• Tingting Wu, Wong Simon Kin Hung SKH Department of Surgery, Prince of Wales Hospital, Hong Kong SAR, China., Betty Tsz Ting Law, Eleanor Grieve, Olivia Wu, Tong Daniel King Hung DKH Surgery Centre, Hong Kong Sanatorium & Hospital, University of Glasgow, Hong Kong SAR, China., David Kai Wing Leung, Lam Cindy Lo Kuen CLK 0000-0001-7536-8481 Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong SAR, China., and Wong Carlos King Ho CKH 0000-0002-6895-6071 Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong SAR, China..
• Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong SAR, China.
• Diabetes Metab. Res. Rev. 2020 Mar 1; 36 (3): e3236.

AimsTo compare disease remission rates, weight loss, and changes of metabolic parameters of patients after bariatric surgery with nonsurgical patients.MethodsBased on the 2006-2017 Hospital Authority database, a population-based retrospective cohort of obese type 2 diabetes mellitus (T2DM) patients with and without bariatric surgery were identified. Surgical patients were matched with nonsurgical patients on 1-to-5 propensity score. Remission rates of diabetes, hypertension, and dyslipidaemia were reported annually up to 60 months. Changes in weight loss measurements (Body Mass Index [BMI], percentage of total weight loss [%TWL], percentage of excess weight loss [%EWL], and percentage of rebound in excess weight loss [%REWL]) and metabolic parameters (haemoglobin A1c [HbA1c ], systolic blood pressure [SBP], diastolic blood pressure [DBP], and low-density lipoprotein cholesterol [LDL-C]) were measured for both groups.ResultsFour hundred one surgical patients (310 restrictive surgeries; 91 bypass surgeries) and 1894 nonsurgical patients were included. Surgical patients had higher remission rates in diabetes and dyslipidaemia and better glycaemic control at 12 to 60 months (all Ps < .01). SBP and DBP were significantly lower for surgical group up to 12 months and similar between two groups after 12 months. Surgical patients had significantly lower BMI during follow-up period. %TWL and %EWL were higher in the surgery group (15.7% vs 3.7%; 48.8% vs 12.0%) at 60 months (P < .001); differences in %REWL between two groups were insignificant. The effectiveness of restrictive and bypass surgeries was similar at 60 months, although restrictive surgeries were slightly more effective in T2DM remission.ConclusionsBariatric surgery was effective in weight loss, remission of diabetes, and dyslipidaemia in 5-year post-surgery.© 2020 John Wiley & Sons, Ltd.

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