• Skip to primary navigation
  • Skip to main content

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Awards
    • Who Is SAGES?
    • Leadership
    • Our Mission
    • Advocacy
    • Committees
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Committee Rosters
      • SAGES Past Presidents
  • Meetings
    • SAGES NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2026 Scientific Session Call for Abstracts
      • 2026 Emerging Technology Call for Abstracts
    • CME Claim Form
    • SAGES Past, Present, Future, and Related Meeting Information
    • SAGES Related Meetings & Events Calendar
  • Join SAGES!
    • Membership Application
    • Membership Benefits
    • Membership Types
      • Requirements and Applications for Active Membership in SAGES
      • Requirements and Applications for Affiliate Membership in SAGES
      • Requirements and Applications for Associate Active Membership in SAGES
      • Requirements and Applications for Candidate Membership in SAGES
      • Requirements and Applications for International Membership in SAGES
      • Requirements for Medical Student Membership
    • Member Spotlight
    • Give the Gift of SAGES Membership
  • Patients
    • Join the SAGES Patient Partner Network (PPN)
    • Patient Information Brochures
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find A SAGES Surgeon
  • Publications
    • Sustainability in Surgical Practice
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • Patient Information From SAGES
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • MesSAGES – The SAGES Newsletter
    • COVID-19 Archive
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • Avoid Opiates After Surgery
    • SAGES Subscription Catalog
    • SAGES TV: Home of SAGES Surgical Videos
    • The SAGES Safe Cholecystectomy Program
    • Masters Program
    • Resident and Fellow Opportunities
      • SAGES Free Resident Webinar Series
      • Fluorescence-Guided Surgery Course for Fellows
      • Fellows’ Career Development Course
      • SAGES Robotics Residents and Fellows Courses
      • MIS Fellows Course
    • SAGES S.M.A.R.T. Enhanced Recovery Program
    • SAGES @ Cine-Med Products
      • SAGES Top 21 Minimally Invasive Procedures Every Practicing Surgeon Should Know
      • SAGES Pearls Step-by-Step
      • SAGES Flexible Endoscopy 101
    • SAGES OR SAFETY Video Activity
  • Opportunities
    • Fellowship Recognition Opportunities
    • SAGES Advanced Flexible Endoscopy Area of Concentrated Training (ACT) SEAL
    • Multi-Society Foregut Fellowship Certification
    • Research Opportunities
    • FLS
    • FES
    • FUSE
    • Jobs Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search the SAGES Site
    • Guidelines Search
    • Video Search
    • Search Images
    • Search Abstracts
  • OWLS/FLS
  • Login

Cardiovascular Risk in Obese and Diabetic Patients Is Significantly Reduced One Year After Gastric Bypass Compared to a One Year of Diabetes Support and Education

Alessandro Mor, MD, Philip Omotosho, MD, Alfonso Torquati, MD. Department of Surgery, Duke University.

INTRODUCTION – Roux-en-Y Gastric Bypass (RYGB) has been proven effective in reducing most of the obesity-related comorbidities that concur to increase the cardiovascular risk in obesity. The Framingham Risk Score (FRS) is designed to be independent of weight and estimates the 10-year risk for coronary heart disease (CHD), myocardial infarction, stroke, cardiovascular disease (CVD), and death from CHD and from CVD. For the first time, we prospectively studied two obese populations with type 2 diabetes (T2DM) matched by weight and most of the risk factors that mainly impact the FRS (age, gender, blood pressure, serum cholesterol and smoking status). Our aim was to evaluate the RYGB effectiveness on improving cardiovascular risk when compared to a control medical group not participating in designed weight-loss intervention. We hypothesize that obese diabetic patients who undergo RYGB will significantly reduce their FRS compared to matched diabetic subjects who undergo Diabetes Support and Education program (DSE).

METHODS – In a prospective cohort study, we evaluated preoperatively and at 12-month sixty-one morbidly obese subjects (BMI 41.7±0.6 kg/m2) with T2DM. 30 patients underwent laparoscopic RYGB and 31 patients received 1-year of DSE, consisting of educational sessions on diet/nutrition, exercise and living with diabetes. The two groups were matched according to gender, age, weight, waist circumferences, systolic blood pressure, serum cholesterol and triglyceride levels, and menopausal status. The cardiovascular risk was assessed at baseline and at 1-year follow-up in both groups using the strict gender-specific Framingham Risk Score which is based on age, total cholesterol, HDL cholesterol, blood pressure, ECG evidence of left ventricular hypertrophy and smoking and diabetes status. Pre- and postoperative variables were compared using a paired sample t-test. The independent t-test was used to determine differences between the two groups.

RESULTS – Change in BMI was -12.20±0.8 Kg/m2 in the RYGB group and 0.3±0.4 Kg/m2 in the DSE group (respectively, P<0.001 and P=0.446). As shown in Table1, the two groups were matched for baseline FRS. After 12 months of intervention, RYGB experienced a significant decrease in all the FRS, whereas control subjects did not show this significant decrease for the 10-year risk for CHD, CVD and death from CVD. The between-group differences for the changes from baseline to 12-month in all the FRS were significant. No Spreaman’s correlations between reduction in FRS and %EWL were found in the RYGB surgery.

Table1. Outcomes calculated using the gender-specific FRS. Data are presented with mean±SEM. CHD, coronary hearth disease; MI, Myocardial infarction; CVD, Cardiovascular disease; CHD-death, death from CHD; CVD-death, death from CVD.

CONCLUSIONS – In a population of diabetic obese patients, the RYGB’s benefits on FRS has never been prospectively compared to the effects of a diabetes support and education program in a matched control group who did not undergo bariatric surgery. As expected, the long-term effects of RYGB surgery on FRS are independent on weight loss and, as we hypothesized, a significant improvement of the cardiovascular risk is observed in morbidly obese patients with diabetes who underwent RYGB, but not in those who were offered DSE.

61

Share this:

  • Click to share on X (Opens in new window) X
  • Click to share on X (Opens in new window) X
  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to share on Reddit (Opens in new window) Reddit
  • Click to share on Pocket (Opens in new window) Pocket
  • Click to share on Mastodon (Opens in new window) Mastodon

Related



  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2025 Society of American Gastrointestinal and Endoscopic Surgeons