title: [Clinical evidence for metabolic surgery].
abstract: The metabolic effect of bariatric surgery is well-established and is considered to be self-evident in morbidly obese patients with a body mass index (BMI) > 40 kg/m(2). Metabolic surgery performed on patients with obesity grades II (BMI 35-40 kg/m(2)) and I (BMI 30-35 kg/m(2)) according to the World Health Organization (WHO) has increased in recent years; however, the indications for metabolic surgery in obesity grades I and II are currently under debate due to insufficient evidence. In the last 5 years several highly qualified randomized clinical trials have been published which evaluated the effect of metabolic surgery in patients with obesity grades I and II in comparison to conservative therapy. Based on these data the efficacy of metabolic surgery in short-term follow-up (12-36 months) is unquestionable when compared to conservative therapy according to the current guidelines. Besides improved glycemic control and remission of diabetes, metabolic surgery has the potential to have a positive influence on diabetic complications, such as diabetic retinopathy, nephropathy and polyneuropathy, as well as on comorbidities, such as arterial hypertension and dyslipidemia. Future clinical trials should address the long-term (> 36 months) effects of metabolic surgery, patient selection criteria and choice of procedure.
authors.affiliation: Klinik für Allgemein-, Viszeral-, und Transplantationschirurgie, Universität Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland.
authors.forename: J D
authors.initials: JD
authors.lastname: Senft
authors.forename: A T
authors.initials: AT
authors.lastname: Billeter
authors.forename: L
authors.initials: L
authors.lastname: Fischer
authors.forename: B P
authors.initials: BP
authors.lastname: Müller-Stich
mesh_terms: D050110:Bariatric Surgery; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000601:surgery; D019317:Evidence-Based Medicine; D005500:Follow-Up Studies; D006801:Humans; D006949:Hyperlipidemias / Q000601:surgery; D006973:Hypertension / Q000601:surgery; D024821:Metabolic Syndrome / Q000601:surgery*; D015431:Weight Loss