Takeaway
- Bariatric surgery is associated with reduced long-term all-cause mortality and incidence of obesity-related diseases including type 2 diabetes mellitus (T2DM), hypertension, dyslipidaemia and ischaemic heart disease in patients with obesity.
Why this matters
- Findings suggest that broader access to bariatric surgery for patients with obesity may reduce the long-term sequelae of this disease and provide population-level benefits.
Study design
- 18 studies (minimum follow-up period of 18 months) including 1,539,904 participants (269,818 receiving bariatric surgery and 1,270,086 control participants) met eligibility criteria after a search across electronic databases.
- Funding: National Institute of Health Research (NIHR) Imperial Biomedical Research Centre grant.
Key results
- Bariatric surgery vs control group had a significant reduction in all-cause mortality (11 studies; pooled OR [POR], 0.62; 95% CI, 0.55-0.69; I2, 71.8%) and cardiovascular mortality (3 studies; POR, 0.50; 95% CI, 0.35-0.71; P<.001 for both).
- Bariatric surgery vs control group had significantly reduced incidence of:
- T2DM (6 studies; POR, 0.39; 95% CI, 0.18-0.83; P=.010; I2, 99.4%);
- hypertension (5 studies; POR, 0.36; 95% CI, 0.32-0.40; P<.001);
- obstructive sleep apnoea (1 study; HR, 0.55; 95% CI, 0.37-0.82; P=.004);
- dyslipidaemia (2 studies; POR, 0.33; 95% CI, 0.14-0.80; P=.010; I2, 98.6%);
- ischaemic heart disease (5 studies; POR, 0.46; 95% CI, 0.29-0.73; P=.001; I2, 78.8%); and
- venous thromboembolism (1 study; HR, 0.60; 95% CI, 0.43-0.84; P=.003).
Limitations
- Heterogeneity among included studies.
- Risk of confounding.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.
