Effect of bariatric surgery on both functional and structural measures of premature atherosclerosis.
OBJECTIVE
To bridge the beneficial metabolic effects of pronounced weight loss on one side and the data on morbidity and mortality on the other side, we investigated the impact of profound weight loss on structural and functional markers of early atherosclerosis.


RESULTS
Thirty-seven obese adults were examined before and 18 months after bariatric surgery. Carotid intima-media thickness (CIMT), brachial flow-mediated dilation (FMD), nitroglycerine-mediated dilation, and abdominal fat distribution were assessed by high-resolution ultrasound. Surgery resulted in a body mass index decrease of 9.1 +/- 4.9 kg/m(2) with concomitant improvements in glucose and lipid metabolism. Carotid intima-media thickness diminished from 0.56 +/- 0.09 to 0.53 +/- 0.08 mm (n = 37; P = 0.004). Flow-mediated dilation improved from 5.81 +/- 3.25 to 9.01 +/- 2.93% (n = 25; P < 0.001). Both CIMT and FMD were associated with intra-abdominal fat diameter.


CONCLUSIONS
The present results demonstrate that bariatric surgery-induced diminution of visceral fat improves both functional and structural markers of early atherosclerosis, providing a link between the weight loss-associated improvements of traditional and non-traditional risk factors and the reduced long-term morbidity and mortality after bariatric surgery.
Sturm
Wolfgang
W
Department of Internal Medicine I, Innsbruck Medical University, Anichstrasse 35, Innsbruck 6020, Austria.
Tschoner
Alexander
A
Engl
Julia
J
Kaser
Susanne
S
Laimer
Markus
M
Ciardi
Christian
C
Klaus
Alexander
A
Weiss
Helmut
H
Sandhofer
Anton
A
Patsch
Josef R
JR
Ebenbichler
Christoph F
CF
D000328:Adult; D050197:Atherosclerosis / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control*; D050110:Bariatric Surgery; D015992:Body Mass Index; D002340:Carotid Artery Diseases / Q000517:prevention & control*; D017536:Carotid Artery, Common / Q000473:pathology*; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000473:pathology; D050356:Lipid Metabolism; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D017539:Tunica Intima / Q000473:pathology; D014664:Vasodilation / Q000502:physiology; D015431:Weight Loss; D055815:Young Adult