Analysis Using Various Models on the Effect of Metabolic Surgery on Cardiovascular Disease Risk in the Chinese Population with Obesity

Figures & data

Table 1 Patient Demographics Grouped According to LSG and RYGB

Characteristic	All, n=64	LSG(n=24)	RYGB(n=40)	P
Age, yr	45.00(38.25,50.75)	42.88±6.33	47.50(39.25,53.75)	0.043
Male(Female)	32(32)	12(12)	20(20)	1
Smoking(%)	8(12.50%)	4(16.67%)	4(10.00%)	0.696
Rate of T2DM	54(84.38%)	14(58.33%)	40(100%)	<0.001
Duration of diabetes	3.00(1.00,8.00)	0.50(0.00,2.50)	6.50(2.00,8.75)	<0.001
Weight, kg	88.50(80.00,105.00)	103.88±16.93	83.50(77.00,93.50)	<0.001
BMI, kg/m^2	32.30(29.13,37.65)	37.33(32.90,39.56)	30.98(27.95,33.42)	<0.001
WC, cm	107.52±12.75	112.92±10.96	104.29±12.78	0.005
SBP, mmHg	130.00(120.00,150.00)	136.54±19.32	130.00(120.00,147.50)	0.651
DBP, mmHg	80.00(77.25,90.00)	82.50(76.50,91.50)	80.00(77.25,90.00)	0.618
FPG, mmol/L	8.37(6.36,11.56)	6.00(5.16,7.49)	10.39(7.49,13.08)	<0.001
PBG, mmol/L	15.68(9.82,21.50)	9.57(7.23,14.32)	19.25±5.48	<0.001
HbA1C,%	6.85(6.00,9.00)	5.95(5.70,6.73)	7.55(6.78,9.40)	<0.001
TC, mmol/L	5.14±1.11	5.08±0.73	5.18±1.29	0.689
TG, mmol/L	1.89(1.32,3.55)	1.73(1.22,2.17)	2.50(1.42,3.94)	0.03
HDL, mmol/L	1.00(0.87,1.11)	1.02(0.91,1.10)	0.99±0.21	0.409
LDL, mmol/L	2.87±0.88	3.08±0.86	2.74±0.88	0.134

Abbreviations: BMI, body mass index; yr, year; LSG, Laparoscopic sleeve gastrectomy; RYGB, Roux-en-Y gastric bypass; WC, waist circumference; SBP, systolic blood pressure; DBP, diastolic blood pressure; FPG, fasting plasma glucose; PBG, Postprandial Blood Glucose; HbA1c, glycosylated hemoglobin; TC, serum total cholesterol; TG, serum triglycerides; HDL, high-density lipoprotein; LDL, low-density lipoprotein.

Figure 1 Trends in weight loss and metabolic indicators from baseline to 3 months and 12 months postoperative for the overall and in both LSG and RYGB data sets. (A-I) represents trends in weight loss and metabolic markers in the total, LSG, and RYGB datasets from baseline to 3 and 12 months post-operative.

Notes: A-I represents box plots of changes in BMI, WC, FPG, HbA1c, SBP, DBP, TC, HDL, and LDL before, 3 months and 12 months after surgery, respectively.

Table 2 10-Year Change in CVD Risk Calculated by Different Cardiovascular Risk Models in LSG and RYGB

CVD Risk	pre-op	3 Months Operation-op	12 Months Operation-op	P	P1	P2	P3
LSG/RYGB
CHINA-PAR
ALL	6.3(2.85,11.28)	2.8(1.5,5.4)	2.0(0.95,4.85)	<0.001	<0.001	<0.001	0.201
LSG	4.55(2.13,9.43)	2.1(1.05,5.4)	1.00(0.85,2.4)	0.002	0.041	0.001	0.092
RYGB	7.7(3.7,11.68)	3.2(1.95,5.48)	2.7(1.3,5.4)	0.001	0.003	0.002	0.665
FRS (LIPID)
ALL	11.65(6.8,18.78)	6.8(4,10.5)	4.5(1.6,6.95)	<0.001	<0.001	<0.001	0.087
LSG	9.00(5,19.53)	4.4(2.45,10.8)	3.8(1.7,6.05)	0.015	0.047	0.007	0.26
RYGB	13.85(9.35,18)	7.25(4.55,10.3)	4.8(1.1,7.8)	<0.001	0.001	<0.001	0.178
FRS (BMI)
ALL	13.65(7.68,19.95)	7.6(3.8,10.5)	6.5(3.2,9.5)	<0.001	<0.001	<0.001	0.41
LSG	11.7(4.73,20.03)	6.5(2.4,10)	4.6(1.9,7.4)	0.009	0.017	0.006	0.436
RYGB	14.55(9.78,19.93)	8.3(5.35,10.65)	6.9(4.1,10.4)	<0.001	<0.001	<0.001	0.634
WHO (TC)
ALL	8(5.25,12.75)	5(3,7)	4(2,6)	<0.001	<0.001	<0.001	0.243
LSG	8(3.25,10)	3(2,7)	3(2,4)	0.007	0.017	0.005	0.379
RYGB	9.5(6,14)	6(4,8.25)	4(3,7)	<0.001	<0.001	<0.001	0.339
WHO (BMI)
ALL	5(3,8.75)	4(3,6)	4(3,6)	0.114	-	-	-
LSG	4(3,9)	4(3,7)	3.5(2.75,5.25)	0.399	-	-	-
RYGB	5(3,8)	4(3,5.25)	4(3,6)	0.206	-	-	-
GLOBAL RISK (BMI)
ALL	6(4,10)	4(3,6)	4(2,6.5)	<0.001	0.001	<0.001	0.477
LSG	8(4,10)	4(2.5,7)	3(2,4)	0.005	0.035	0.002	0.163
RYGB	6(4,10)	4(3,6)	4(2,7)	0.015	0.008	0.038	0.875
GLOBAL RISK (TC)
ALL	12(7,18)	5(3,9)	3(2,8)	<0.001	<0.001	<0.001	0.2
LSG	8.5(4,16)	3(3,7)	2(2,3)	0.001	0.009	<0.001	0.152
RYGB	13(8,18)	6(3.75,10)	4(3,8)	<0.001	<0.001	<0.001	0.425

Notes: P: Differences among the three groups; P1: Differences between preoperative and 3 months postoperative; P2: Differences between preoperative and 12 months postoperative; P3: Difference between 3 and 12 months post-operative.

Table 3 Comparison of the 10-Year Risk of CVD After LSG and RYGB by Different Risk Models

CVD Risk	Pre-op	12 Months Operation-op	RRR(%)	P4	P5	P6
LSG/RYGB
CHINA-PAR
LSG	4.55(2.13,9.43)	1.00(0.85,2.4)	0.70(0.5,0.77)	0.188	0.036	0.699
RYGB	7.7(3.7,11.68)	2.7(1.3,5.4)	0.62(0.46,0.80)
FRS (LIPID)
LSG	9.00(5,19.53)	3.8(1.7,6.05)	0.54(0.31,0.85)	0.112	0.502	0.65
RYGB	13.85(9.35,18)	4.8(1.1,7.8)	0.71(0.10,0.85)
FRS (BMI)
LSG	11.7(4.73,20.03)	4.6(1.9,7.4)	0.55(0.51,0.71)	0.349	0.169	0.887
RYGB	14.55(9.78,19.93)	6.9(4.1,10.4)	0.57(0.48,0.71)
WHO (TC)
LSG	8(3.25,10)	3(2,4)	0.5(0.2,0.7)	0.026	0.054	0.381
RYGB	9.5(6,14)	4(3,7)	0.59(0.42,0.71)
WHO (BMI)
LSG	4(3,9)	3.5(2.75,5.25)	0.33(0.25,0.47)	0.699	0.403	0.823
RYGB	5(3,8)	4(3,6)	0.23(0,0.59)
GLOBAL RISK (TC)
LSG	8.5(4,16)	2(2,3)	0.75(0.5,0.78)	0.027	0.044	0.984
RYGB	13(8,18)	4(3,8)	0.7(0.36,0.84)
GLOBAL RISK (BMI)
LSG	8(4,10)	3(2,4)	0.5(0.33,0.55)	0.867	0.232	0.395
RYGB	6(4,10)	4(2,7)	0.4(0.14,0.6)

Notes: P4: LSG vs RYGB preoperatively; P5: LSG vs RYGB 1 year postoperatively; P6: RRR between LSG and RYGB.

Table 4 30-Year Change in CVD Risk Calculated by FRS in LSG and RYGB

CVD Risk	Pre-op	3 Months Operation-op	12 Months Operation-op	P	P1	P2	P3
LSG/RYGB
FRS-FULL (LIPID)
ALL	53.5(33.5,69.25)	32(21.8,45)	20(10,38.5)	<0.001	<0.001	<0.001	0.207
LSG	44(24.5,69.75)	24(14,44)	17.5(9.5,35)	0.03	0.022	0.035	0.804
RYGB	59.5(40.75,69.25)	36.7(27.75,45.4)	22(8,46)	<0.001	<0.001	<0.001	0.163
FRS-HARD (LIPID)
ALL	36(22,51)	19(11,28)	12(4,20)	<0.001	<0.001	<0.001	0.172
LSG	23.5(14,50)	12(7,26.5)	9.5(4,18.5)	0.029	0.024	0.031	0.744
RYGB	39(31,52)	25(13.7,31.25)	12(3,21)	<0.001	<0.001	<0.001	0.153
FRS-FULL (BMI)
ALL	59.5(40.25,72)	35(24,45)	30(16,37.5)	<0.001	<0.001	<0.001	0.15
LSG	57(27,75.75)	28(13.5,42)	21(11.75,31.5)	0.001	0.005	0.001	0.342
RYGB	60(49.5,71.5)	40(29,46.25)	34(20,41)	<0.001	<0.001	<0.001	0.21
FRS-HARD (BMI)
ALL	43(28.25,61.5)	23(14,33)	17(8.5,24)	<0.001	<0.001	<0.001	0.179
LSG	40(16.75,64.5)	17(6.5,27)	13(5.75,19.75)	0.001	0.003	0.002	0.481
RYGB	45.5(36,56.75)	27(15.75,34)	18(10,28)	<0.001	<0.001	<0.001	0.197

Notes: P: Differences among the three groups; P1: Differences between preoperative and 3 months postoperative; P2: Differences between preoperative and 12 months postoperative; P3: Difference between 3 and 12 months post-operative.

Table 5 Comparison of the 30-Year Risk of CVD After LSG and RYGB by Different Risk Models

CVD Risk	Pre-op	12 Months Operation-op	RRR(%)	P4	P5	P6
LSG/RYGB
FRS-FULL (LIPID)
LSG	44(24.5,69.75)	17.5(9.5,35)	0.54(−0.31,0.61)	0.03	0.792	0.502
RYGB	59.5(40.75,69.25)	22(8,46)	0.60(0.03,0.79)
FRS-HARD (LIPID)
LSG	23.5(14,50)	9.5(4,18.5)	0.52(−0.21,0.71)	0.03	0.855	0.231
RYGB	39(31,52)	12(3,21)	0.71(0.08,0.87)
FRS-FULL (BMI)
LSG	57(27,75.75)	21(11.75,31.5)	0.58(0.51,0.65)	0.338	0.123	0.502
RYGB	60(49.5,71.5)	34(20,41)	0.52(0.33,0.69)
FRS-HARD (BMI)
LSG	40(16.75,64.5)	13(5.75,19.75)	0.63(0.56,0.74)	0.261	0.157	0.951
RYGB	45.5(36,56.75)	18(10,28)	0.65(0.39,0.76)

Notes: P4: LSG vs RYGB preoperatively; P5: LSG vs RYGB 1 year postoperatively; P6: RRR between LSG and RYGB.