Effects of obesity and bariatric surgery on HDL functionality and microvascular complications of obesity

2016 ◽  
Vol 252 ◽  
pp. e221-e222 ◽  
Author(s):  
Y. Liu ◽  
T. Siahmansur ◽  
J.D. Schofield ◽  
S. Hama ◽  
R. Yadav ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Microvascular Complications ◽  
Hdl Functionality

scholarly journals The impact of bariatric surgery on incident microvascular complications in patients with type 2 diabetes: A matched controlled population-based retrospective cohort study

2020 ◽  
Author(s):  
Pushpa Singh ◽  
Nicola Adderley ◽  
Anuradhaa Subramanian ◽  
Krishna Gokhale ◽  
Rishi Singhal ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Cohort Study ◽  
Microvascular Complications ◽  
Population Based ◽  
Type2 Diabetes ◽  
Foot Disease ◽  
The Impact ◽  
Surgical Group

Aim: To assess the impact of bariatric surgery (BS) on incident microvascular complications [diabetes-related foot disease (DFD), sight threatening diabetic retinopathy (STDR), chronic kidney disease (CKD)] in patients with type 2 diabetes and obesity. <p>Methods: <a>A retrospective matched, controlled population-based cohort study of adults with type 2 diabetes between 1/1/1990 and 31/1/2018 using </a><a>IQVIA Medical Research Data (IMRD), </a>a database of primary care electronic records. <a>Each patient with type2 diabetes who subsequently had BS (surgical) was matched on index date with up to 2 patients with type 2 diabetes did not have BS (non-surgical) within the same general practice by age, sex, pre-index body mass index and diabetes duration</a>.</p> <p>Results: 1126 surgical and 2219 non-surgical participants were included. In the study population, 2261 (68%) were women; Mean (SD) age was 49.87 (9.3) vs 50.12 (9.3) years and BMI was 46.76 (7.96) kg/m<sup>2</sup> vs 46.14 (7.49) kg/m<sup>2</sup> in surgical vs non-surgical group respectively. In surgical group, 22.1%, 22.7%, 52.2% and 1.1% patients had gastric band, sleeve gastrectomy, gastric bypass & duodenal switch respectively.</p> <p>Over median (IQR) follow-up was 3.9 years (1.8-6.4), BS was associated with reduction in incident combined microvascular complications (adjusted HR 0.63, 95% CI 0.51 to 0.78, p<0.001), DFD (0.61, 0.50 to 0.75, p<0.001), STDR (0.66, 0.44 to 1.00, p<0.001), CKD (0.63, 0.51 to 0.78, p<0.001). Analysis based on the type of surgery showed that all types of surgery were associated with favourable impact on the incident of composite microvascular complications, greatest reduction RYGB.</p> <p>Conclusions: BS was associated with a significant reduction in incident diabetes-related microvascular complications. </p>

scholarly journals Renal experiences of bariatric surgery in patients with type 2 diabetes mellitus

2018 ◽  
Vol 90 (10) ◽  
pp. 99-108
Author(s):  
I I Larina ◽  
A S Severina ◽  
M S Shamkhalova ◽  
M V Shestakova
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Diabetes Mellitus Type 2 ◽  
Diabetic Kidney Disease ◽  
Microvascular Complications ◽  
Incretin Effect ◽  
Patients With Diabetes ◽  
Surgically Induced

The review addresses the questions of the literature devoted to the problem of the influence of bariatric surgery on the course of diabetic nephropathy in patients with diabetes mellitus type 2 after achieving a surgically induced remission. This approach was shown to have positive aspects, such as decrease in creatinine, decrease in albuminuria, an increase in GFR, normalization of glycemia and blood pressure, "incretin effect"’s influence on the kidneys. Descriptions of the currently expected pathogenetic mechanisms involved in achieving the observed improvement in microvascular complications of diabetes, namely diabetic kidney disease, are also described in details.

scholarly journals Bariatric surgery, glycaemic status, and microvascular complications – Authors' reply

2017 ◽  
Vol 5 (6) ◽  
pp. 416-417
Author(s):  
Lena M S Carlsson ◽  
Kajsa Sjöholm ◽  
Björn Carlsson ◽  
Markku Peltonen
Keyword(s):  
Bariatric Surgery ◽  
Microvascular Complications

Obesity, Metabolic Syndrome and the Risk of Microvascular Complications in Patients with Diabetes mellitus

2019 ◽  
Vol 25 (18) ◽  
pp. 2051-2059 ◽  
Author(s):  
Niki Katsiki ◽  
Panagiotis Anagnostis ◽  
Kalliopi Kotsa ◽  
Dimitrios G. Goulis ◽  
Dimitri P. Mikhailidis
Keyword(s):  
Diabetes Mellitus ◽  
Bariatric Surgery ◽  
Metabolic Syndrome ◽  
Kidney Disease ◽  
Microvascular Complications ◽  
Atherogenic Dyslipidemia ◽  
Cardiac Autonomic Neuropathy ◽  
Alcoholic Fatty Liver ◽  
The Metabolic Syndrome ◽  
Diabetic Microvascular Complications

Background:: Obesity frequently co-exists with type 2 diabetes mellitus (T2DM), leading to the socalled “diabesity epidemic”. The metabolic syndrome (MetS), a cluster of central obesity, hypertension, dysglycemia, insulin resistance and/or atherogenic dyslipidemia, as well as non-alcoholic fatty liver disease (NAFLD), a hepatic manifestation of MetS, has been associated with increased cardiovascular disease (CVD), T2DM and chronic kidney disease (CKD) incidence. However, the association between obesity, MetS (including NAFLD) and diabetic microvascular complications is less evident. Methods:: The present narrative review discusses the associations of obesity, MetS and NAFLD with diabetic kidney disease (DKD), diabetic retinopathy (DR) and diabetic peripheral neuropathy (DPN) as well as cardiac autonomic neuropathy (CAN). The available data on the effects of lifestyle measures and bariatric surgery on these diabetic complications are also briefly discussed. Results: : Overall, both obesity and MetS have been related to DKD, DR and DPN, although conflicting results exist. Links between NAFLD and diabetic microvascular complications have also been reported but data are still limited. Lifestyle intervention and bariatric surgery may prevent the development and/or progression of these microvascular complications but more evidence is needed. Conclusion:: Clinicians should be aware of the frequent co-existence of MetS and/or NAFLD in T2DM patients to prevent or treat these metabolic disorders, thus potentially minimizing the risk for both CVD and diabetic microvascular complications.

scholarly journals Improvements in Diabetic Neuropathy and Nephropathy After Bariatric Surgery: a Prospective Cohort Study

2020 ◽  
Author(s):  
Safwaan Adam ◽  
Shazli Azmi ◽  
Jan H. Ho ◽  
Yifen Liu ◽  
Maryam Ferdousi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Bariatric Surgery ◽  
Cohort Study ◽  
Diabetic Neuropathy ◽  
Microvascular Complications ◽  
Glomerular Hyperfiltration ◽  
Obese Patients ◽  
Obese People ◽  
Symptom Profile ◽  
The Impact

Abstract Purpose There are limited data on the impact of bariatric surgery on microvascular complications of type 2 diabetes (T2D), particularly diabetic neuropathy. We assessed microvascular complications (especially neuropathy) in obese patients with T2D before and 12 months after bariatric surgery. Materials and Methods This was a prospective observational cohort study. Measurements of neuropathy symptom profile (NSP), neuropathy disability score (NDS), vibration (VPT), cold (CPT) and warm (WPT) perception thresholds, nerve conduction studies (NCS) and corneal confocal microscopy (CCM) to quantify corneal nerve fibre density (CNFD), branch density (CNBD) and fibre length (CNFL); urinary albumin/creatinine ratio (uACR), estimated glomerular filtration rate (eGFRcyst-creat) and retinal grading were taken. Results Twenty-six (62% female; median age 52 years) obese patients with T2D were recruited. Body mass index (BMI) (47.2 to 34.5 kg/m2; p < 0.001) decreased post-operatively. There were improvements in CNFD (27.1 to 29.2/mm2; p = 0.005), CNBD (63.4 to 77.8/mm2; p = 0.008), CNFL (20.0 to 20.2/mm2; p = 0.001), NSP (3 to 0/38; p < 0.001) and eGFRcyst-creat (128 to 120 ml/min; p = 0.015) post-bariatric surgery. Changes in (Δ) triglycerides were independently associated with ΔCNFL (β = − 0.53; p = 0.024) and Δsystolic blood pressure (β = 0.62;p = 0.017), and %excess BMI loss (β = − 0.004; p = 0.018) were associated with ΔeGFRcyst-creat. There was no significant change in NDS, VPT, CPT, WPT, NCS, uACR or retinopathy status. Glomerular hyperfiltration resolved in 42% of the 12 patients with this condition pre-operatively. Conclusion Bariatric surgery results in improvements in small nerve fibres and glomerular hyperfiltration in obese people with T2D, which were associated with weight loss, triglycerides and systolic blood pressure, but with no change in retinopathy or uACR at 12 months.

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