Effect of bariatric surgery on flow mediated dilation and carotid intima-media thickness in patients with morbid obesity: 1-year follow-up study

Abstract

Objective: Obesity is associated with increased cardiovascular (CV) mortality and morbidity. Bariatric surgery (BS) is currently an established therapeutic approach for severely obese patients. Carotid intima-media thickness (CIMT) and brachial artery flow-mediated dilation (FMD) provide important prognostic information beyond traditional CV risk factors. This study aimed to examine the effect of bariatric surgery-induced weight loss on CIMT and brachial artery FMD in morbidly obese patients. Methods: A total of 23 morbidly obese patients (40.4±5.6 years, 13 females) were examined before and after BS for 1 year with 3-month periods. CIMT, FMD, body composition, and metabolic parameters were determined. Results: All the patients exhibited significant weight loss following BS (p<0.001). Carotid intima-media thickness reduction was not significant from baseline to 6 months (p=0.069), but at 9 months (p=0.004), it became significant. Similarly, the difference between the preoperative and 6-month FMD assessments was not significant (p=0.057), but at 9 months (p<0.001), it became significant. Conclusion: Our study reveals that weight loss following BS causes improvements in CV risk factors, which is evident after 9 months of surgery.

Effect of Bariatric Surgery on Flow-Mediated Vasodilation as a Measure of Endothelial Function: A Systematic Review and Meta-Analysis

“…Surprisingly, there is no conclusive evidence that non-surgical weight loss in patients with obesity is associated with a lower risk of cardiovascular events [ 56 ]. These findings suggest that endothelial function may be improved via weight-independent processes such as endocrine and incretin-mediated effects as well as the improved inflammatory status [ 47 , 57 ]. It is suggested that positive metabolic and cardiovascular effects of bariatric surgery may also be due to changes in intestinal physiology rather than to weight loss alone.…”

Prognostic Value of Carotid Intima-Media Thickness

“…We would like to thank the authors of the letter for their criticism about the present study published in the March issue of Anatol J Cardiol 2020; 23: 218-22 (1). The present study revealed that CIMT reduction was not significant from baseline to the 6 th month, whereas it became significant at the 9 th month of followup (1).…”

“…We found the paper by Elitok et al (1) very interesting. In the study, the authors have investigated the effect of bariatric surgery on carotid intima-media thickness (CIMT).…”

A Prediction Equation to Estimate Vascular Endothelial Function in Different Body Mass Index Populations

“…However, analysis of these four risk factors also implies that we can improve the function of endotheliocytes through early intervention such as weight loss, a healthy diet and exercise. In some obese people with low FMD, physical exercise or bariatric surgery can increase FMD while losing weight, which suggests the recovery of endothelial injury ( 14 , 47 , 48 ). Aging of endotheliocyte is also not static.…”