O IMPACTO DA CIRURGIA BARIÁTRICA NO CONTROLE E REMISSÃO DE DOENÇAS METABÓLICAS E CARDIOVASCULARES: UMA ANÁLISE A LONGO PRAZO

Abstract

Introduction: Obesity has become a major global epidemic, significantly contributing to the burden of diseases by increasing the risk of diabetes, cardiovascular disease, and liver disease, as well as precipitating metabolic syndrome. Adipose tissue remodeling, involving angiogenesis, hypoxia, and inflammation, plays a key role in the development of obesity and related metabolic changes. Bariatric surgery has proven effective for weight control and the improvement of associated comorbidities, although the exact mechanisms behind its benefits remain unclear. Understanding these mechanisms could unlock new therapeutic strategies. Cardiovascular disease (CVD) associated with obesity is influenced by the effects of adipose tissue, which impacts the myocardium and blood vessels, leading to hypertension and renal dysfunction. Risk factors such as hypertension, diabetes, and chronic inflammation are prevalent, elevating the risk for severe cardiovascular conditions. Methodology: This systematic review utilized data from PubMed and LILACS over the last 10 years to analyze the effectiveness of bariatric surgery in the long-term control and remission of metabolic and cardiovascular diseases. Despite observed advances, gaps were identified in the literature, such as a lack of uniformity in techniques and outcomes, indicating a need for more controlled studies. Future research should investigate the techniques and technologies applied to bariatric surgery and their impact on complex conditions such as advanced diabetes and cardiovascular disease, potentially improving clinical outcomes and broadening the safe use of these interventions. Results and Discussion: The review began with 150 articles, of which 5 were selected after rigorous screening to evaluate the benefits and challenges of bariatric surgery. The studies indicate that procedures such as Roux-en-Y gastric bypass and vertical sleeve gastrectomy promote, beyond weight loss, significant hormonal and metabolic changes that benefit cardiovascular health and glycemic control. Frigolet highlights the transformation of adipose tissue, which reduces inflammation and adjusts adipokines like leptin and adiponectin, thereby lowering cardiovascular risk. Liao explores the impacts of surgery on microbiota and lipid profiles, contributing to more stable cardiovascular health. Veldhuisen notes the reduction in mortality and incidence of severe cardiac events in patients who underwent bariatric surgery. Wong, in turn, highlights benefits in renal function and reduced cardiovascular complications among diabetic patients. Conclusions: Bariatric surgery is an effective intervention for the long-term control and remission of metabolic and cardiovascular diseases, especially in obese patients with type 2 diabetes. The effects of surgery include hormonal and metabolic alterations that improve glycemic control and reduce cardiovascular risk, playing a crucial role in hypertension remission and lipid profile improvement. Studies confirm the surgery’s preventive effect against cardiovascular events and underscore the importance of continuous clinical follow-up to maximize benefits and adapt patient support.