The Effect of Roux-en-Y gastric bypass and sleeve gastrectomy on adults with obesity and its Impact on Their Cardiovascular Risk Assessment Score in Abu Dhabi, United Arab Emirates

BACKGROUND Obesity is a global health issue with significant public health implications. In addition, obesity plays a role in the development of obesity-related chronic illnesses like type 2 diabetes [T2DM], dyslipidemia, hypertension [HTN], and major adverse cardiovascular events [MACE]. Metabolic and bariatric surgery leads to significant and sustained weight loss and improves T2DM, HTN, dyslipidemia, and a lower rate of MACEs. OBJECTIVE To assess the impact of Roux-en-Y gastric bypass [RYGB] and sleeve gastrectomy [SG] on Framingham risk score and the major modifiable cardiovascular risk factors including Type 2 Diabetes, dyslipidemia, and hypertension. MATERIALS AND METHODS A single-center retrospective cohort study, for all adult patients with obesity who underwent RYGB or SG at the Bariatric & Metabolic Institute (BMI Abu Dhabi) at Sheikh Khalifa Medical City (SKMC), United Arab Emirates (UAE) from January 2010 to December 2013. The cardiovascular risk score was calculated for 2 years before and 2 years after undergoing RYGB or SG for each patient. Electronic medical records were reviewed. All statistical analysis and data analysis were carried out using the R software, version 3.0.3 RESULTS During the study period, 363 adults with obesity underwent bariatric surgery at BMI Abu Dhabi (220 patients had Laparoscopic Roux-en Y gastric bypass (RYGB), 102 patients had Laparoscopic sleeve gastrectomy (SG), and 41 patients had other type of bariatric procedures). The overall risk reduction in cardiovascular risk score was 34.02% over 2 years from baseline. There was a significant reduction in the cardiovascular risk score in the first year after RYGB and SG followed by a plateau for the second year. Additionally, systolic blood pressure (SBP) improved by 9.02%, diastolic blood pressure (DBP) improved by 7.52%, and body mass index (BMI) improved by 39.93%. In addition, the total cholesterol, triglycerides, and low-density lipoprotein (LDL) levels declined by 9.07%, 29.98%, and 21.93% respectively. Furthermore, there was a considerable increase in high-density lipoprotein (HDL) levels of 35.65% over the same time, drop in glycated Hemoglobin (HbA1c) by 10.79%, drop in fasting blood glucose (FBS) by 10.30%, and drop in random blood glucose (RBG) by 15.55%. CONCLUSION A significant reduction in cardiovascular risk score after RYGB and SG was observed. In addition, RYGB and SG led to significant weight loss and improvement in other obesity-related medical conditions.