OA）、类风湿关节炎和银屑病关节炎的患病率显著降低（OR 0.20；95% CI 0.12至0.33；P = 0.01）。OA患者的WOMAC指数在MBS术后6个月（MD -20.60分；95% CI -28.73至-12.47；P < 0.01）和12个月（MD -15.88分；95% CI -19.09至-12.66；P < 0.01）时总体有统计学意义的降低。MBS术后用药显著减少，在随访超过2年时（OR 0.49；95% CI 0.35至0.69；P < 0.01）以及随访至2年时（OR 0.32；95% CI 0.15至0.69；P < 0.01）均如此。在这项荟萃分析中，我们发现接受MBS手术的患者中，风湿性疾病患病率显著降低，WOMAC指数得到改善，用药减少。
