Frequency of cardiovascular risk factors before and 6 and 12 months after bariatric surgery

Maria Alayde Mendonça da Silva, Ivan Romero Rivera, Emília Maria Wanderley de Gusmão Barbosa, Maria Angélica Correia Crispim, Guilherme Costa Farias, Alberto Jorge Albuquerque Fontan, Rodrigo Azavedo Bezerra, Larissa Gabriella de Souza Sá
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Abstract

Objective

To compare the frequency of cardiovascular risk factors (CVRFs) in obese patients of the Brazilian Unified Health System (Sistema Único de Saúde – SUS) with indication of bariatric surgery during the preoperative period and after the sixth month and the first year of the procedure.

Methods

An observational, longitudinal, prospective, and analytical study was performed, with consecutive selection of obese patients with indication for surgery referred to preoperative cardiac evaluation. The protocol consisted of: medical history, physical examination, electrocardiogram, echocardiogram, and biochemical analysis. This study analyzed the following variables: weight, body mass index (BMI), waist circumference (WC), systemic arterial hypertension (SAH), diabetes mellitus type 2(DM), dyslipidemia (high LDL cholesterol; low HDL cholesterol; hypertriglyceridemia), and metabolic syndrome (MS). The chi-squared test and the Tukey-Kramer method were used for statistical analysis.

Results

The sample was composed of 96 obese people, among which 86 were women, aged between 18 and 58 years old (median 35 years old). At the end of six months, significant reductions of 88%, 95%, 71%, 89%, and 80% in the frequency of SAH, high LDL cholesterol, hypertriglyceridemia, DM, and MS could already be observed. A significant and small reduction in the frequency of low HDL cholesterol (24%) and abnormal WC (31%) was observed only at the end of 12 months. After six months and one year, weight and BMI experienced reductions of 33.4 kg and 44.3 kg, and 13.1 kg/m2 and 17.2 kg/m2, respectively.

Conclusion

The positive impact on weight loss and the reduction in BMI, WC, and in the frequency of CVRFs are already extremely significant after six months and remain so one year after bariatric surgery.

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减肥手术前及手术后6、12个月心血管危险因素的频率
目的比较巴西统一卫生系统(Sistema Único de Saúde - SUS)肥胖患者术前、手术后第6个月和第一年的心血管危险因素(cvrf)频率。方法采用观察性、纵向、前瞻性和分析性研究,连续选择有手术指征的肥胖患者进行术前心脏评估。方案包括:病史、体格检查、心电图、超声心动图和生化分析。本研究分析了以下变量:体重、身体质量指数(BMI)、腰围(WC)、全身性动脉高血压(SAH)、2型糖尿病(DM)、血脂异常(高LDL胆固醇;低高密度脂蛋白胆固醇;高甘油三酯血症)和代谢综合征(MS)。采用卡方检验和Tukey-Kramer法进行统计分析。结果本组96例肥胖者,其中女性86例,年龄18 ~ 58岁,中位年龄35岁。6个月后,SAH、高LDL胆固醇、高甘油三酯血症、糖尿病和多发性硬化症的发生率分别显著降低88%、95%、71%、89%和80%。仅在12个月结束时观察到低高密度脂蛋白胆固醇(24%)和异常WC(31%)的频率有显著而小的减少。6个月和1年后,体重和BMI分别下降了33.4 kg和44.3 kg, 13.1 kg/m2和17.2 kg/m2。结论在减肥手术6个月后,对体重减轻、BMI、WC和cvrf频率的降低的积极影响已经非常显著,并且在减肥手术后一年内仍然如此。
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