title: Metabolic surgery: shifting the focus from glycaemia and weight to end-organ health.
abstract: Bariatric surgery is the most effective treatment for weight loss and glycaemic control. The focus of clinical studies and clinical experience has predominantly been on the numerical reductions of bodyweight and glucose after surgery. In this Series paper, we examine evidence on the efficacy of bariatric surgery for pancreatic, renal, retinal, peripheral nervous, cardiovascular, hepatic, and reproductive end-organ damage or disease. The overall conclusions are that, in most cases, patients' end-organ damage is expected to either stabilise or improve postoperatively. However, some of these clinical outcomes have not been assessed with robust methods and, in many cases, do not have support from randomised controlled clinical trials comparing bariatric surgery with non-surgical interventions. Such trials are urgently needed to inform patients and clinicians on whether the risks of surgery outweigh the significant benefits for end-organ health.
authors.affiliation: Molecular and Metabolic Imaging group, Institute of Clinical Sciences, Imperial College London, Hammersmith Hospital, London, UK. Electronic address: a.miras@nhs.net.
authors.forename: Alexander D
authors.initials: AD
authors.lastname: Miras
authors.affiliation: Diabetes Complications Research Centre, UCD Conway Institute, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland; Department of Gastrosurgical Research and Education, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Carel W
authors.initials: CW
authors.lastname: le Roux
mesh_terms: D050110:Bariatric Surgery; D001786:Blood Glucose; D048909:Diabetes Complications / Q000517:prevention & control; D003928:Diabetic Nephropathies / Q000517:prevention & control; D003929:Diabetic Neuropathies / Q000517:prevention & control; D003930:Diabetic Retinopathy / Q000517:prevention & control; D006801:Humans; D007246:Infertility / Q000150:complications; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications / Q000517:prevention & control; D009765:Obesity / Q000453:epidemiology / Q000601:surgery*; D010179:Pancreas / Q000503:physiopathology
chemical_list: D001786:Blood Glucose