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Effect of bariatric surgery on cardiometabolic risk in elderly patients: A population‐based study
Author(s) -
Batsis John A,
Miranda William R,
Prasad Chaithra,
CollazoClavell Maria L,
Sarr Michael G,
Somers Virend K,
LopezJimenez Francisco
Publication year - 2016
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/ggi.12527
Subject(s) - medicine , body mass index , obesity , dyslipidemia , waist , diabetes mellitus , population , blood pressure , type 2 diabetes , risk factor , metabolic syndrome , framingham risk score , framingham heart study , surgery , endocrinology , environmental health , disease
Aim Obesity is a major cardiovascular ( CV ) risk factor. Bariatric surgery ( BSx ) is an approved therapeutic alternative for class II–III obesity, but little evidence focuses on older adults. We assessed the effect of BSx on cardiometabolic variables and long‐term CV risk in older adults. Methods We carried out a population‐based, observational study from 1990–2009, of 40 consecutive elderly (age ≥60 years) residents of O lmsted C ounty, MN , USA, with class II – III obesity treated with BSx at a University‐based, academic health center. Data were obtained from the R ochester E pidemiology P roject. Metabolic syndrome ( MetS ) was defined using American Heart Association/National Heart, Lung, Blood Institute (AHA/NHLBI) criteria (increased triglycerides, low high‐density lipoprotein, increased blood pressure, increased glucose and body mass index as a modified measure of obesity instead of waist circumference). Change in CV risk factors, MetS prevalence, and impact on predicted CV risk using the Framingham risk score was ascertained at 1 year postoperatively and assessed statistically. Results Mean age and body mass index were 64.4 ± 3.7 and 45.0 ± 6.3 kg/m 2 , respectively, and 28 out of 40 (70%) were women. One participant died during the 11‐month study period after BSx from respiratory complications related to BSx , and one participant died at 2 years. Percentage of excess weight loss decreased by 57.5% at 1 year. Prevalence 1 year after BSx decreased for diabetes (57.5% to 22.5%; P < 0.03), hypertension 87.5% to 73.7% ( P = 0.003), dyslipidemia (80% to 42.5%; P < 0.001) and sleep apnea (62.5% to 23.7%; P < 0.001). MetS prevalence decreased from 80% to 45% ( P < 0.002). Baseline risk was 14.1%, which changed at follow up at 8.2%. Conclusions In older adults, BSx induces considerable weight loss, improves CV risk factors, decreases MetS prevalence and is an effective treatment in this population. Geriatr Gerontol Int 2016; 16: 618–624.