Short-term impact of bariatric surgery on structural and functional parameters of arterial remodeling in morbidly obese patients

Abstract

Purpose: To assess if severe obesity results in structural and functional remodeling of arteries and to evaluate if weight reduction as a result of bariatric surgery leads to the improvement of these parameters. Material and methods: For the prospective analysis we included 40 patients with severe obesity, assessed before bariatric surgery procedures (OB1) and six months later (OB2). The control group comprised 15 women with normal body mass. Anthropometric measurements, hsCRP, HbA1C, glucose, insulin, MMP-2, MMP-9, adiponectin, E-selectin, CD40L, PAI-1, echocardiogram, intima-media thickness (IMT), pulse wave velocity (PWV), flow-mediated dilatation (FMD%) and nitroglicerine-mediated dilatation (NTG-MD%) were assessed in all subjects and were revaluated in OB2. Results: BMI of patients with severe obesity decreased during the 6-month follow-up post-surgery period (kg/m2): from 47,73 to 35,22. We found hypoadiponectinemia in 90% patients in OB1, in 35% patients in OB2, and in 20% patients in the control group. IMT varied between OB1, OB2: 0,59 vs. 0,52; p<0,0001, and were within the reference value range. In OB1 IMT correlated significantly with body mass (r=0,472), FFM (r=0,427), FM (r=0,368), BMI (r=0,423), 2h insulin concentration (r=0,343), HR (r=0,319), MMP-9 (r=-0,309), CD40L (r=-0,290), HbA1C (r=0,296), NTG-MD% (r=-0,301). Moreover, PWV differed between groups: 8,53 vs. 7,82 m/s; p<0,001. In OB1 PWV correlated with age (r=0,492), HR (r=0,324), and %FM (r=0,328). In OB1 PWV correlated with NTG% (r=-0,332, p=0,036) and hsCRP (r= 0,394, p=0,014). In multivariable analysis, age (p=0,0005) and hsCRP (p=0,0014), were found to be significant predictors of PWV. NTG-MD % differed between OB1 and OB2 (21,47 vs. 28,54%; p<.0001) and were lower in comparison to the control group (31,42±5,95%; p=0,0005). NTG-MD% values correlated with E-selectin values in OB1 (r=-0,380; p=0,015). Conclusions: It seems that weight reduction following bariatric surgery improves both structural and functional indices of large arteries.