Decreased Cardiovascular Risk after Roux-en-Y Gastric Bypass Surgery in Chinese Diabetic Patients with Obesity

J Diabetes Res. 2017:2017:5612049. doi: 10.1155/2017/5612049. Epub 2017 Jul 4.

Abstract

Background: The influence of bariatric surgery on cardiovascular risks in Chinese diabetic patients remains unclear. Here, we aimed to explore the impact of Roux-en-Y gastric bypass surgery (RYGB) on cardiovascular risks in Chinese diabetic patients with obesity.

Methods: Twenty Chinese patients with T2DM and obesity undergoing RYGB surgery were included in this study. Cardiovascular risk factors were measured before and 18 months after surgery. A 10-year cardiovascular risk was calculated by the UKPDS risk engine. Linear regression analysis was performed on CHD risk, stroke risk, and baseline metabolic parameters.

Results: The complete remission rate of diabetes was 90% after RYGB surgery, with significant improvements in blood pressure, BMI, glucose, and lipid metabolism (P < 0.05). The 10-year cardiovascular risk of coronary heart disease reduced from 13.05% to 3.81% (P = 0.001) and the 10-year risk of stroke reduced from 19.66% to 14.22% (P = 0.002). In subgroup analysis, Chinese diabetic patients who were women, <45 years old, with BMI < 35 kg/m2, and DM duration > 5 years, using noninsulin therapy presented more obvious improvements in the 10-year cardiovascular risk after RYGB surgery. WHR, age, LDL-C, and HbA1c were the most important factors influencing CHD or stroke risk after RYGB surgery (P < 0.01).

Conclusion: RYGB surgery is an effective treatment to reduce cardiovascular risk in Chinese diabetic patients with obesity.

MeSH terms

  • Adult
  • Biomarkers / blood
  • Blood Glucose / metabolism
  • Blood Pressure
  • Body Mass Index
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control*
  • China
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / drug therapy
  • Female
  • Gastric Bypass / methods*
  • Glycated Hemoglobin / metabolism
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Laparoscopy*
  • Linear Models
  • Lipids / blood
  • Male
  • Middle Aged
  • Obesity / blood
  • Obesity / complications
  • Obesity / diagnosis
  • Obesity / surgery*
  • Protective Factors
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Waist-Hip Ratio

Substances

  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Lipids
  • hemoglobin A1c protein, human