Cardiovascular risk factors after bariatric surgery: Do patients gain more than expected from their substantial weight loss?

Abstract

Background While it has been established that even limited weight loss (5–10%) improves obesity-associated cardiovascular risk factors, it is not known if considerable weight loss following laparoscopic adjustable silicone gastric banding (LASGB) results in a cardiovascular risk profile that is comparable, worse, or even better than that of matched control subjects. Methods Cardiovascular risk factors were compared in three groups of 24 women each: an index group that had lost considerable weight following LASGB for morbid obesity (BMI > 40 kg/m 2), a control group with the same BMI that the index group achieved after weight loss, and a pre-weight loss group of women with a BMI above 40 kg/m 2. Anthropometric measures, fasting serum glucose, insulin, lipids, C-reactive protein, and homocysteine levels were determined and insulin sensitivity was estimated using a homeostasis model assessment index (HOMA-IR). Results After bariatric surgery, the index group had a BMI of 32.0 ± 0.8 kg/m 2. This resulted in a significantly better cardiovascular risk profile than that of the pre-weight loss group (BMI 42.8 ± 0.6 kg/m 2). Unexpectedly, after weight loss, the index group had significantly lower systolic blood pressure, fasting serum insulin, and HOMA-IR than the BMI-matched (32.8 ± 0.9 kg/m 2) control group. Although not significant, diastolic blood pressure, LDL-cholesterol, and CRP levels were also lower. Conclusion Considerable weight loss following bariatric surgery leads to a greater improvement in cardiovascular risk factors than might be expected from the weight loss.