Cardiovascular Effects of Weight Loss in Obese Patients with Diabetes: Is Bariatric Surgery the Additional Arrow in the Quiver?
Abstract
:1. Introduction
2. Literature Sources and Search Strategy
3. Bariatric Surgery: Overview
4. Epidemiology
5. Pathophysiological Changes after Bariatric Surgery
6. Effects of Bariatric Surgery on Diabetes Mellitus and Other Cardiovascular Risk Factors
6.1. T2DM
6.2. Systemic Arterial HTN
6.3. Dyslipidemia
6.4. Inflammation
6.5. Health-Related Quality of Life
7. Long-Term Impact of Bariatric Surgery on Metabolic Profile and Cardiovascular System
8. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
References
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MBS | Principal Mechanism of Action | Technical Aspects | Expected Weight Loss | Side Effects |
---|---|---|---|---|
AGB | Gastric restriction |
| 20–25% |
|
SG | Gastric restriction |
| 25–30% |
|
BPD and DS | Mainly malabsorptive |
| 35–45% |
|
RYGB | Mixed restrictive and malabsorptive |
| 30–35% |
|
OAGB | Mixed restrictive and malabsorptive |
| 35–45% |
|
Molecule/Hormone | Change Direction | Final Physiologic Effect | Clinical Changes |
---|---|---|---|
Adiponectin | Reduction in inflammatory state - Changes in total fat mass | Reduced risk of atherosclerosis | |
GLP-1 | Improvement of obesity-induced endothelial dysfunction - Restoration of the endothelial protective properties of HDL - Improvement of B-cell function and reduction of insulin resistance - Satiety induction - Inhibition of glucagon release | Decreased incidence of common carotid artery intima-media thickness augmentation - Improvement of T2DM - Facilitation of weight loss | |
Hsp60 | Reduced inflammation | Reduced CVD risk | |
PRA, aldosterone, ACE activity, endothelin-1 | Reduced vasoconstriction | Improvement in blood pressure control | |
ACE/ACE2 ratio, atrial natriuretic peptide, neprylisin | Augmented vasodilatation | Improvement in blood pressure control | |
Succinate | Limitation of Krebs Cycle with a reduction in glucose production | Better T2DM control | |
PYY | Regulation of central appetite - Regulation of glucose homeostasis | Improvement of T2DM - Facilitation of weight loss |
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Bottino, R.; Carbone, A.; Formisano, T.; D’Elia, S.; Orlandi, M.; Sperlongano, S.; Molinari, D.; Castaldo, P.; Palladino, A.; Barbareschi, C.; et al. Cardiovascular Effects of Weight Loss in Obese Patients with Diabetes: Is Bariatric Surgery the Additional Arrow in the Quiver? Life 2023, 13, 1552. https://doi.org/10.3390/life13071552
Bottino R, Carbone A, Formisano T, D’Elia S, Orlandi M, Sperlongano S, Molinari D, Castaldo P, Palladino A, Barbareschi C, et al. Cardiovascular Effects of Weight Loss in Obese Patients with Diabetes: Is Bariatric Surgery the Additional Arrow in the Quiver? Life. 2023; 13(7):1552. https://doi.org/10.3390/life13071552
Chicago/Turabian StyleBottino, Roberta, Andreina Carbone, Tiziana Formisano, Saverio D’Elia, Massimiliano Orlandi, Simona Sperlongano, Daniele Molinari, Pasquale Castaldo, Alberto Palladino, Consiglia Barbareschi, and et al. 2023. "Cardiovascular Effects of Weight Loss in Obese Patients with Diabetes: Is Bariatric Surgery the Additional Arrow in the Quiver?" Life 13, no. 7: 1552. https://doi.org/10.3390/life13071552