title: Role of metabolic surgery in less obese or non-obese subjects with type 2 diabetes: influence over cardiovascular events.
abstract: 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.
authors: The Center of Excellence of Metabolic and Bariatric Surgery, Oswaldo Cruz Hospital, São Paulo, Brazil. ricardo.cohen@haoc.com.br
authors: Ricardo
authors: R
authors: Cohen
authors: Pedro Paulo
authors: PP
authors: Caravatto
authors: Tarissa
authors: T
authors: Petry
authors: David
authors: D
authors: Cummings
mesh_terms: D000818:Animals; D050110:Bariatric Surgery / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000601:surgery*; D006801:Humans; D009765:Obesity / Q000150:complications / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology
references: Ann Surg. 2011 Apr;253(4):699-703
references: 21475009
references: JAMA. 2008 Jan 23;299(3):341-3
references: 18212321
references: J Gastrointest Surg. 2012 Jan;16(1):45-51; discussion 51-2
references: 22042564
references: Diabetes Care. 2012 Jul;35(7):1420-8
references: 22723580
references: Stroke. 1992 Dec;23(12):1705-11
references: 1448818
references: Curr Atheroscler Rep. 2010 Nov;12(6):432-9
references: 20652839
references: Lancet. 2012 Aug 11;380(9841):572-80
references: 22607825
references: Surg Endosc. 2008 Mar;22(3):706-16
references: 17704886
references: Diabetes Care. 2012 Dec;35(12):2613-7
references: 22855732
references: Curr Opin Clin Nutr Metab Care. 2006 Jul;9(4):497-507
references: 16778583
references: Surgery. 2010 May;147(5):664-9
references: 20004451
references: JAMA. 2008 Jan 23;299(3):316-23
references: 18212316
references: JAMA. 2013 Jun 5;309(21):2250-61
references: 23736734
references: Surg Obes Relat Dis. 2012 Jan-Feb;8(1):20-4
references: 21924686
references: Diabetes Care. 2011 Jan;34 Suppl 1:S11-61
references: 21193625
references: Diabetes Care. 2005 Nov;28(11):2780-6
references: 16249558
references: N Engl J Med. 2011 Oct 27;365(17):1597-604
references: 22029981
references: Lancet. 1998 Sep 12;352(9131):837-53
references: 9742976
references: Ann Surg. 2004 Jan;239(1):1-11
references: 14685093
references: Surg Obes Relat Dis. 2010 Jul-Aug;6(4):332-8
references: 19846351
references: J Clin Endocrinol Metab. 2008 Jul;93(7):2479-85
references: 18430778
references: Popul Health Metr. 2010 Oct 22;8:29
references: 20969750
references: Surg Obes Relat Dis. 2012 Jul-Aug;8(4):375-80
references: 22410638
references: Surg Endosc. 2009 Jul;23(7):1569-73
references: 19263156
references: Diabetes Care. 2008 Feb;31 Suppl 2:S290-6
references: 18227499
references: N Engl J Med. 2003 Jan 30;348(5):383-93
references: 12556541
references: JAMA. 2012 Dec 19;308(23):2517-8
references: 23287825
references: N Engl J Med. 2007 Aug 23;357(8):753-61
references: 17715409
references: Arch Intern Med. 2010 Sep 27;170(17):1566-75
references: 20876408
references: Surg Obes Relat Dis. 2012 Sep-Oct;8(5):e66-8
references: 21925965
references: Diabetes Obes Metab. 2012 Mar;14(3):262-70
references: 22051116
references: Obes Surg. 2013 Jun;23(6):809-18
references: 23564465
references: Obes Surg. 2011 Jul;21(7):889-95
references: 21499957
references: Diabetes Care. 2013 Apr;36(4):1033-46
references: 23468086
references: JAMA. 2012 Dec 19;308(23):2489-96
references: 23288372
references: Diabetes Res Clin Pract. 2011 Dec;94(3):311-21
references: 22079683
references: Ann Surg. 2012 Jul;256(1):72-8
references: 22664560
references: Heart. 2012 Dec;98(24):1763-77
references: 23077152
references: JAMA. 2012 Jan 4;307(1):56-65
references: 22215166
references: Ann Surg. 2010 Jun;251(6):1049-55
references: 20485144
references: N Engl J Med. 2012 Aug 23;367(8):695-704
references: 22913680
references: Diabetologia. 2009 Jun;52(6):1027-30
references: 19308351
references: Rev Hosp Clin Fac Med Sao Paulo. 2003 Sep-Oct;58(5):I-VIII
references: 16722003
references: Surg Obes Relat Dis. 2007 Mar-Apr;3(2):195-7
references: 17386401
references: N Engl J Med. 2012 Apr 26;366(17):1567-76
references: 22449319
references: N Engl J Med. 2008 Feb 7;358(6):580-91
references: 18256393
references: Obes Surg. 2013 Jan;23(1):93-102
references: 23161525
references: Am J Cardiol. 2011 Nov 15;108(10):1499-507
references: 21880286
references: Diabetes Care. 2005 Feb;28(2):337-442
references: 15677789
references: N Engl J Med. 2012 Apr 26;366(17):1577-85
references: 22449317
references: Rev Diabet Stud. 2011 Fall;8(3):432-40
references: 22262079
references: J Lipid Res. 2010 Aug;51(8):2405-12
references: 20631298