Endothelial function in obesity and effects of bariatric and metabolic surgery

Sanches, Elijah E.; Topal, Besir; Proczko, Monika; Stepaniak, Pieter S.; Severin, Richard; Philips, Shane A; Sabbahi, Ahmad; Rafols, Juan Pujol; Pouwels, Sjaak

doi:10.1080/14779072.2020.1767594

Cited by 5 publications

(4 citation statements)

References 115 publications

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“…The favorable impact of metabolic surgery on the risk of COVID-19 severity shown here is supported by the established physiological benefits of metabolic surgery which include a resolution of chronic low-grade systemic inflammation [ 35 ], improvement in pulmonary function [ 36 ], reduction in the pro-thrombotic potential [ 37 ], and improved endothelial function [ 38 ]. In addition, recent evidence suggests that patients who underwent metabolic surgery had fewer unplanned hospital admissions during short-midterm follow-up for infection when compared to non-operated controls [ 39 ].…”

Section: Discussionmentioning

confidence: 86%

Prior metabolic surgery reduced COVID-19 severity: Systematic analysis from year one of the COVID-19 pandemic

Wood

Benotti

Fano

et al. 2023

Heliyon

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Section: Discussionmentioning

confidence: 86%

Prior metabolic surgery reduced COVID-19 severity: Systematic analysis from year one of the COVID-19 pandemic

Wood

Benotti

Fano

et al. 2023

Heliyon

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Liu

Zhang

et al. 2022

Front. Cardiovasc. Med.

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ObjectiveVascular endothelial dysfunction is considered an early predictor of endothelial injury and the initiating factor of atherosclerosis (AS). Brachial artery flow-mediated dilation (FMD) can detect endothelial injury early and provide important prognostic information beyond traditional cardiovascular (CV) risk factors. This study aimed to find the influencing factors of FMD and develop a simple prediction model in populations with different body mass indices (BMIs).MethodsIn total, 420 volunteers with different BMIs were recruited in our study. Subjects were randomly assigned to the derivation and validation cohorts (the ratio of the two was 1:2) with simple random sampling. The former was used for influencing factors searching and model construction of FMD and the latter was used for verification and performance evaluation.ResultsThe population was divided into two groups, i.e., 140 people in the derivation group and 280 people in the verification group. Analyzing in the training data, we found that females had higher FMD than males (p < 0.05), and FMD decreased with age (p < 0.05). In people with diabetes, hypertension or obesity, FMD was lower than that in normal individuals (p < 0.05). Through correlation analysis and linear regression, we found the main influencing factors of FMD: BMI, age, waist-to-hip radio (WHR), aspartate aminotransferase (AST) and low-density lipoprotein (LDL). And we developed a simple FMD prediction model: FMD = −0.096BMI−0.069age−4.551WHR−0.015AST−0.242LDL+17.938, where R2 = 0.599, and adjusted R2 = 0.583. There was no statistically significant difference between the actual FMD and the predicted FMD in the verification group (p > 0.05). The intra-class correlation coefficient (ICC) was 0.77. In a Bland-Altman plot, the actual FMD and the predicted FMD also showed good agreement. This prediction model had good hints in CV risk stratification (area under curve [AUC]: 0.780, 95 % confidence intervals [95% CI]: 0.708–0.852, p < 0.001), with a sensitivity and specificity of 73.8 and 72.1%, respectively.ConclusionsMales, older, obesity, hypertension, diabetes, smoking, etc. were risk factors for FMD, which was closely related to CV disease (CVD). We developed a simple equation to predict FMD, which showed good agreement between the training and validation groups. And it would greatly simplify clinical work and may help physicians follow up the condition and monitor therapeutic effect. But further validation and modification bears great significance.

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“…Blood pressure shows a similar prompt response: in hypertensive patients, a drop in blood pressure during the first week of surgery frequently enables a reduction in antihypertensive medication [ 9 ]. Endothelial function may also improve; however, there is currently minimal information regarding the timing of any improvements and their relationship to weight loss [ 10 ]. Weight loss can improve arterial stiffness, another indicator of vascular function, but the impact of sleeve gastrectomy is still unknown.…”

Section: Introductionmentioning

confidence: 99%

Gut Microbiome and Associated Metabolites Following Bariatric Surgery and Comparison to Healthy Controls

et al. 2023

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The gut microbiome plays a significant role in regulating the host’s ability to store fat, which impacts the development of obesity. This observational cohort study recruited obese adult men and women scheduled to undergo sleeve gastrectomy and followed up with them 6 months post-surgery to analyse their microbial taxonomic profiles and associated metabolites in comparison to a healthy control group. There were no significant differences in the gut bacterial diversity between the bariatric patients at baseline and at follow-up or between the bariatric patients and the cohort of healthy controls. However, there were differential abundances in specific bacterial groups between the two cohorts. The bariatric patients were observed to have significant enrichment in Granulicatella at baseline and Streptococcus and Actinomyces at follow-up compared to the healthy controls. Several operational taxonomic units assigned to commensal Clostridia were significantly reduced in the stool of bariatric patients both at baseline and follow-up. When compared to a healthy cohort, the plasma levels of the short chain fatty acid acetate were significantly higher in the bariatric surgery group at baseline. This remained significant when adjusted for age and sex (p = 0.013). The levels of soluble CD14 and CD163 were significantly higher (p = 0.0432 and p = 0.0067, respectively) in the bariatric surgery patients compared to the healthy controls at baseline. The present study demonstrated that there are alterations in the abundance of certain bacterial groups in the gut microbiome of obese patients prior to bariatric surgery compared to healthy individuals, which persist post-sleeve gastrectomy.

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Endothelial function in obesity and effects of bariatric and metabolic surgery

Cited by 5 publications

References 115 publications

Prior metabolic surgery reduced COVID-19 severity: Systematic analysis from year one of the COVID-19 pandemic

Prior metabolic surgery reduced COVID-19 severity: Systematic analysis from year one of the COVID-19 pandemic

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

Gut Microbiome and Associated Metabolites Following Bariatric Surgery and Comparison to Healthy Controls

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