Lifestyle, Diabetes, and Cardiovascular Risk Factors 10 Years after Bariatric Surgery
The Swedish Obese Subjects Study followed obese subjects treated with gastric surgery and contemporaneously matched, conventionally treated obese controls. Surgically treated subjects who were enrolled for at least 2 years (4047 subjects) or 10 years (1703 subjects) had a lower incidence of diabetes...
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| Published in | The New England journal of medicine Vol. 351; no. 26; pp. 2683 - 2693 |
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| Main Authors | , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Boston, MA
Massachusetts Medical Society
23.12.2004
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| Subjects | |
| Online Access | Get full text |
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| Abstract | The Swedish Obese Subjects Study followed obese subjects treated with gastric surgery and contemporaneously matched, conventionally treated obese controls. Surgically treated subjects who were enrolled for at least 2 years (4047 subjects) or 10 years (1703 subjects) had a lower incidence of diabetes, hypertriglyceridemia, and hyperuricemia; differences in the incidence of hypercholesterolemia and hypertension were not significant.
Bariatric surgery appears to be a viable option in the treatment of severe obesity, resulting in long-term weight loss, improved lifestyle, and amelioration of some risk factors.
Obesity is associated with increased morbidity and mortality.
1
The increased morbidity is assumed to be mediated mainly by insulin resistance, diabetes, hypertension, and lipid disturbances — conditions that affect one quarter of the North American population.
2
,
3
Over the short term (one to three years), lifestyle changes resulting in weight loss result in improvements in insulin resistance,
4
diabetes,
5
–
7
hypertension,
8
and lipid disturbances
9
–
11
or in the prevention of these conditions. In contrast, several (but not all
12
) observational epidemiologic studies have suggested that weight loss is associated with increased overall mortality and mortality from cardiovascular causes, not only among . . . |
|---|---|
| AbstractList | The Swedish Obese Subjects Study followed obese subjects treated with gastric surgery and contemporaneously matched, conventionally treated obese controls. Surgically treated subjects who were enrolled for at least 2 years (4047 subjects) or 10 years (1703 subjects) had a lower incidence of diabetes, hypertriglyceridemia, and hyperuricemia; differences in the incidence of hypercholesterolemia and hypertension were not significant.
Bariatric surgery appears to be a viable option in the treatment of severe obesity, resulting in long-term weight loss, improved lifestyle, and amelioration of some risk factors.
Obesity is associated with increased morbidity and mortality.
1
The increased morbidity is assumed to be mediated mainly by insulin resistance, diabetes, hypertension, and lipid disturbances — conditions that affect one quarter of the North American population.
2
,
3
Over the short term (one to three years), lifestyle changes resulting in weight loss result in improvements in insulin resistance,
4
diabetes,
5
–
7
hypertension,
8
and lipid disturbances
9
–
11
or in the prevention of these conditions. In contrast, several (but not all
12
) observational epidemiologic studies have suggested that weight loss is associated with increased overall mortality and mortality from cardiovascular causes, not only among . . . BACKGROUND: Weight loss is associated with short-term amelioration and prevention of metabolic and cardiovascular risk, but whether these benefits persist over time is unknown. METHODS: The prospective, controlled Swedish Obese Subjects Study involved obese subjects who underwent gastric surgery and contemporaneously matched, conventionally treated obese control subjects. We now report follow-up data for subjects (mean age, 48 years; mean body-mass index, 41) who had been enrolled for at least 2 years (4047 subjects) or 10 years (1703 subjects) before the analysis (January 1, 2004). The follow-up rate for laboratory examinations was 86.6 percent at 2 years and 74.5 percent at 10 years. RESULTS: After two years, the weight had increased by 0.1 percent in the control group and had decreased by 23.4 percent in the surgery group (P<0.001). After 10 years, the weight had increased by 1.6 percent and decreased by 16.1 percent, respectively (P<0.001). Energy intake was lower and the proportion of physically active subjects higher in the surgery group than in the control group throughout the observation period. Two- and 10-year rates of recovery from diabetes, hypertriglyceridemia, low levels of high-density lipoprotein cholesterol, hypertension, and hyperuricemia were more favorable in the surgery group than in the control group, whereas recovery from hypercholesterolemia did not differ between the groups. The surgery group had lower 2- and 10-year incidence rates of diabetes, hypertriglyceridemia, and hyperuricemia than the control group; differences between the groups in the incidence of hypercholesterolemia and hypertension were undetectable. CONCLUSIONS: As compared with conventional therapy, bariatric surgery appears to be a viable option for the treatment of severe obesity, resulting in long-term weight loss, improved lifestyle, and, except for hypercholesterolemia, amelioration in risk factors that were elevated at baseline. Weight loss is associated with short-term amelioration and prevention of metabolic and cardiovascular risk, but whether these benefits persist over time is unknown. The prospective, controlled Swedish Obese Subjects Study involved obese subjects who underwent gastric surgery and contemporaneously matched, conventionally treated obese control subjects. We now report follow-up data for subjects (mean age, 48 years; mean body-mass index, 41) who had been enrolled for at least 2 years (4047 subjects) or 10 years (1703 subjects) before the analysis (January 1, 2004). The follow-up rate for laboratory examinations was 86.6 percent at 2 years and 74.5 percent at 10 years. After two years, the weight had increased by 0.1 percent in the control group and had decreased by 23.4 percent in the surgery group (P<0.001). After 10 years, the weight had increased by 1.6 percent and decreased by 16.1 percent, respectively (P<0.001). Energy intake was lower and the proportion of physically active subjects higher in the surgery group than in the control group throughout the observation period. Two- and 10-year rates of recovery from diabetes, hypertriglyceridemia, low levels of high-density lipoprotein cholesterol, hypertension, and hyperuricemia were more favorable in the surgery group than in the control group, whereas recovery from hypercholesterolemia did not differ between the groups. The surgery group had lower 2- and 10-year incidence rates of diabetes, hypertriglyceridemia, and hyperuricemia than the control group; differences between the groups in the incidence of hypercholesterolemia and hypertension were undetectable. As compared with conventional therapy, bariatric surgery appears to be a viable option for the treatment of severe obesity, resulting in long-term weight loss, improved lifestyle, and, except for hypercholesterolemia, amelioration in risk factors that were elevated at baseline. Weight loss is associated with short-term amelioration and prevention of metabolic and cardiovascular risk, but whether these benefits persist over time is unknown.BACKGROUNDWeight loss is associated with short-term amelioration and prevention of metabolic and cardiovascular risk, but whether these benefits persist over time is unknown.The prospective, controlled Swedish Obese Subjects Study involved obese subjects who underwent gastric surgery and contemporaneously matched, conventionally treated obese control subjects. We now report follow-up data for subjects (mean age, 48 years; mean body-mass index, 41) who had been enrolled for at least 2 years (4047 subjects) or 10 years (1703 subjects) before the analysis (January 1, 2004). The follow-up rate for laboratory examinations was 86.6 percent at 2 years and 74.5 percent at 10 years.METHODSThe prospective, controlled Swedish Obese Subjects Study involved obese subjects who underwent gastric surgery and contemporaneously matched, conventionally treated obese control subjects. We now report follow-up data for subjects (mean age, 48 years; mean body-mass index, 41) who had been enrolled for at least 2 years (4047 subjects) or 10 years (1703 subjects) before the analysis (January 1, 2004). The follow-up rate for laboratory examinations was 86.6 percent at 2 years and 74.5 percent at 10 years.After two years, the weight had increased by 0.1 percent in the control group and had decreased by 23.4 percent in the surgery group (P<0.001). After 10 years, the weight had increased by 1.6 percent and decreased by 16.1 percent, respectively (P<0.001). Energy intake was lower and the proportion of physically active subjects higher in the surgery group than in the control group throughout the observation period. Two- and 10-year rates of recovery from diabetes, hypertriglyceridemia, low levels of high-density lipoprotein cholesterol, hypertension, and hyperuricemia were more favorable in the surgery group than in the control group, whereas recovery from hypercholesterolemia did not differ between the groups. The surgery group had lower 2- and 10-year incidence rates of diabetes, hypertriglyceridemia, and hyperuricemia than the control group; differences between the groups in the incidence of hypercholesterolemia and hypertension were undetectable.RESULTSAfter two years, the weight had increased by 0.1 percent in the control group and had decreased by 23.4 percent in the surgery group (P<0.001). After 10 years, the weight had increased by 1.6 percent and decreased by 16.1 percent, respectively (P<0.001). Energy intake was lower and the proportion of physically active subjects higher in the surgery group than in the control group throughout the observation period. Two- and 10-year rates of recovery from diabetes, hypertriglyceridemia, low levels of high-density lipoprotein cholesterol, hypertension, and hyperuricemia were more favorable in the surgery group than in the control group, whereas recovery from hypercholesterolemia did not differ between the groups. The surgery group had lower 2- and 10-year incidence rates of diabetes, hypertriglyceridemia, and hyperuricemia than the control group; differences between the groups in the incidence of hypercholesterolemia and hypertension were undetectable.As compared with conventional therapy, bariatric surgery appears to be a viable option for the treatment of severe obesity, resulting in long-term weight loss, improved lifestyle, and, except for hypercholesterolemia, amelioration in risk factors that were elevated at baseline.CONCLUSIONSAs compared with conventional therapy, bariatric surgery appears to be a viable option for the treatment of severe obesity, resulting in long-term weight loss, improved lifestyle, and, except for hypercholesterolemia, amelioration in risk factors that were elevated at baseline. |
| Author | Wedel, Hans Bouchard, Claude Sullivan, Marianne Lindroos, Anna-Karin Carlsson, Björn Narbro, Kristina Sjöström, Carl David Torgerson, Jarl Dahlgren, Sven Sjöström, Lars Peltonen, Markku Larsson, Bo |
| Author_xml | – sequence: 1 givenname: Lars surname: Sjöström fullname: Sjöström, Lars – sequence: 1 givenname: Carl David surname: Sjöström fullname: Sjöström, Carl David – sequence: 2 givenname: Anna-Karin surname: Lindroos fullname: Lindroos, Anna-Karin – sequence: 3 givenname: Markku surname: Peltonen fullname: Peltonen, Markku – sequence: 4 givenname: Jarl surname: Torgerson fullname: Torgerson, Jarl – sequence: 5 givenname: Claude surname: Bouchard fullname: Bouchard, Claude – sequence: 6 givenname: Björn surname: Carlsson fullname: Carlsson, Björn – sequence: 7 givenname: Sven surname: Dahlgren fullname: Dahlgren, Sven – sequence: 8 givenname: Bo surname: Larsson fullname: Larsson, Bo – sequence: 9 givenname: Kristina surname: Narbro fullname: Narbro, Kristina – sequence: 11 givenname: Marianne surname: Sullivan fullname: Sullivan, Marianne – sequence: 12 givenname: Hans surname: Wedel fullname: Wedel, Hans |
| BackLink | http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16365698$$DView record in Pascal Francis https://www.ncbi.nlm.nih.gov/pubmed/15616203$$D View this record in MEDLINE/PubMed https://gup.ub.gu.se/publication/55561$$DView record from Swedish Publication Index |
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| Snippet | The Swedish Obese Subjects Study followed obese subjects treated with gastric surgery and contemporaneously matched, conventionally treated obese controls.... Weight loss is associated with short-term amelioration and prevention of metabolic and cardiovascular risk, but whether these benefits persist over time is... Background Weight loss is associated with short-term amelioration and prevention of metabolic and cardiovascular risk, but whether these benefits persist over... BACKGROUND: Weight loss is associated with short-term amelioration and prevention of metabolic and cardiovascular risk, but whether these benefits persist over... |
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| SubjectTerms | Biological and medical sciences blood Body Mass Index complications Diabetes Mellitus Diabetes Mellitus - epidemiology Diabetes Mellitus - etiology Diabetes. Impaired glucose tolerance Endocrine pancreas. Apud cells (diseases) Endocrinopathies Energy Intake epidemiology etiology Etiopathogenesis. Screening. Investigations. Target tissue resistance Exercise Female Follow-Up Studies Gastric Bypass Gastroplasty General aspects Humans Hyperlipidemias Hyperlipidemias - epidemiology Hyperlipidemias - etiology Hypertension Hypertension - epidemiology Hypertension - etiology Hyperuricemia Hyperuricemia - epidemiology Hyperuricemia - etiology Incidence Insulin resistance Life Style Male Medical and Health Sciences Medical sciences Medicin och hälsovetenskap Middle Aged Mortality Obesity Obesity - blood Obesity - complications Obesity - mortality Obesity - surgery Risk Factors Surgery Treatment Outcome Weight control Weight Loss |
| Title | Lifestyle, Diabetes, and Cardiovascular Risk Factors 10 Years after Bariatric Surgery |
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