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Early Regression of Carotid Intima-Media Thickness after Bariatric Surgery and Its Relation to Serum Leptin Reduction

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Abstract

Purpose

Bariatric surgery (BS) promotes carotid intima-media thickness (C-IMT) regression as early as 6 months post-surgery. To verify whether C-IMT regression occurs even earlier, we aimed at the effect of Roux-en-Y gastric bypass (RYGBP) and biliopancreatic diversion (BPD) on C-IMT 1–2 months and 12 months post-surgery.

Subjects/Methods

Prospective trial. BS was performed on 109 patients either with (RYGBP = 42; BDP = 40) or without type 2 diabetes (RYGBP = 27). Healthy volunteers served as control group. Follow-up: baseline, 1–2 months, 12 months post-surgery. Endpoints: changes (∆) in C-IMT, weight, body mass index, fat mass, waist and neck circumferences, blood pressure, HbA1c, glucose, insulin, insulin sensitivity [HOMA-IR; OGIS, from meal tolerance test], lipids, C-reactive protein, leptin, adiponectin, MCP-1.

Results

All surgery subgroups had similar levels of ∆-C-IMT. C-IMT in the pooled surgery group reduced from [mean (95% confidence interval)] 0.81 (0.77–0.84) mm to 0.66 (0.63–0.69) mm, p < 0.001 [−17.1 (−20.4 to −13.8)%] at 1–2 months, and to 0.63 (0.59–0.66) mm, p < 0.001 [−21.8 (−25.3 to −18.4)%] at 12 months post-surgery. ∆-C-IMT 1–2 months and 12 months post-surgery correlated to baseline C-IMT, and with ∆-leptin at 1–2 months, but not at 12 months post-surgery. In linear regression analysis, ∆-leptin and baseline C-IMT were predictors of ∆-C-IMT 1–2 months post-surgery.

Conclusions

A remarkable C-IMT regression occurred as early as 1–2 months after BS in obese patients either with or without type 2 diabetes, which was associated to the early reduction in leptin, (at least partially) independent of weight loss. Whether this is a causative or correlative association needs further investigation.

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Author information

Author notes

  1. G. Lambert and Marcelo Miranda de Oliveira Lima contributed equally to this work.

Authors and Affiliations

  1. Laboratory of Investigation in Metabolism and Diabetes (LIMED)/Gastrocentro, State University of Campinas (UNICAMP), R. Carlos Chagas, 420, Cidade Universitária, Campinas, SP, 13081-970, Brazil

    G. Lambert, Marcelo Miranda de Oliveira Lima, A. C. Felici, J. C. Pareja, A. C. J. Vasques, F. S. Novaes, S. Rodovalho, F. F. P. Hirsch, J. R. Matos-Souza & B. Geloneze

  2. Department of Internal Medicine, Discipline of Cardiology, State University of Campinas (UNICAMP), Campinas, Brazil

    J. R. Matos-Souza

  3. National Council for Scientific and Technological Development (CNPq), National Institute of Science and Technology of Obesity and Metabolism, Campinas, Brazil

    J. C. Pareja & B. Geloneze

  4. Department of Surgery, State University of Campinas (UNICAMP), Campinas, Brazil

    J. C. Pareja & Élinton A. Chaim

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  1. G. Lambert
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  2. Marcelo Miranda de Oliveira Lima
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Corresponding author

Correspondence to Marcelo Miranda de Oliveira Lima.

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Funding

This work was partially funded by Ethicon Endo-Surgery.

Conflict of Interest Disclosure

The authors declare that they have no conflict of interest.

Ethical Statement

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.

Consent Statement

Informed consent was obtained from all individual participants included in the study.

Grant Support

The present study was partially supported by Ethicon Endo-Surgery.

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Lambert, G., Lima, M.M., Felici, A.C. et al. Early Regression of Carotid Intima-Media Thickness after Bariatric Surgery and Its Relation to Serum Leptin Reduction. OBES SURG 28, 226–233 (2018). https://doi.org/10.1007/s11695-017-2839-7

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  • DOI: https://doi.org/10.1007/s11695-017-2839-7

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