Microvascular complications of obesity and diabetes-Role of bariatric surgery

被引：15

作者：

Bashir, Bilal ^{[1
,2
]}

Iqbal, Zohaib ^{[1
,2
]}

Adam, Safwaan ^{[1
,3
]}

Ferdousi, Maryam ^{[1
]}

Chick, William ^{[4
]}

Hussein, Heleen A. ^{[5
]}

Syed, Akheel A. ^{[1
,6
]}

Le Roux, Carel W. ^{[7
]}

Cohen, Ricardo V. ^{[8
]}

Malik, Rayaz A. ^{[1
,9
]}

Soran, Handrean ^{[1
,2
]}

机构：

[1] Univ Manchester, Fac Biol Med & Hlth, Manchester, England

[2] Manchester Univ NHS Fdn Trust, Ctr Diabet Endocrinol & Metab, Manchester, England

[3] Christie NHS Fdn Trust, Dept Endocrinol, Manchester, England

[4] East & North Hertfordshire NHS Trust, Lister Hosp, Stevenage, England

[5] Hawler Med Univ, Coll Med, Erbil, Iraq

[6] Salford Royal Hosp NHS Fdn Trust, Dept Endocrinol Diabet & Obes Med, Salford, England

[7] Univ Coll Dublin, Conway Inst Biomol & Biomed Res, Diabet Complicat Res Ctr, Sch Med, Dublin, Ireland

[8] Oswaldo Cruz German Hosp, Ctr Obes & Diabet, Sao Paulo, Brazil

[9] Weill Cornell Med Qatar, Dept Med, Doha, Qatar

来源：

OBESITY REVIEWS | 2023年 / 24卷 / 10期

关键词：

bariatric surgery; metabolic syndrome; microvascular complications; obesity; Y GASTRIC BYPASS; GLOMERULAR-FILTRATION-RATE; BODY-MASS INDEX; PERIPHERAL NEUROPATHY; RISK-FACTORS; RENAL-FUNCTION; SUBCLINICAL INFLAMMATION; DENSITY-LIPOPROTEIN; PROSPECTIVE COHORT; WEIGHT-REDUCTION;

D O I：

10.1111/obr.13602

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Bariatric surgery in people with obesity can lead to long-term remission of type 2 diabetes mellitus (T2DM) and a reduction in the incidence of macrovascular complications. The impact of bariatric surgery on microvascular complications is less clear. In this narrative review, we sought to evaluate the effect of bariatric surgery on microvascular complications in patients with and without diabetes. The risk of developing microvascular complications is increased in people with obesity, and this is amplified in those with T2DM. The impact of metabolic surgery on microvascular complications is limited to a subgroup analysis of studies or statistical modeling to predict the glycemia-independent effect of bariatric surgery. While bariatric surgery halts the progression of retinopathy in those with minimal retinopathy, it may worsen in those with advanced retinopathy. Bariatric surgery improves proteinuria and major renal outcomes, regardless of the severity of renal impairment. Bariatric surgery in patients with obesity with or without diabetes is associated with an improvement in neuropathic symptoms and regeneration of small nerve fibers. In conclusion, bariatric surgery is associated with an improvement in microvascular complications. Further studies are needed to elucidate the underlying mechanisms for the favorable effect of bariatric surgery on microvascular outcomes.

引用

页数：20

共 137 条

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