Neurological complications such as peripheral neuropathies are the most common complications among patients with morbid obesity following bariatric surgery. Reduction in nutrient intake especially thiamin may develop polyneuropathy, while neuropathic symptoms improved in patients with diabetes independent of glycemic control after bariatric surgery. The aim of the present review is to investigate the effect of bariatric surgery on peripheral neuropathy. Electronic literature search was done via scientific search engines. After the removal of duplicates and selection of articles of interest, 4 studies were included. A random effects model was applied in this meta-analysis. Considering the pooled analysis, bariatric surgery was significantly associated with Neuropathy Symptoms Score (NSS) (ES = − 3.393, 95% CI (− 4.507, − 2.278), and P value < 0.0001). Reduction in NSS for patients with type 2 diabetes and BMI < 35 kg/m2 who were insulin-dependent was more than patients with morbid obesity without diabetes. Furthermore, neuropathy disability score (NDS) significantly decreased in patients having bariatric surgery (ES = − 0.626, 95% CI (− 1.120, − 0.132), and P value < 0.013). The NDS significantly decreased in patients with type 2 diabetes and BMI < 35 kg/m2 treated with insulin as well as patients with morbid obesity and type 2 diabetes. In subgroup of patients with follow-up of more than 6 months after surgery, a significant reduction in NDS was detected while this reduction was not significant in patients with a follow-up of 6 months or less. Bariatric surgery had a positive effect on peripheral neuropathy, though many studies showed neuropathy as one of the complications of bariatric surgery.
Obesity Bariatric surgery Peripheral neuropathy Symptom Disability
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This study was funded (grant No. 97-4-75-12930) and supported by Iran University of Medical Sciences.
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Conflict of Interest
The authors declare that they have no conflict of interest.
Ethical Approval Statement
This article does not contain any studies with human participants or animals performed by any of the authors.
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Does not apply.
Khosravi-Largani M, Nojomi M, Aghili R, et al. Evaluation of all types of metabolic bariatric surgery and its consequences: a systematic review and meta-analysis. Obes Surg. 2019;29(2):651–90.CrossRefPubMedGoogle Scholar
Lin I-C, Lin Y-L. Peripheral polyneuropathy after bariatric surgery for morbid obesity. J Fam Community Med. 2011;18(3):162–4.CrossRefGoogle Scholar
Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. Jama. 2004;292(14):1724–37.CrossRefPubMedGoogle Scholar
Gasteyger C, Suter M, Gaillard RC, et al. Nutritional deficiencies after Roux-en-Y gastric bypass for morbid obesity often cannot be prevented by standard multivitamin supplementation. Am J Clin Nutr. 2008;87(5):1128–33.CrossRefPubMedGoogle Scholar
Machado FCN, Valério BCO, Morgulis RNF, et al. Acute axonal polyneuropathy with predominant proximal involvement: an uncommon neurological complication of bariatric surgery. Arq Neuropsiquiatr. 2006;64(3A):609–12.CrossRefPubMedGoogle Scholar
Thaisetthawatkul P, Collazo-Clavell M, Sarr M, et al. A controlled study of peripheral neuropathy after bariatric surgery. Neurology. 2004;63(8):1462–70.CrossRefPubMedGoogle Scholar
Chaves LCL, Faintuch J, Kahwage S, et al. A cluster of polyneuropathy and Wernicke-Korsakoff syndrome in a bariatric unit. Obes Surg. 2002;12(3):328–34.CrossRefPubMedGoogle Scholar
Azmi S, Alam U, Ferdousi M, et al. Bariatric surgery improves neuropathic symptoms, deficits, and corneal nerve morphology in obese patients with diabetes. Diabetes. 2017;66:A550. EnglishGoogle Scholar
Casellini CM, Parson HK, Hodges K, et al. Bariatric surgery restores cardiac and sudomotor autonomic C-fiber dysfunction towards normal in obese subjects with type 2 diabetes. PLoS One. 2016;11(5):e0154211.CrossRefPubMedPubMedCentralGoogle Scholar
Müller-Stich BP, Billeter AT, Fleming T, et al. Nitrosative stress but not glycemic parameters correlate with improved neuropathy in nonseverely obese diabetic patients after roux-Y gastric bypass. Surg Obes Relat Dis. 2015;11(4):847–54.CrossRefPubMedGoogle Scholar
Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6(7):e1000100.CrossRefPubMedPubMedCentralGoogle Scholar
Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25(9):603–5.CrossRefGoogle Scholar
Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ Br Med J. 2003;327(7414):557–60.CrossRefGoogle Scholar
Sterne JA, Egger M, Smith GD. Systematic reviews in health care: investigating and dealing with publication and other biases in meta-analysis. BMJ. 2001;323(7304):101–5.CrossRefPubMedPubMedCentralGoogle Scholar
Alsabah A, Al Sabah S, Al-Sabah S, et al. Investigating factors involved in post laparoscopic sleeve gastrectomy (LSG) neuropathy. Obes Surg. 2017;27(5):1271–6.CrossRefPubMedGoogle Scholar
Malek M, Yousefi R, Safari S, et al. Dietary intakes and biochemical parameters of morbidly obese patients prior to bariatric surgery. Obes Surg. 2019;29(6):1816–22.CrossRefPubMedGoogle Scholar
Bordalo LA, Teixeira TFS, Bressan J, et al. Bariatric surgery: how and why to supplement. Rev Assoc Méd Bras (Engl Ed). 2011;57(1):111–8.CrossRefGoogle Scholar
Frame-Peterson LA, Megill RD, Carobrese S, et al. Nutrient deficiencies are common prior to bariatric surgery. Nutr Clin Pract. 2017;32(4):463–9.CrossRefPubMedGoogle Scholar
Obrosova IG, Mabley JG, Zsengellér Z, et al. Role for nitrosative stress in diabetic neuropathy: evidence from studies with a peroxynitrite decomposition catalyst. FASEB J. 2005;19(3):401–3.CrossRefPubMedGoogle Scholar
Al Khalifa K, Al Ansari A, Alsayed AR, et al. The impact of sleeve gastrectomy on hyperlipidemia: a systematic review. J Obes. 2013;2013:1–7.CrossRefGoogle Scholar
Spivak H, Sakran N, Dicker D, et al. Different effects of bariatric surgical procedures on dyslipidemia: a registry-based analysis. Surg Obes Relat Dis. 2017;13(7):1189–94.CrossRefPubMedPubMedCentralGoogle Scholar
Coleman KJ, Haneuse S, Johnson E, et al. Long-term microvascular disease outcomes in patients with type 2 diabetes after bariatric surgery: evidence for the legacy effect of surgery. Diabetes Care. 2016;39(8):1400–7.CrossRefPubMedPubMedCentralGoogle Scholar
Smith AG, Graham T, Volckmann E, et al. Bariatric surgery improves peripheral nerve function and intraepidermal nerve fiber density in obese patients without symptomatic neuropathy (P1. 144). AAN Enterprises. 2016;86(16 Supplement):P1.144.Google Scholar