Metabolic and Bariatric Surgery vs Glucagon-like peptide-1 Receptor Agonist Therapy

作者：Wissam Ghusn, Robert A. Vierkant, Noura Jawhar, Tala Abedalqader, Nour El Ghazal, Maria Antonia Espinosa, Jose Villamarin, Rene Rivera Gutierrez, Regina Castaneda, Dima Bechenati, Sima Fansa, Maria D. Hurtado, Andres Acosta, Omar M. Ghanem · 发表于：Annals of Surgery · 年份：2026 · DOI：10.1097/sla.0000000000007064 · 被引用次数：2 · 研究领域：Diabetes Treatment and Management、Bariatric Surgery and Outcomes、Cardiovascular Disease and Adiposity

OBJECTIVE: To compare 1-year changes in estimated 10-year and lifetime atherosclerotic cardiovascular disease (ASCVD) risk following metabolic and bariatric surgery (MBS) versus glucagon-like peptide-1 receptor agonist (GLP-1RA) therapy among adults with obesity. SUMMARY BACKGROUND DATA: Obesity is a major driver of ASCVD through adverse metabolic and inflammatory pathways. Metabolic and bariatric surgery and GLP-1 receptor agonists represent the most effective contemporary treatments for obesity and are increasingly used to mitigate cardiovascular risk. However, their comparative effects on integrated short-term and lifetime ASCVD risk in real-world clinical practice remain incompletely characterized. METHODS: We conducted a retrospective cohort study of adults with obesity (body mass index ≥30 kg/m²) who underwent MBS or initiated GLP-1RA therapy between 2020 and 2023 within a large tertiary health care system in the United States. Participants were identified from electronic health records and followed for 12 months. Primary outcomes were 1-year changes in estimated 10-year and lifetime ASCVD risk. Secondary outcomes included percent total body weight loss, blood pressure, and lipid parameters. Multivariable linear regression models were used to adjust for baseline body mass index and baseline ASCVD risk. RESULTS: The final cohort included 812 patients, of whom 579 underwent MBS and 233 initiated GLP-1RA therapy. At baseline, patients receiving GLP-1RAs were older and had ...