Evidence map›Paper›PMID 41697578›Full record

SynthesisObesity surgery2026

Efficacy of Metabolic and Bariatric Surgery Compared with GLP-1 Receptor Agonist Treatment in Preventing Mortality and Major Adverse Cardiac Events Among Individuals with Obesity and Type 2 Diabetes: A Systematic Review and Meta-analysis.

Joshua Chadwick, Chandru Sivamani, Suchitra Lakshmi, Vishali Baskaran, Swathi N L, Lavanya Ayyasamy, Ganeshkumar Parasuraman, Bhavani Shankara Bagepally

Abstract readComparative StudyMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Obesity surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Joshua ChadwickICMR-National Institute of Epidemiology, Chennai, India. joshuachadwick89@gmail.com.
Chandru SivamaniICMR-National Institute of Epidemiology, Chennai, India.
Suchitra LakshmiICMR-National Institute of Epidemiology, Chennai, India.
Vishali BaskaranSRM Institute of Science and Technology, Chennai, India.
Swathi N LManipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Lavanya AyyasamySRM Medical College Hospital and Research Centre, Chennai, India.
Ganeshkumar ParasuramanICMR-National Institute of Epidemiology, Chennai, India.
Bhavani Shankara BagepallyICMR-National Institute of Epidemiology, Chennai, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionObesity and type 2 diabetes mellitus (T2DM) significantly increase cardiovascular morbidity and mortality worldwide. Metabolic and bariatric surgery (MBS) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are effective interventions for T2DM and obesity, but comparative evidence on their long-term impact on major adverse cardiovascular events (MACE) and all-cause mortality is lacking. This systematic review and meta-analysis evaluated the efficacy of MBS versus GLP-1 RAs therapy in reducing these outcomes.

methodsThe review was registered in PROSPERO beforehand and carried out following the PRISMA framework. A comprehensive literature search identified randomized controlled trials (RCTs) and observational studies comparing MBS with GLP-1 RAs regimens in adults with obesity and T2DM. The primary outcomes were all-cause mortality and MACE. We used the Cochrane Risk of Bias 2.0 (ROB 2) tool and Newcastle-Ottawa Scale (NOS) to assess the quality of the study. Meta-analytic techniques were used to synthesize effect estimates.

resultsPooled analysis of eligible studies suggested that MBS offered greater reductions in both MACE and all-cause mortality than GLP-1 RAs therapy. The relative risk reduction for MACE was approximately 52% in favor of MBS. Despite notable heterogeneity, sensitivity analyses confirmed result robustness. The overall certainty of evidence was moderate, reflecting variations in populations, interventions, and study designs.

conclusionMBS offers significantly greater cardiovascular protection than GLP-1 RAs therapy in individual with obesity and T2DM, reducing MACE and all-cause mortality. GLP-1 RAs remains an important option, particularly for patients contraindicated for surgery or preferring pharmacotherapy. Further long-term comparative and cost effectiveness studies are needed to inform the clinical decisions.

Indexed as

Bariatric SurgeryCardiovascular DiseasesDiabetes Mellitus, Type 2Glucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsObesityHumansTreatment OutcomeGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsAll-cause mortalityLong-term CVD outcomesMACEObesityType 2 diabetes mellitus

Identifiers

PMID41697578
PMCPMC13038674

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.