title: Carotid intima-media thickness is reduced 12 months after gastric bypass surgery in obese patients with type 2 diabetes or impaired glucose tolerance.
abstract: OBJECTIVE
  To investigate whether Roux-en-Y gastric bypass surgery (RYGB) - an in vivo model for normalisation of hyperglycaemia - improves carotid intima-media thickness (IMT) in patients with type 2 diabetes (T2D)/impaired glucose tolerance (IGT) and normal glucose tolerance (NGT).
  
  
  METHODS
  Observational prospective study, 34 obese patients (T2D (n = 14)/IGT (n = 4), and NGT (n = 16)) were investigated before and six and 12months after RYGB.
  
  
  RESULTS
  Mean carotid IMT was significantly reduced 12months after RYGB in patients with T2D/IGT (-0.041 mm (95% CI -0.069; -0.012, p = 0.005)) but not in patients with NGT (-0.010 mm (-0.039; 0.020, p = 0.52)). The between-group difference was not significant (p=0.13). Twelve months after RYGB, patients with respectively T2D/IGT and NGT demonstrated changes in weight: -29.9 kg, p<0.001/-30.6 kg, p < 0.001, HbA1c: -0.7%, p < 0.001/-0.1%, p = 0.33, systolic blood pressure: -2 mmHg, p = 0.68/-10 mmHg, p = 0.01 and diastolic blood pressure: -8 mmHg, p = 0.003/-11 mmHg, p < 0.001. 80% of T2D patients terminated antihyperglycaemic medication.
  
  
  CONCLUSIONS
  Mean carotid IMT was significantly reduced 12months after RYGB in patients with T2D/IGT which provides evidence to support that the earliest atherosclerotic changes in the arterial wall are reversible. Although numerically different from the changes observed in patients with NGT, the between-group difference was not statistically significant.
authors.affiliation: Steno Diabetes Center, Niels Steensens Vej 2, 2820 Gentofte, Denmark; Department of Paediatrics, Copenhagen University Hospital Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark. Electronic address: louise.lundby.christensen@gmail.com.
authors.forename: Louise
authors.initials: L
authors.lastname: Lundby-Christensen
authors.affiliation: Steno Diabetes Center, Niels Steensens Vej 2, 2820 Gentofte, Denmark; Nordsjællands University Hospital Hillerød, Dyrehavevej 29, 3400 Hillerød, Denmark.
authors.forename: Lise
authors.initials: L
authors.lastname: Tarnow
authors.affiliation: Department of Endocrinology, Copenhagen University Hospital Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark.
authors.forename: Dorte L
authors.initials: DL
authors.lastname: Hansen
authors.affiliation: Department of Endocrinology, Copenhagen University Hospital Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark.
authors.forename: Dorte
authors.initials: D
authors.lastname: Worm
authors.affiliation: The Gastro Unit, Department of Surgery, Copenhagen University Hospital Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark.
authors.forename: Lars S
authors.initials: LS
authors.lastname: Naver
authors.affiliation: The Gastro Unit, Department of Surgery, Copenhagen University Hospital Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark.
authors.forename: Lisbeth E
authors.initials: LE
authors.lastname: Hvolris
authors.affiliation: Department of Physiology and Nuclear Medicine, Copenhagen University Hospital Frederiksberg, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Wiinberg
authors.affiliation: Steno Diabetes Center, Niels Steensens Vej 2, 2820 Gentofte, Denmark; Department of Endocrinology, University of Copenhagen Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.
authors.forename: Allan
authors.initials: A
authors.lastname: Vaag
authors.affiliation: Steno Diabetes Center, Niels Steensens Vej 2, 2820 Gentofte, Denmark; Department of Medicine F, Copenhagen University Hospital Gentofte, Niels Andersens Vej 65, 2900 Hellerup, Denmark.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Almdal
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D059168:Carotid Intima-Media Thickness; D003718:Denmark / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D003925:Diabetic Angiopathies / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control*; D015536:Down-Regulation; D005260:Female; D015390:Gastric Bypass; D018149:Glucose Intolerance / Q000097:blood / Q000150:complications*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control; D006973:Hypertension / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000150:complications / Q000601:surgery*; D012307:Risk Factors; D014652:Vascular Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control; D015431:Weight Loss; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Bariatric surgery; Carotid intima-media thickness; Gastric bypass; Impaired glucose tolerance; Type 2 diabetes