TY - JOUR
T1 - Long-term mortality and incidence of cardiovascular diseases and type 2 diabetes in diabetic and nondiabetic obese patients undergoing gastric banding
T2 - A controlled study
AU - Pontiroli, Antonio Ettore Maria
AU - Zakaria, Ahmed S.
AU - Mantegazza, Ermanno
AU - Morabito, Alberto
AU - Saibene, Alessandro
AU - Mozzi, Enrico Stefano Maria
AU - Micheletto, Giancarlo
AU - Veronelli, A.
AU - Zecchini, Barbara
AU - Zakaria, Ahmed
AU - Frigè, Francesca
AU - Rossetti, Luca
AU - Benetti, A.
AU - Cristina, Maurizio
AU - Paganelli, Michele
AU - Vedani, Paola
AU - Ceriani, Valerio
AU - Angeletti, Maria Grazia
AU - Autelitano, Mariangela
AU - D'Oro, L. C.
AU - Berni, Piergiorgio
AU - Russo, Antonio Giampiero
PY - 2016/2/27
Y1 - 2016/2/27
N2 - Background and aim: Aim of this retrospective study was to compare long-term mortality and incidence of new diseases [diabetes and cardiovascular (CV) disease] in morbidly obese diabetic and nondiabetic patients, undergoing gastric banding (LAGB) in comparison to medical treatment. Patients and methods: Medical records of obese patients [body mass index (BMI) > 35 kg/m2 undergoing LAGB (n = 385; 52 with diabetes) or medical treatment (controls, n = 681; 127 with diabetes), during the period 1995-2001 (visit 1)] were collected. Patients were matched for age, sex, BMI, and blood pressure. Identification codes of patients were entered in the Italian National Health System Lumbardy database, that contains life status, causes of death, as well as exemptions, drug prescriptions, and hospital admissions (proxies of diseases) from visit 1 to September 2012. Survival was compared across LAGB patients and matched controls using Kaplan-Meier plots adjusted Cox regression analyses. Results: Observation period was 13.9 ± 1.87 (mean ± SD). Mortality rate was 2.6, 6.6, and 10.1 % in controls at 5, 10, and 15 years, respectively; mortality rate was 0.8, 2.5, and 3.1 % in LAGB patients at 5, 10, and 15 years, respectively. Compared to controls, surgery was associated with reduced mortality [HR 0.35, 95 % CI 0.19-0.65, p <0.001 at univariate analysis, HR 0.41, 95 % CI 0.21-0.76, p <0.005 at adjusted analysis], similar in diabetic [HR 0.34, 95 % CI 0.13-0.87, p = 0.025] and nondiabetic [HR 0.42, 95 % CI 0.19-0.97, p = 0.041] patients. Surgery was also associated with lower incidence of diabetes (15 vs 48 cases, p = 0.035) and CV diseases (52 vs 124 cases, p = 0.048), and of hospital admissions (88 vs 197, p = 0.04). Conclusion: Up to 17 years, gastric banding is associated with reduced mortality in diabetic and nondiabetic patients, and with reduced incidence of diabetes and cardiovascular diseases.
AB - Background and aim: Aim of this retrospective study was to compare long-term mortality and incidence of new diseases [diabetes and cardiovascular (CV) disease] in morbidly obese diabetic and nondiabetic patients, undergoing gastric banding (LAGB) in comparison to medical treatment. Patients and methods: Medical records of obese patients [body mass index (BMI) > 35 kg/m2 undergoing LAGB (n = 385; 52 with diabetes) or medical treatment (controls, n = 681; 127 with diabetes), during the period 1995-2001 (visit 1)] were collected. Patients were matched for age, sex, BMI, and blood pressure. Identification codes of patients were entered in the Italian National Health System Lumbardy database, that contains life status, causes of death, as well as exemptions, drug prescriptions, and hospital admissions (proxies of diseases) from visit 1 to September 2012. Survival was compared across LAGB patients and matched controls using Kaplan-Meier plots adjusted Cox regression analyses. Results: Observation period was 13.9 ± 1.87 (mean ± SD). Mortality rate was 2.6, 6.6, and 10.1 % in controls at 5, 10, and 15 years, respectively; mortality rate was 0.8, 2.5, and 3.1 % in LAGB patients at 5, 10, and 15 years, respectively. Compared to controls, surgery was associated with reduced mortality [HR 0.35, 95 % CI 0.19-0.65, p <0.001 at univariate analysis, HR 0.41, 95 % CI 0.21-0.76, p <0.005 at adjusted analysis], similar in diabetic [HR 0.34, 95 % CI 0.13-0.87, p = 0.025] and nondiabetic [HR 0.42, 95 % CI 0.19-0.97, p = 0.041] patients. Surgery was also associated with lower incidence of diabetes (15 vs 48 cases, p = 0.035) and CV diseases (52 vs 124 cases, p = 0.048), and of hospital admissions (88 vs 197, p = 0.04). Conclusion: Up to 17 years, gastric banding is associated with reduced mortality in diabetic and nondiabetic patients, and with reduced incidence of diabetes and cardiovascular diseases.
KW - Adjustable gastric banding
KW - Bariatric surgery
KW - Cardiovascular disease
KW - Cox proportional hazards model
KW - Diabetes mellitus
KW - Exemptions
KW - Hospital admissions
KW - ICD10
KW - Kaplan-Meier
KW - Mortality
KW - Obesity
KW - Prevention of cardiovascular disease
KW - Prevention of diabetes
KW - Survival
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U2 - 10.1186/s12933-016-0347-z
DO - 10.1186/s12933-016-0347-z
M3 - Article
SN - 1475-2840
VL - 15
JO - Cardiovascular Diabetology
JF - Cardiovascular Diabetology
IS - 1
M1 - 39
ER -