Effect of bariatric surgery on both functional and structural measures of premature atherosclerosis

• Published in: European heart journal Vol. 30; no. 16; pp. 2038 - 2043
• Main Authors: Sturm, Wolfgang, Tschoner, Alexander, Engl, Julia, Kaser, Susanne, Laimer, Markus, Ciardi, Christian, Klaus, Alexander, Weiss, Helmut, Sandhofer, Anton, Patsch, Josef R., Ebenbichler, Christoph F.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01-08-2009; Oxford Publishing Limited (England)
• Subjects: Adult; Atherosclerosis; Atherosclerosis (general aspects, experimental research); Atherosclerosis - metabolism; Atherosclerosis - pathology; Atherosclerosis - prevention & control; Bariatric Surgery; Biological and medical sciences; Blood and lymphatic vessels; Body Mass Index; Cardiology. Vascular system; Carotid Artery Diseases - prevention & control; Carotid Artery, Common - pathology; Diseases of mother, fetus and pregnancy; Female; Flow mediated vasodilation; Gynecology. Andrology. Obstetrics; Humans; Intima media thickness; Intra-Abdominal Fat - pathology; Lipid Metabolism; Male; Medical sciences; Metabolic diseases; Middle Aged; Obesity; Obesity - metabolism; Obesity - pathology; Obesity - surgery; Pregnancy. Fetus. Placenta; Prospective Studies; Stomach, duodenum, intestine, rectum, anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Tunica Intima - pathology; Vasodilation - physiology; Weight Loss; Young Adult; Obesity; Flow mediated vasodilation; Atherosclerosis; Bariatric surgery; Weight loss; Intima media thickness; Premature; Nutrition disorder; Media; Cardiovascular disease; Vasodilation; Vascular disease; Thickness; Intima; Circulatory system; Cardiology; Nutritional status
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/eurheartj/ehp211

Aims To bridge the beneficial metabolic effects of pronounced weight loss on one side and the data on morbidity and mortality on the other side, we investigated the impact of profound weight loss on structural and functional markers of early atherosclerosis. Methods and results Thirty-seven obese adults were examined before and 18 months after bariatric surgery. Carotid intima–media thickness (CIMT), brachial flow-mediated dilation (FMD), nitroglycerine-mediated dilation, and abdominal fat distribution were assessed by high-resolution ultrasound. Surgery resulted in a body mass index decrease of 9.1 ± 4.9 kg/m2 with concomitant improvements in glucose and lipid metabolism. Carotid intima–media thickness diminished from 0.56 ± 0.09 to 0.53 ± 0.08 mm (n = 37; P = 0.004). Flow-mediated dilation improved from 5.81 ± 3.25 to 9.01 ± 2.93% (n = 25; P < 0.001). Both CIMT and FMD were associated with intra-abdominal fat diameter. Conclusion The present results demonstrate that bariatric surgery-induced diminution of visceral fat improves both functional and structural markers of early atherosclerosis, providing a link between the weight loss-associated improvements of traditional and non-traditional risk factors and the reduced long-term morbidity and mortality after bariatric surgery.