Background

Obesity is the leading risk factor for type 2 Diabetes Mellitus (T2DM), which increases the risk to develop serious cardiovascular complications. Metabolic and Bariatric Surgery (BaS) is the most effective treatment for these conditions. We aim to analyze the impact of BaS and rapid weight loss on cardiovascular risk in patients with obesity and T2DM.

Methods

A retrospective review of patients with T2DM and obesity who underwent BaS at our institution was performed. The United Kingdom Prospective Study (UKPDS) risk engine was utilized to obtain the risks for fatal and non-fatal coronary heart disease (CHD) as well fatal and non-fatal stroke preoperatively and 12 months postoperatively. Common demographics and comorbidities were collected along with lipid profiles for analysis.

Results

A total of 534 patients were included in our study with a mean age of 58.6 + 12.9. The majority were females 67% (n=358). The risk for CHD preoperatively was 23.4 + 21.5 % and 19.9 + 18.5% postoperatively (p=0.005). Fatal CHD risk decreased from 18.2 + 19.2% to 15.4 + 16.4% after surgery (p=0.01). No significant change was found for the risk of fatal and non-fatal stroke. The lipid profile showed a statistically significant decrease postoperatively. A relative risk reduction of 14.9% was found for CHD.

Conclusions

Obesity associated to T2DM increases the risk of fatal and non-fatal cardiovascular disease. Bariatric surgery and its metabolic effect produce significant improvements on macrovascular complications, decreasing the risk of mortality in patients with Diabetes. Additional studies are necessary to confirm these findings.