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Erschienen in:
12.08.2017 | Original Contributions
Early Regression of Carotid Intima-Media Thickness after Bariatric Surgery and Its Relation to Serum Leptin Reduction
Erschienen in: Obesity Surgery | Ausgabe 1/2018
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Purpose
Bariatric surgery (BS) promotes carotid intima-media thickness (C-IMT) regression as early as 6 months post-surgery. To verify whether C-IMT regression occurs even earlier, we aimed at the effect of Roux-en-Y gastric bypass (RYGBP) and biliopancreatic diversion (BPD) on C-IMT 1–2 months and 12 months post-surgery.
Subjects/Methods
Prospective trial. BS was performed on 109 patients either with (RYGBP = 42; BDP = 40) or without type 2 diabetes (RYGBP = 27). Healthy volunteers served as control group. Follow-up: baseline, 1–2 months, 12 months post-surgery. Endpoints: changes (∆) in C-IMT, weight, body mass index, fat mass, waist and neck circumferences, blood pressure, HbA1c, glucose, insulin, insulin sensitivity [HOMA-IR; OGIS, from meal tolerance test], lipids, C-reactive protein, leptin, adiponectin, MCP-1.
Results
All surgery subgroups had similar levels of ∆-C-IMT. C-IMT in the pooled surgery group reduced from [mean (95% confidence interval)] 0.81 (0.77–0.84) mm to 0.66 (0.63–0.69) mm, p < 0.001 [−17.1 (−20.4 to −13.8)%] at 1–2 months, and to 0.63 (0.59–0.66) mm, p < 0.001 [−21.8 (−25.3 to −18.4)%] at 12 months post-surgery. ∆-C-IMT 1–2 months and 12 months post-surgery correlated to baseline C-IMT, and with ∆-leptin at 1–2 months, but not at 12 months post-surgery. In linear regression analysis, ∆-leptin and baseline C-IMT were predictors of ∆-C-IMT 1–2 months post-surgery.
Conclusions
A remarkable C-IMT regression occurred as early as 1–2 months after BS in obese patients either with or without type 2 diabetes, which was associated to the early reduction in leptin, (at least partially) independent of weight loss. Whether this is a causative or correlative association needs further investigation.