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Morphological Changes in the Carotid Artery Intima after Gastric Bypass for Morbid Obesity

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Abstract

Background

Carotid intima-media thickness (C-IMT) can be considered as an early marker of atherosclerosis, thus representing a reliable cardiovascular risk predictor. Bariatric surgery decreases the burden of cardiovascular disease in obese patients through complex mechanisms, of which weight loss is merely the most evident epiphenomenon. The aim of this study is to evaluate C-IMT variations in patients undergoing Roux-en-Y gastric bypass (RYGB) and possible correlations with biometric parameters and cardiovascular risk factors.

Methods

Thirty patients undergoing RYGB for morbid obesity were enrolled for carotid artery B-mode ultrasound evaluation before surgery and at 1-, 3-, 6-, and 12-month follow-up; C-IMT was recorded at three levels (bulb, common, and internal carotid). At each one of the follow-ups, biometric and serohematic parameters were also collected.

Results

The 22 patients who completed the follow-up and were included in the study showed significant C-IMT reduction at all three levels at 12-month follow-up (p < 0.001). Along with a significant BMI reduction and diabetes/hypertension remission, we found a considerable decrease in total cholesterol (219 vs 164 mg/dl; p < 0.001) and uric acid (5.6 vs 4.5 mg/dl; p < 0.01) and a significant increase in HDL cholesterol (43.9vs59.2 mg/dl; p < 0.001). The data imply that the mean 10-year cardiovascular risk score drops by nearly 50 % (5.7 ± 5.6 vs. 2.9 ± 2.7 %, p < 0.001) according to Framingham cardiovascular risk stratification.

Conclusions

RYGB is associated with significant decrease in C-IMT at 1 year. Pathophysiologic processes underlying such a variation, probably involving lipid and urate metabolism and their correlation with cardiovascular risk reduction should be confirmed by long-term prospective trials.

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Authors and Affiliations

  1. Dipartimento di Scienze Chirurgiche, sezione di Clinica Chirurgica Generale e Terapia Chirurgica, Università degli studi di Parma, Via Gramsci n.14, 43100, Parma, Italy

    Federico Marchesi, Valeria Reggiani, Giuseppina De Sario, Francesco Tartamella, Elisa Melani, Maria Teresa Mita, Francesco Giovanni Cinieri, Stefano Cecchini & Luigi Roncoroni

  2. Clinica ‘Città di Parma’, Dipartimento di Medicina Interna, piazzale Maestri 5, Parma, Italy

    Roberto Giacosa

  3. Azienda provinciale per i servizi sanitari della p.a di Trento, UOPSAL. Viale Verona, 38123, Trento, Italy

    Matteo Ricco’

  4. Dipartimento di Scienze Chirurgiche, sezione di Chirurgia Vascolare, Università degli studi di Parma, Via Gramsci n.14, 43100, Parma, Italy

    Pierfranco Salcuni

Authors
  1. Federico Marchesi
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  2. Roberto Giacosa
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  3. Valeria Reggiani
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  4. Giuseppina De Sario
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  5. Francesco Tartamella
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  6. Elisa Melani
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  7. Maria Teresa Mita
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  8. Francesco Giovanni Cinieri
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  9. Stefano Cecchini
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  10. Matteo Ricco’
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  11. Pierfranco Salcuni
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  12. Luigi Roncoroni
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Corresponding author

Correspondence to Federico Marchesi.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Conflict of Interest

Drs. Federico Marchesi, Roberto Giacosa, Valeria Reggiani, Giuseppina De Sario, Francesco Tartamella, Elisa Melani, Maria Teresa Mita, Francesco Giovanni Cinieri, Stefano Cecchini, Matteo Ricco’, Pierfranco Salcuni, and Luigi Roncoroni have no conflicts of interest or financial ties to disclose.

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Marchesi, F., Giacosa, R., Reggiani, V. et al. Morphological Changes in the Carotid Artery Intima after Gastric Bypass for Morbid Obesity. OBES SURG 27, 357–363 (2017). https://doi.org/10.1007/s11695-016-2279-9

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