title: Insulin resistance and cardiovascular risk marker evaluation in morbid obesity 12 months after bariatric surgery compared to weight-matched controls.
abstract: BACKGROUND
  Insulin resistance (IR) after bariatric surgery is significantly lower than controls matched for body mass index (BMI) and is indistinguishable from lean subjects however it is not known if this is the same for associated cardiovascular risk (CVR) markers (endothelial function (EF) and clot structure and function (maximum absorbance (MA) lysis potential (LT) and clot formation time (FT).
  
  
  OBJECTIVE
  We sought to determine if IR and associated CVR markers one year after bariatric surgery were comparable to post surgery age and BMI matched controls.
  
  
  METHODS
  Ten patients had before and 12 months after Roux-en-Y surgery CVR measurements compared to controls.
  
  
  RESULTS
  BMI reduced after surgery to 33.3±1.7 kg/m(2) p<0.001 comparable to controls 32.6±1.6 kg/m(2) p=0.87. Fasting glucose reduced after surgery to 4.6±0.1 mmol/L, lower than controls 5.0±0.1 mmol/L p=0.03. IR (calculated using HOMA-IR) reduced 0.77±0.14 p=0.03 and was lower than controls 2.35±0.32 p= 0.02. Systolic blood pressure (BP) reduced to 114.2±3.6 mmHg which was lower than controls 127.7±4.1 mmHg p=0.04, but diastolic BP was unaffected by surgery and no different to controls. EF, hsCRP and HDL-cholesterol improved after surgery and did not differ to controls. Markers of blood clotting: MA and FT were unaffected by surgery and no different to controls, LT improved after surgery 3078±580 to 1665±330s p= 0.04) and was no different to controls (2088±556s p=0.12) CONCLUSIONS: Bariatric surgery improved cardiovascular risk parameters to that of the equivalent controls post surgery for weight including EF, hsCRP and LT supporting bariatric surgery as an effective management of obesity.
authors.affiliation: Department of Diabetes and Endocrinology, University of Hull, Hull, UK, alison.dawson3@nhs.net.
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Dawson
authors.forename: Thozhukat
authors.initials: T
authors.lastname: Sathyapalan
authors.forename: Peter
authors.initials: P
authors.lastname: Sedman
authors.forename: Ramzi
authors.initials: R
authors.lastname: Ajjan
authors.forename: Eric S
authors.initials: ES
authors.lastname: Kilpatrick
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Atkin
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D015992:Body Mass Index; D001835:Body Weight; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D015897:Comorbidity; D005215:Fasting; D005260:Female; D005342:Fibrinolysis; D015390:Gastric Bypass; D006801:Humans; D007333:Insulin Resistance; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000097:blood / Q000453:epidemiology / Q000601:surgery*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D015415:Biomarkers; D001786:Blood Glucose