Network meta-analysis of metabolic surgery procedures for the treatment of obesity and diabetes

Currie, Andrew C.; Askari, Alan; Fangueiro, Ana; Mahawar, Kamal

doi:10.1007/s11695-021-05643-z

Cited by 41Bariatric Surgery and OutcomesMinimally Invasive Surgical TechniquesDiabetes, Cardiovascular Risks, and Lipoproteins

Network meta-analysis of metabolic surgery procedures for the treatment of obesity and diabetes

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Currie, Andrew C., Askari, Alan, Fangueiro, Ana, Mahawar, Kamal·2021·Obesity Surgery

DOI 10.1007/s11695-021-05643-zPMC PMC8346344

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Abstract

Background Metabolic surgery is part of a well-established treatment intensification strategy for obesity and its related comorbidities including type 2 diabetes (T2DM). Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG) and one-anastomosis gastric bypass (OAGB) are the most commonly performed metabolic surgeries worldwide, but comparative efficacy is uncertain. This study employed network meta-analysis to compare weight loss, T2DM remission and perioperative complications in adults between RYGB, SG and OAGB.Methods MEDLINE, EMBASE, trial registries were searched for randomised trials comparing RYGB, SG and OAGB. Study outcomes were excess weight loss (at 1, 2 and 3-5 years), trial-defined T2DM remission at any time point and perioperative complications.Results Twenty randomised controlled trials were included involving 1803 patients investigating the three metabolic surgical interventions. RYGB was the index for comparison. The excess weight loss (EWL) demonstrated minor differences at 1 and 2 years, but no differences between interventions at 3-5 years. T2DM remission was more likely to occur with either RYGB or OAGB when compared to SG. Perioperative complications were higher with RYGB when compared to either SG or OAGB. Two-way analysis of EWL and T2DM remission against the risk of perioperative complications demonstrated OAGB was the most positive on this assessment at all time points.Conclusion OAGB offers comparable metabolic control through weight loss and T2DM remission to RYGB and SG whilst minimising perioperative complications. Registration number: CRD42020199779 (https:// www.crd.york.ac.uk/PROSPERO ).

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Metabolic surgery is effective for diabetes remission in people with type 2 diabetes and a BMI ≥25 kg/m2.
“Metabolic surgery also appears to be effective for diabetes remission in people with type 2 diabetes and a BMI $ 25 kg/m 2 , although ef fi cacy for both weight loss and diabetes remission appears to vary by surgical type (133 -135).”
From Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (2022) · cites this paper as [134]
The Discussion reports that metabolic surgery can induce type 2 diabetes remission, with remission more common after RYGB or OAGB than after SG. The Results table lists substantially higher BMI thresholds for the trials shown; the paper does not establish effectiveness across the full claimed BMI ≥25 kg/m² range. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Efficacy of metabolic surgery for weight loss and diabetes remission varies by surgical type.
“although ef fi cacy for both weight loss and diabetes remission appears to vary by surgical type (133 -135).”
From Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (2022) · cites this paper as [134]

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Comparison of Benefits and Risks of Metabolic Surgery for Long-Term (Over 5 Years) Weight Loss and Diabetes Remission in Overweight/Obese Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis of Randomized TrialsPreprint
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Authors: Currie, A. C., Askari, A., Fangueiro, A., & Mahawar, K.
Affiliations: St Peter's Hospital (GB)
Luton and Dunstable Hospital (GB)
Sunderland Royal Hospital (GB)
Corresponding author: Currie, Andrew C.
ORCID: Currie, Andrew C.
Askari, Alan
Mahawar, Kamal
Venue: Obesity Surgery
Publisher: Springer Science and Business Media LLC
Published: 2021-08-07
Volume: 31
Issue: 10
Pages: 4528-4541
ISSN: 0960-8923 (ISSN-L)
1708-0428
DOI: 10.1007/s11695-021-05643-z
PMC: PMC8346344
OpenAlex: W3187714336
Cited by: 41
References: 84
Citations by year: 2026: 2 · 2025: 7 · 2024: 11 · 2023: 15 · 2022: 6
FWCI: 1.93
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.springernature.com/gp/researchers/text-and-data-mining (tdm)
www.springernature.com/gp/researchers/text-and-data-mining (vor)
Locations: Obesity Surgery (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords: metabolic surgery, obesity
MeSH terms: Adult, Diabetes Mellitus, Type 2, Gastrectomy, Humans, Obesity, Obesity, Morbid, Retrospective Studies, Gastric Bypass, Treatment Outcome, Bariatric Surgery

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