Modification of cardiometabolic profile in obese diabetic patients after bariatric surgery: changes in cardiovascular risk.
OBJECTIVE
Bariatric surgery is a valuable tool for metabolic control in obese diabetic patients. The aim of this study was to determine changes in weight and carbohydrate and lipid metabolism in obese diabetic patients during the first 4 years after bariatric surgery.


METHODS
A retrospective study was performed in 104 patients (71 women; mean age, 53.0 [0.9] years; mean body mass index, 46.8 [0.7]) with type 2 diabetes mellitus (median duration, 3 years) who underwent laparoscopic proximal gastric bypass.


RESULTS
Blood glucose levels and glycated hemoglobin concentrations decreased during the first 1-3 postoperative months. Values stabilized for the rest of the study period, allowing hypoglycemic treatment to be discontinued in 80% of the patients. No significant differences were observed as a function of the body mass index, diabetes mellitus duration, or previous antidiabetic treatment. Weight decreased during the first 15-24 months and slightly increased afterward. Levels of total cholesterol, triglycerides, and low-density lipoprotein significantly decreased, and target values were reached after 12 months in 80% of the patients. No correlation was found between these reductions and weight loss. Similarly, high-density lipoprotein concentrations decreased until 12 months after surgery. Although concentrations showed a subsequent slight increase, target or lower high-density lipoprotein values were achieved at 24 months postintervention in 85% of the patients.


CONCLUSIONS
Bariatric surgery is effective for the treatment of obese diabetic patients, contributing to their metabolic control and reducing their cardiovascular risk.
Servicio de Endocrinología y Nutrición, Hospital Vital Álvarez Buylla, Mieres, Asturias, Spain. Electronic address: pedropujanteal@gmail.com.
Pedro
P
Pujante
Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain.
María D
MD
Hellín
Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain.
Aisa
A
Fornovi
Oficina de Investigación Biosanitaria y Universidad de Oviedo, Universidad de Oviedo, Oviedo, Asturias, Spain.
Pablo
P
Martínez Camblor
Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain.
Mercedes
M
Ferrer
Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain.
Victoria
V
García-Zafra
Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain.
Antonio M
AM
Hernández
Departamento de Cirugía General, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain.
María D
MD
Frutos
Departamento de Cirugía General, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain.
Juan
J
Luján-Monpeán
Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain.
Javier
J
Tébar
D000328:Adult; D050110:Bariatric Surgery / Q000379:methods*; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000378:metabolism / Q000517:prevention & control; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008075:Lipoproteins, HDL / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D040242:Risk Reduction Behavior; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
D001786:Blood Glucose; D008075:Lipoproteins, HDL
BMI; Diabetes mellitus; HDL; HbA(1c); High-density lipoprotein; Hipercolesterolemia; Hypercholesterolemia; LDL; Lipoproteínas de alta densidad; Lipoproteínas de baja densidad; Low-density lipoprotein; Obesidad; Obesity; T2DM; body mass index; glycated hemoglobin A(1c); high-density lipoprotein; low-density lipoprotein; type 2 diabetes mellitus