title: Improvement of atherosclerotic markers in non-diabetic patients after bariatric surgery.
abstract: BACKGROUND
  The objective of this study was to assess the impact of bariatric surgery performed in extremely obese non-diabetic subjects on the following parameters: endothelial function, inflammatory processes (assessed by high-sensitivity C-reactive protein [hs-CRP]), carotid artery intima-media thickness (CIMT), and glucose and lipid profiles.
  
  
  METHODS
  Forty-seven obese individuals with body mass index >40 kg/m(2) underwent bariatric surgery and returned for post-procedure assessment between 6 and 19 months after surgery. Ninety-three percent of patients were female. Their age ranged from 18 to 65 (mean 41) years old at baseline. Baseline was defined as the maximum of 30 days before surgery. Before and after surgery, all patients were subjected to a brachial artery ultrasound examination to evaluate endothelial-dependent dilation, CIMT by ultrasound, and laboratory analyses including glucose, lipid and inflammatory profiles were performed.
  
  
  RESULTS
  Subjects lost an average of 33 % of their original weight (p < 0.001). Flow-mediated dilation showed significant improvement after surgery from 7.4 % to 18.9 % (p < 0.001) on average. There was regression of CIMT, with the median being reduced from 0.8 to 0.5 mm (p < 0.001). The median Hs-CRP reduced from 0.83 to 0.18 mg/dl (p < 0.001), while glucose and lipid profiles were also improved after surgery.
  
  
  CONCLUSIONS
  This study shows that severely obese, non-diabetic patients who had pronounced weight loss after bariatric surgery had an overall improvement in brachial flow-mediated dilation, CIMT, high-sensitivity CRP, and glucose and lipid metabolism. The best responses of the brachial flow-mediated dilation after surgery were observed in non-smokers and in younger subjects.
authors: Instituto Dante Pazzanese de Cardiologia, State of Sao Paulo - Health Secretary, Sao Paulo, Brazil. medsaleh@uol.com.br
authors: Mohamed Hassan
authors: MH
authors: Saleh
authors: Marcelo Chiara
authors: MC
authors: Bertolami
authors: Jorge Eduardo
authors: JE
authors: Assef
authors: Mohamed Ibrahim
authors: MI
authors: Taha
authors: Wilson
authors: W
authors: de Freitas
authors: Ana Claudia Gomes
authors: AC
authors: Petisco
authors: Rodrigo Bellio Mattos
authors: RB
authors: Barretto
authors: David Costa
authors: DC
authors: Le Bihan
authors: Jose Eduardo Martins
authors: JE
authors: Barbosa
authors: Carlos Alberto
authors: CA
authors: de Jesus
authors: Amanda Guerra Moraes Rego
authors: AG
authors: Sousa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000097:blood* / Q000503:physiopathology / Q000517:prevention & control; D050110:Bariatric Surgery; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D002097:C-Reactive Protein / Q000378:metabolism*; D059168:Carotid Intima-Media Thickness; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000503:physiopathology; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008055:Lipids; D002097:C-Reactive Protein