Identifying predictive markers of increased life expectancy after bariatric surgery

Obesity accelerates aging and reduces life expectancy.

In the SOS study, obesity conferred an ~8-year reduction in life expectancy that was partly reversed (by ~3-years) by bariatric surgery.

However, despite the benefits, individual responses vary and the treatment is not suitable for all, motivating the need to identify markers for prediction of bariatric surgery outcomes to facilitate precision medicine in patients with obesity.

Common causes of death in people with obesity, such as cardiovascular disease and cancer, also increase with age in the general population, suggesting that unexplored factors common to both chronological and obesity-accelerated aging contribute to these diseases.

Age-related somatic mutation-driven clonal hematopoiesis, known to increase the risk of blood cancer, was recently also linked to cardiovascular disease and total mortality, and could possibly mediate accelerated aging in obesity.

The overall aim of this project is to determine how bariatric surgery affects life expectancy in subgroups defined by glucose status or genetic markers and to increase our understanding of how this treatment affects the major causes of death in obesity.

Specifically we will: 1) examine the effects of surgical treatment on life expectancy in patients with type 2 diabetes, 2) determine if markers of genetic susceptibility affect the benefit of bariatric surgery and 3) examine the effects of bariatric surgery in patients with and without clonal hematopoiesis.