title: Circulating endothelial progenitor cells, microvascular density and fibrosis in obesity before and after bariatric surgery.
abstract: It is not known whether, in obesity, the capillary density or the number of circulating endothelial progenitor cells (EPCs) are reduced, or whether fibrosis of small vessels is also present. In addition, possible effects of weight reduction on these parameters have never been evaluated. Therefore, we investigated EPCs and capillary density in 25 patients with severe obesity, all submitted to bariatric surgery, and in 18 normotensive lean subjects and 12 hypertensive lean patients as controls. All patients underwent a biopsy of subcutaneous fat during bariatric surgery. In five patients, a second biopsy was obtained after consistent weight loss, about 1 year later, during a surgical intervention for abdominoplasty. EPCs and capillary density were reduced in obesity, and EPCs were significantly increased after weight reduction. Vascular collagen content was clearly increased in obese patients. No significant difference in vascular collagen was observed between normotensive obese patients and hypertensive obese patients. After pronounced weight reduction, collagen content was nearly normalized. No difference in stress-strain relation was observed among groups or before and after weight loss. In conclusion, our data suggest that microvascular rarefaction occurs in obesity. EPCs were significantly reduced in obese patients. Pronounced weight loss induced by bariatric surgery seems to induce a significant improvement of EPC number, but not of capillary rarefaction. A pronounced fibrosis of subcutaneous small resistance arteries is present in obese patients, regardless of the presence of increased blood pressure values. Consistent weight loss induced by bariatric surgery may induce an almost complete regression of microvascular fibrosis.
authors.affiliation: Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
authors.forename: Carolina
authors.initials: C
authors.lastname: De Ciuceis
authors.forename: Claudia
authors.initials: C
authors.lastname: Rossini
authors.forename: Enzo
authors.initials: E
authors.lastname: Porteri
authors.forename: Elisa
authors.initials: E
authors.lastname: La Boria
authors.forename: Claudia
authors.initials: C
authors.lastname: Corbellini
authors.forename: Francesco
authors.initials: F
authors.lastname: Mittempergher
authors.forename: Ernesto
authors.initials: E
authors.lastname: Di Betta
authors.forename: Beatrice
authors.initials: B
authors.lastname: Petroboni
authors.forename: Annamaria
authors.initials: A
authors.lastname: Sarkar
authors.forename: Claudia
authors.initials: C
authors.lastname: Agabiti-Rosei
authors.forename: Claudio
authors.initials: C
authors.lastname: Casella
authors.forename: Riccardo
authors.initials: R
authors.lastname: Nascimbeni
authors.forename: Rita
authors.initials: R
authors.lastname: Rezzani
authors.forename: Luigi F
authors.initials: LF
authors.lastname: Rodella
authors.forename: Francesca
authors.initials: F
authors.lastname: Bonomini
authors.forename: Enrico
authors.initials: E
authors.lastname: Agabiti-Rosei
authors.forename: Damiano
authors.initials: D
authors.lastname: Rizzoni
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D002196:Capillaries / Q000473:pathology; D042783:Endothelial Cells / Q000473:pathology*; D005260:Female; D005355:Fibrosis / Q000097:blood / Q000473:pathology; D005385:Fingers / Q000098:blood supply; D006801:Humans; D006973:Hypertension / Q000473:pathology / Q000601:surgery; D008297:Male; D055806:Microvessels / Q000473:pathology; D009765:Obesity / Q000097:blood* / Q000473:pathology / Q000601:surgery*; D013234:Stem Cells / Q000473:pathology*