Bariatric Surgery and Cardiovascular Risk Factors

作者：Paul Poirier, Marc‐André Cornier, Theodore Mazzone, Sasha Stiles, Susan Cummings, Samuel Klein, Peter A. McCullough, Christine Ren Fielding, Barry A. Franklin · 发表于：Circulation · 年份：2011 · DOI：10.1161/cir.0b013e3182149099 · 被引用次数：339 · 研究领域：Bariatric Surgery and Outcomes、Diet and metabolism studies、Cardiovascular Disease and Adiposity

MetabolismT he rate of obesity is rising logarithmically, especially in those with severe obesity (body mass index [BMI] Ͼ40 kg/m 2 ).Cardiologists, endocrinologists, internists, family practitioners, and most healthcare professionals are increasingly confronted with the severely obese patient and with postoperative bariatric patients because obesity is associated with significant morbidity and increased mortality.In addition, more adolescents these days are severely obese.Substantial long-term successes of lifestyle modifications and drug therapy have been disappointing in this population.The National Institutes of Health has suggested that surgical therapy be proposed to those patients with BMI Ͼ40 kg/m 2 or Ͼ35 kg/m 2 with serious obesity-related comorbidities such as systemic hypertension, type 2 diabetes mellitus, and obstructive sleep apnea.When indicated, surgical intervention leads to significant improvements in decreasing excess weight and comorbidities that can be maintained over time.These include diabetes mellitus, dyslipidemia, liver disease, systemic hypertension, obstructive sleep apnea, and cardiovascular dysfunction.Recent prospective, nonrandomized, observational, or case-control population studies have also shown bariatric surgery to prolong survival in the severely obese.Different types of bariatric procedures are being performed.Historically, operative mortality was between 0.1% and 2.0% with more recent data not exceeding 1%.Early complications include p...