The trend of atherogenic indices in patients with type 2 diabetes after bariatric surgery: a national cohort study

Abstract

Background: Bariatric surgery has profound effects on weight loss, metabolic regulation, and gut hormone modulation, which make it an efficient tool for managing obesity and improving diabetes outcomes. Objectives: The objective of this study is to evaluate the atherogenic indices, including atherogenic index of plasma (AIP), atherogenic coefficient (AC), Castelli's risk index II (CRI-II), and lipoprotein combine index (LCI) in individuals with type 2 diabetes (T2D) living with excess weight, who have undergone bariatric surgery. Setting: Three types of surgery including one-anastomosis gastric bypass/mini gastric bypass (OAGB/MGB), sleeve gastrectomy (SG), and Roux-en-Y gastric bypass (RYGB) were performed on patients with obesity and T2D in the period of August 2009 to February 2021 at the Surgical Department of Hazrat-e Rasool Hospital (University Hospital), Tehran, Iran. Methods: In this retrospective cohort, 1246 individuals with obesity and T2D who underwent 3 types of bariatric surgery including RYGB, SG, and OAGB/MGB were studied for 2 years after the surgery; the data were derived from the National Iranian Obesity Surgery Database. Afterward, the trend of biochemical parameters, total weight loss (TWL), and atherogenesis-related indices were evaluated from baseline up to 2 years in 5 follow-up visits. Results: A total of 1246 patients with T2D and obesity who underwent bariatric surgery were included in this study. The trend of all atherogenesis-related indices, including AIP, LCI, CRI-II, and AC, showed a significant reduction (49.2, 53.4, 20.8, 22, respectively) 2 years after the bariatric surgery (P < .05). In the 6-month follow-up, 1-year follow-up, and 2-year follow-up, 1023 (83.10), 719 (57.70), and 341 (27.36) individuals participated, respectively. In addition, a significant increase in high-density lipoprotein cholesterol levels was observed 2 years after the surgery in both sexes (P <.05). Conclusions: The bariatric surgery significantly reduced the levels of atherogenic indices including AIP, CRI-II, LCI, and AC. (c) 2025 Published by Elsevier Inc. on behalf of American Society for Metabolic and Bariatric Surgery.