Changes in Soluble TWEAK Concentrations, but Not Those in Amyloid-β(1–40), Are Associated with a Decrease in Carotid Intima-Media Thickness after Bariatric Surgery in Obese Women

Abstract

Background/Aim: Soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) and amyloid-β(1–40) (Aβ₄₀) emerged as markers of cardiovascular risk because of their actions in the endothelium and their role in atherosclerotic progression. The aim of this study was to analyze the association of these two factors with the decrease in carotid intima-media thickness (cIMT) after bariatric surgery in obese women. Methods: We studied 60 severely obese women, of whom 20 were submitted to laparoscopic Roux-en-Y gastric bypass (RYGB), 20 to sleeve gastrectomy (SG), and 20 to lifestyle modification therapy. Circulating sTWEAK, Aβ₄₀, high-sensitivity C-reactive protein, plasminogen activator inhibitor type 1, insulin resistance (HOMA-IR), and cIMT were measured at baseline and after 1 year of follow-up. Results: sTWEAK increased similarly after both surgical procedures, whereas the increase observed after lifestyle intervention did not reach statistical significance. Aβ₄₀ showed no differences between groups of women, nor did it change during follow-up. The decrease in cIMT at 12 months correlated with the decrease in body mass index (BMI) (r = 0.45; p < 0.001) and fasting insulin (r = 0.30; p = 0.038), and also with the increase in sTWEAK (r = –0.43; p = 0.002). Multivariate linear regression showed that only the changes in BMI (β = 0.389; p = 0.005) and sTWEAK (β = –0.358; p = 0.009) were associated with the decrease in cIMT (R² = 0.313; F = 9.348; p < 0.001). Conclusions: One year after bariatric surgery, RYGB and SG induced a similar increase in circulating sTWEAK that occurred in parallel to the decrease observed in cIMT.

The Amelioration of Inflammation and Endothelial Dysfunction, and the Increase in Testosterone After Obesity Surgery Decreases Carotid Intima-Media Thickness in Men

“…Therefore, low levels of sTWEAK are found in different atherosclerotic states such as stable coronary artery disease, chronic kidney disease or peripheral artery disease (46). In our study, the increase in sTWEAK after both RYGB and SG compared to controls was associated, after the multivariate analysis, with the decrease in cIMT in men, in agreement with previously reported data of our own from a cohort of women submitted to obesity surgery (17).…”

“…Also after SG the reduction in cIMT was associated with a decrease in insulin resistance and several pro-in ammatory markers (16). Published data of our own have also shown this association between the decrease in in ammatory markers after both SG and RYGB and the reduction in cIMT in women (17). Proteomic approaches demonstrated speci c molecular mechanisms, genes and proteins that improve adipose tissue function after obesity surgery characterized by increased glucose uptake, higher insulin sensitivity and lower in ammation (18).…”

“…Moreover, high circulating concentrations of PAI-1, together with insulin resistance and the presence of the metabolic syndrome, predicted higher cIMT and/or carotid atherosclerotic plaque (50). We previously reported a decrease in PAI-1 after obesity surgery in women, but failed to demonstrate a correlation with the decrease in cIMT (17). Conversely, our present data show that in men, PAI-1 decreases after both RYGB and SG and it is associated with the decrease in cIMT after surgery.…”

Effect of Bariatric Surgery on Intima Media Thickness: A Systematic Review and Meta-Analysis

“…In cohort studies, although most of the selected studies [ 16 , 32 , 33 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ] showed representativeness of the cases, the majority of them were distinguished by a lack of nonexposed group definition information. Since most of the studies did not include a control group, they were not assessed for comparability.…”

“… ( A ) Forest plot displaying standardized mean difference and 95% confidence intervals showing the consequence of bariatric surgery on IMT [ 16 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ]; ( B ) Leave-one-out sensitivity analyses indicating the effect of bariatric surgery on IMT [ 16 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , …”