Lancet Regional Health-Europe最新文献

{"title":"Long–term effects of gastric bypass and sleeve gastrectomy in type 2 diabetes: a matched retrospective cohort study from Sweden","authors":"Ala Mejaddam ,&nbsp;Hanne K. Carlsen ,&nbsp;Ingrid Larsson ,&nbsp;Katarina Eeg-Olofsson ,&nbsp;Moa Lugner ,&nbsp;Johan Ottosson ,&nbsp;Erik Stenberg ,&nbsp;Gudrun Höskuldsdóttir ,&nbsp;Björn Eliasson","doi":"10.1016/j.lanepe.2025.101430","DOIUrl":"10.1016/j.lanepe.2025.101430","url":null,"abstract":"<div><h3>Background</h3><div>Long-term data on the efficacy and safety of Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) in people with type 2 diabetes mellitus (T2DM) are still limited. Using a matched cohort design, we aimed to evaluate the long-term effects of RYGB and SG on individuals with T2DM, focussing on obesity- and surgery-related outcomes over a follow-up period of up to 14 years.</div></div><div><h3>Methods</h3><div>A nationwide, matched, longitudinal study was conducted using data from the Swedish National Diabetes Register (NDR) and the Swedish Obesity Surgery Registry (SOReg). Between 2007 and 2020, all individuals with T2DM who underwent primary surgery (RYGB = 7294 and SG = 1105) were identified through SOReg and matched by age, sex, and BMI to a control group of individuals with T2DM from NDR who had not undergone surgery (n = 8399). Data on all-cause mortality and obesity- and surgery-related outcomes after RYGB and SG were retrieved from national registers with almost complete coverage. Risks were expressed as incidence rates per 10,000 person-years and analysed using adjusted Cox regression models, which included duration of diabetes, yielding adjusted hazard ratios (HR) with 95% confidence intervals (CI).</div></div><div><h3>Findings</h3><div>During follow-up, the percentage total weight loss and reductions in HbA1c levels were significantly greater after RYGB and SG than in unexposed individuals (%TWL: RYGB 23·2 vs. 3·6 and SG 17·1 vs. 3·1 at two years, smd &gt; 0·1) and (mean HbA1c: RYGB 46 (SD 14) vs. 58 (SD 17) and SG 46 (SD 13) vs. 55 (SD 15) at two years, smd &gt; 0·1). RYGB was associated with sustainable reductions in all-cause mortality (adjusted HR of 0·62 (95% CI [0·51–0·71])) and obesity-related comorbidities, with risks as much as 45% lower compared to unexposed individuals (p &lt; 0·001). However, individuals after RYGB face as much as a twofold increased risk of malabsorption and micronutrient deficiency (adjusted HR of 2·00 (95% CI [1·76–2·28])) and alcohol use disorder (adjusted HR of 2·82 (95% CI [2·37–3·36])), p &lt; 0·001. The risk of other psychiatric disorders, such as depression (adjusted HR of 1·28 (95% CI [1·14–1·43])), and surgical complications, such as bowel obstruction (adjusted HR of 3·96 (95% CI [3·15–4·98])), was also higher after RYGB (p &lt; 0·001). In contrast, the SG cohort showed no significant effects on obesity-related conditions and risk of surgical complications, despite similar weight reduction in both surgery groups.</div></div><div><h3>Interpretation</h3><div>The study highlights the advantages and limitations of RYGB and SG, providing insights to guide an individualised approach. The limited efficacy of SG in lowering obesity-related disease risks should be a key consideration when selecting individuals with T2DM for surgery.</div></div><div><h3>Funding</h3><div>A grant from the <span>Swedish state</span> under the agreement with the county councils.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"58 ","pages":"Article 101430"},"PeriodicalIF":13.0,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144917519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifting the smoke screen on economic inactivity","authors":"Paul Crawshaw ,&nbsp;Joanne Gray","doi":"10.1016/j.lanepe.2025.101437","DOIUrl":"10.1016/j.lanepe.2025.101437","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"57 ","pages":"Article 101437"},"PeriodicalIF":13.0,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144917753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on: diagnostic accuracy and predictive value of the QuantiFERON-TB Gold Plus assay for tuberculosis in immunocompromised individuals: a prospective TBnet study","authors":"Victoria Allen,&nbsp;James Galloway","doi":"10.1016/j.lanepe.2025.101436","DOIUrl":"10.1016/j.lanepe.2025.101436","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"57 ","pages":"Article 101436"},"PeriodicalIF":13.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary embolism and COVID-19 in Europe: epidemiological shifts, inequities, and lessons for the future","authors":"Marco Zuin","doi":"10.1016/j.lanepe.2025.101450","DOIUrl":"10.1016/j.lanepe.2025.101450","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"58 ","pages":"Article 101450"},"PeriodicalIF":13.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In the framework of the EU Trio Presidency–supporting the European Code Against Cancer","authors":"Paweł Koczkodaj ,&nbsp;Michael Damianos ,&nbsp;Beata Jagielska ,&nbsp;Elisabete Weiderpass ,&nbsp;Joachim Schüz","doi":"10.1016/j.lanepe.2025.101451","DOIUrl":"10.1016/j.lanepe.2025.101451","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"57 ","pages":"Article 101451"},"PeriodicalIF":13.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Essential medicines as an integral element of care for displaced people","authors":"Mohammad-Salar Hosseini","doi":"10.1016/j.lanepe.2025.101453","DOIUrl":"10.1016/j.lanepe.2025.101453","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"57 ","pages":"Article 101453"},"PeriodicalIF":13.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Student protests in Serbia: change the country or change countries","authors":"Biljana Vučković,&nbsp;Milica Krčo","doi":"10.1016/j.lanepe.2025.101439","DOIUrl":"10.1016/j.lanepe.2025.101439","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"57 ","pages":"Article 101439"},"PeriodicalIF":13.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Europe must act: a unified call to end complicity in the Gaza famine and genocide","authors":"Karl Blanchet ,&nbsp;Sultan Barakat ,&nbsp;Benjam Schmid ,&nbsp;Orit Abrahim ,&nbsp;Ghassan Abu-Sittah","doi":"10.1016/j.lanepe.2025.101444","DOIUrl":"10.1016/j.lanepe.2025.101444","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"57 ","pages":"Article 101444"},"PeriodicalIF":13.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing cardiovascular health disparities: global perspectives from the patient community","authors":"Karen Padilla Cabrera,&nbsp;Neil Johnson","doi":"10.1016/j.lanepe.2025.101404","DOIUrl":"10.1016/j.lanepe.2025.101404","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"56 ","pages":"Article 101404"},"PeriodicalIF":13.0,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144904369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing clinical perspectives on sex and healthcare disparities in ischaemic heart disease","authors":"Angela Maas ,&nbsp;Edina Cenko ,&nbsp;Viola Vaccarino ,&nbsp;Irene Göttgens ,&nbsp;Maria Bergami ,&nbsp;Olivia Manfrini ,&nbsp;Lina Badimon ,&nbsp;Guiomar Mendieta ,&nbsp;Sabine Oertelt-Prigione ,&nbsp;Zorana Vasiljevic-Pokracic ,&nbsp;Maria Dorobantu ,&nbsp;Marija Vavlukis ,&nbsp;Bela Merkely ,&nbsp;Martha Gulati ,&nbsp;Raffaele Bugiardini","doi":"10.1016/j.lanepe.2025.101370","DOIUrl":"10.1016/j.lanepe.2025.101370","url":null,"abstract":"<div><div>Ischaemic heart disease (IHD) has historically been under-researched in women, leading to significant gaps in understanding sex-specific risk factors and outcomes. To address this issue, The Lancet Regional Health–Europe convened experts from a broad range of countries to evaluate sex-related cardiovascular inequalities and propose recommendations to address these disparities. Despite developing IHD a decade later than men, women experience higher mortality rates. Global Burden of Disease data highlight persistent sex differences in IHD mortality, with women showing higher mortality despite lower prevalence. Factors such as psychosocial stress, reproductive health, and physical inactivity disproportionately impact women's cardiovascular health, while caregiving responsibilities and delayed healthcare access further exacerbate these disparities. There is an urgent need to recognize chest pain symptoms in women and to reduce the time lag between symptom onset and hospital presentation. Addressing these gaps requires targeted public health interventions, expanded research, and improved clinical practices, emphasizing equitable healthcare access and greater inclusion of women in clinical trials. Tailoring treatment guidelines to account for sex differences in outcomes could significantly improve survival rates for women with IHD.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"56 ","pages":"Article 101370"},"PeriodicalIF":13.0,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144904388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}