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Sleeve Gastrectomy and Gastric Bypass Decrease the Carotid Intima-Media Thickness in Obese Men: Association with Weight Loss, Cardiovascular Risk Factors, and Circulating Testosterone

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Abstract

Background

Obesity surgery has shown to decrease the carotid intima-media thickness (IMT), but studies that compare different surgical techniques are scarce, especially in men.

Objective

To evaluate the changes in IMT in men after laparoscopic Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) and its association with circulating testosterone.

Setting

Academic Hospital.

Methods

We studied 40 men with severe obesity, of whom 20 were submitted to laparoscopic RYGB and 20 to SG. Twenty control men matched for age and degree of obesity were also included. Both patients and controls were evaluated at baseline and 6 months after surgery or conventional treatment with diet and exercise, respectively.

Results

The mean carotid IMT decreased after surgery irrespective of the surgical technique whereas no changes were observed in the control men submitted to conventional therapy (Wilks’ λ = 0.745, P < 0.001 for the interaction, P < 0.001 for RYGB vs. controls, P = 0.001 for SG vs. controls, P = 0.999 for RYGB vs. SG). The decrease in the carotid IMT correlated with the increase in total testosterone (r = 0.428, P = 0.010) and lost BMI (r = 0.486, P < 0.001). Multivariate linear regression retained only the decrease in BMI (β = 0.378, P = 0.003) after adjustment (R2 = 0.245, F = 9.229, P = 0.001).

Conclusion

Both RYGB and SG decrease carotid IMT in men with obesity compared with conventional treatment with diet and exercise.

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Fig. 1

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Acknowledgments

We thank the nurse staff of the Department of Endocrinology and Nutrition for their help with the anthropometric and blood sampling of the patients.

Funding Information

This study was supported by grant AES/ISCIII - PI18/00132. CIBERobn is also an initiative of Instituto de Salud Carlos III.

Author information

Correspondence to José I. Botella-Carretero.

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The authors declare that they have no conflict of interest.

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All procedures performed 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.

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Written informed consent was obtained from all the participants included in the study.

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Cobeta, P., Osorio, A., Cuadrado-Ayuso, M. et al. Sleeve Gastrectomy and Gastric Bypass Decrease the Carotid Intima-Media Thickness in Obese Men: Association with Weight Loss, Cardiovascular Risk Factors, and Circulating Testosterone. OBES SURG (2020). https://doi.org/10.1007/s11695-020-04405-7

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Keywords

  • Carotid intima-media thickness
  • Gastric bypass
  • Obesity surgery
  • Sleeve gastrectomy
  • Male hypogonadism
  • Testosterone