368-OR: Life Expectancy and Causes of Death after Bariatric Surgery or Usual Care in Patients Stratified by Baseline Type 2 Diabetes in the Swedish Obese Subjects Study

Abstract

Introduction: Patients with and without type 2 diabetes (T2D) differ in terms of metabolic disturbances and cardiovascular risk factors. Thus, it is possible that the increased survival after surgical obesity treatment is due to reduction of different causes of death. Here, we determined mortality and causes of death after bariatric surgery in relation to baseline T2D status in the prospective controlled Swedish Obese Subjects (SOS) study. Methods: Deaths after bariatric surgery or usual care were determined in subgroups defined by baseline T2D (n=697) or non-T2D (n=3335) during a median follow-up of 26 years. The Swedish Cause of Death Register, case sheets and autopsy reports were assessed to determine the direct cause of death. Analyses were adjusted for preselected risk factors (age, sex, BMI and smoking at baseline, and year of inclusion in the study). Results In T2D and non-T2D subgroups, bariatric surgery was associated with increased life expectancy (2.1, 95% confidence interval (95% CI) 0.2-4.0 and 1.6, 0.5-2.7 years, respectively) and lower overall mortality (adjusted hazard ratio (adjHR)=0.77, 95% CI 0.61-0.97; and 0.82, 0.72-0.94, respectively), and the treatment benefit was similar (p for interaction 0.615). Bariatric surgery was associated with reduced cardiovascular mortality in both subgroups (adjHR=0.65, 95% CI 0.46-0.91; and 0.70, 0.55-0.88, respectively (p for interaction 0.516)). Conclusions: Bariatric surgery is associated with similar reduction of overall and cardiovascular mortality and increased life expectancy regardless of baseline diabetes status. Disclosure K.Sjöholm: None. J.C.Andersson assarsson: None. M.Taube: None. L.Carlsson ekander: None. Funding Swedish Research Council; Swedish State; Swedish Heart and Lung Foundation; Swedish Diabetes Foundation; Adlerbert Research Foundation