title: Increased serum nitric oxide concentration after bariatric surgery--a potential mechanism for cardiovascular benefit.
abstract: BACKGROUND
  It is believed that endothelial dysfunction associated with obesity contributes to reduced vascular production of nitric oxide (NO). Weight reduction after bariatric surgery is known to decrease the risk of cardiovascular disease. The purpose of this study was to determine whether bariatric surgery leads to improvement of metabolic markers of endothelial function: serum NO and its precursor (arginine) concentrations in obese patients.
  
  
  METHODS
  Serum NO and L-arginine concentrations were measured in 25 morbidly obese patients directly before and 6 months after bariatric surgery. Moreover, selected parameters that may be involved in development of endothelial dysfunction were also studied. Control group consisted of ten healthy individuals with normal body weight.
  
  
  RESULTS
  Six months after bariatric surgery, serum NO concentration was approximately 40% higher than before surgery. Surprisingly, serum NO concentration in nonobese controls was essentially similar to obese patients before surgery. In contrast, serum L-arginine concentration was higher in obese patients than in controls and decreased significantly after surgery. The body weight, blood pressure, triacylglycerols, LDL/HDL-cholesterol ratio, insulin, homeostasis model assessment score (HOMA-index), C-reactive protein, and white blood cell count were higher in obese patients as compared with controls and decreased significantly after surgery.
  
  
  CONCLUSIONS
  Our results indicate that improvement of insulin resistance, lipidemia, and blood pressure as well as reduction of systemic inflammation after bariatric surgery were associated with the increase of serum NO concentration. We propose that the increase in serum NO concentration contribute to diverse beneficial effects of weight loss after bariatric surgery especially in the context of risk of atherosclerosis.
authors.affiliation: Department of Pharmaceutical Biochemistry, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Sledzinski
authors.forename: Maciej
authors.initials: M
authors.lastname: Sledzinski
authors.forename: Ryszard Tomasz
authors.initials: RT
authors.lastname: Smolenski
authors.forename: Julian
authors.initials: J
authors.lastname: Swierczynski
mesh_terms: D000328:Adult; D000368:Aged; D001120:Arginine / Q000097:blood / Q000378:metabolism; D050110:Bariatric Surgery; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood*; D016022:Case-Control Studies; D004730:Endothelium, Vascular / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood*; D009767:Obesity, Morbid / Q000097:blood* / Q000503:physiopathology / Q000601:surgery; D012307:Risk Factors; D015431:Weight Loss / Q000502:physiology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D009569:Nitric Oxide; D001120:Arginine