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Obesity Surgery
Published in: Obesity Surgery 2/2017

01-02-2017 | Original Contributions

Morphological Changes in the Carotid Artery Intima after Gastric Bypass for Morbid Obesity

Authors: Federico Marchesi, Roberto Giacosa, Valeria Reggiani, Giuseppina De Sario, Francesco Tartamella, Elisa Melani, Maria Teresa Mita, Francesco Giovanni Cinieri, Stefano Cecchini, Matteo Ricco’, Pierfranco Salcuni, Luigi Roncoroni

Published in: Obesity Surgery | Issue 2/2017

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Abstract

Background

Carotid intima-media thickness (C-IMT) can be considered as an early marker of atherosclerosis, thus representing a reliable cardiovascular risk predictor. Bariatric surgery decreases the burden of cardiovascular disease in obese patients through complex mechanisms, of which weight loss is merely the most evident epiphenomenon. The aim of this study is to evaluate C-IMT variations in patients undergoing Roux-en-Y gastric bypass (RYGB) and possible correlations with biometric parameters and cardiovascular risk factors.

Methods

Thirty patients undergoing RYGB for morbid obesity were enrolled for carotid artery B-mode ultrasound evaluation before surgery and at 1-, 3-, 6-, and 12-month follow-up; C-IMT was recorded at three levels (bulb, common, and internal carotid). At each one of the follow-ups, biometric and serohematic parameters were also collected.

Results

The 22 patients who completed the follow-up and were included in the study showed significant C-IMT reduction at all three levels at 12-month follow-up (p < 0.001). Along with a significant BMI reduction and diabetes/hypertension remission, we found a considerable decrease in total cholesterol (219 vs 164 mg/dl; p < 0.001) and uric acid (5.6 vs 4.5 mg/dl; p < 0.01) and a significant increase in HDL cholesterol (43.9vs59.2 mg/dl; p < 0.001). The data imply that the mean 10-year cardiovascular risk score drops by nearly 50 % (5.7 ± 5.6 vs. 2.9 ± 2.7 %, p < 0.001) according to Framingham cardiovascular risk stratification.

Conclusions

RYGB is associated with significant decrease in C-IMT at 1 year. Pathophysiologic processes underlying such a variation, probably involving lipid and urate metabolism and their correlation with cardiovascular risk reduction should be confirmed by long-term prospective trials.
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Metadata
Title
Morphological Changes in the Carotid Artery Intima after Gastric Bypass for Morbid Obesity
Authors
Federico Marchesi
Roberto Giacosa
Valeria Reggiani
Giuseppina De Sario
Francesco Tartamella
Elisa Melani
Maria Teresa Mita
Francesco Giovanni Cinieri
Stefano Cecchini
Matteo Ricco’
Pierfranco Salcuni
Luigi Roncoroni
Publication date
01-02-2017
Publisher
Springer US
Published in
Obesity Surgery / Issue 2/2017
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-016-2279-9

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