title: Cardiovascular risk profile in Mediterranean patients submitted to bariatric surgery and intensive lifestyle intervention: impact of both interventions after 1 year of follow-up.
abstract: BACKGROUND
  The aim was to compare obesity-related cardiovascular (CV) risk factors (classic and emerging) and the estimated CV risk at 10 years (calculated by REGICOR) in obese Mediterranean patients submitted to bariatric surgery and intensive lifestyle intervention at baseline and after 1 year of follow-up.
  
  
  METHODS
  Patients submitted to bariatric surgery (n = 108) and standardized program of therapeutic changes in lifestyle (n = 90) were retrospectively included. Clinical history, physical examination, and laboratory analysis were routinely determined before weight loss intervention and at 1 year follow-up.
  
  
  RESULTS
  Seventy-five percent of the surgery patients had a CV risk lower than 5 % and not one patient had a 10-year CV risk higher than 15 %. The percentage of patients with comorbidities (diabetes and sleep apnea syndrome) was higher in the surgery group. Seventeen of the surgery patients had no comorbidities. The improvement in CV risk profile was significant higher in the surgery group. CV risk benefit of both intervention groups was related to baseline higher CV risk, with type 2 diabetes with poor metabolic control and high cholesterol levels being the most important predictors for surgery patients. Neither body mass index nor excess of weight loss was related to CV risk improvement.
  
  
  CONCLUSIONS
  Mediterranean patients undergoing a weight loss intervention have a low CV risk. In comparison with lifestyle intervention, surgery induces a better improvement of CV risk. This benefit is related to estimated CV risk, presence of diabetes, and cholesterol levels at baseline. These observations should be taken into account in order to optimize health resources.
authors.affiliation: Endocrinology and Nutrition Department, Hospital Son Llàtzer, University Institute of Health Sciences Research (IUNICS), Health Research Institute of Palma (IdISPa), Palma de Mallorca, Spain, pilar.sanchis@hotmail.com.
authors.forename: Pilar
authors.initials: P
authors.lastname: Sanchis
authors.forename: Carla
authors.initials: C
authors.lastname: Frances
authors.forename: Joana
authors.initials: J
authors.lastname: Nicolau
authors.forename: Rosmeri
authors.initials: R
authors.lastname: Rivera
authors.forename: Regina
authors.initials: R
authors.lastname: Fortuny
authors.forename: Xavier
authors.initials: X
authors.lastname: Julian
authors.forename: Salvador
authors.initials: S
authors.lastname: Pascual
authors.forename: Luis A
authors.initials: LA
authors.lastname: Gomez
authors.forename: Irene
authors.initials: I
authors.lastname: Rodriguez
authors.forename: Josefina
authors.initials: J
authors.lastname: Olivares
authors.forename: Luisa
authors.initials: L
authors.lastname: Ayala
authors.forename: Luis
authors.initials: L
authors.lastname: Masmiquel
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000706:statistics & numerical data; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D019083:Mediterranean Region / Q000453:epidemiology; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000453:epidemiology* / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D040242:Risk Reduction Behavior; D015431:Weight Loss