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B-type natriuretic peptide increases after gastric bypass surgery and correlates with weight loss

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Abstract

Background

Coronary artery disease is the primary cause of death in the United States, with obesity as a leading preventable risk factor. Previous studies have established the beneficial effect of Roux-en-Y gastric bypass on both weight and cardiac risk factors. Further assessment of cardiac function may be accomplished using B-type natriuretic peptide (BNP), which has demonstrated clinical utility in diagnosing congestive heart failure. This study aimed to assess changes in BNP after intentional weight loss through gastric bypass surgery.

Methods

Plasma volume, weight, and BNP were measured preoperatively and at 3, 6, and 12 months postoperatively for 101 consecutive patients undergoing laparoscopic gastric bypass surgery by a single surgeon in an academic medical setting. Outcomes were compared by matched t-test. Multivariable linear regression and Pearson’s correlation were used to examine predictors of pro-B-type natriuretic peptide (NT-proBNP) concentration.

Results

The concentration of BNP increased significantly from a mean preoperative level of 50.5 ng/l to postoperative levels of 73.9 ng/l at 3 months (P = 0.013), 74.3 ng/l at 6 months (P < 0.001), and 156.3 ng/l at 12 months (P < 0.001). In addition, excess weight loss was the only statistically significant predictor of increased BNP concentration (odds ratio, 1.483; P < 0.05).

Conclusion

Gastric bypass leads to significant excess weight loss and surprisingly increased BNP concentrations. Correlation of BNP increase with weight loss suggests an additional novel mechanism for surgically induced weight loss.

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Disclosures

John Morton has an educational Grant from Ethicon Endo-Surgery. Eric M. Changchien, Shushmita Ahmed, Francesca Betti, Jennifer Higa, Kate Kiely, and Tina Hernandez-Boussard have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Surgery, Stanford Medical Center, 300 Pasteur Drive, H3680, Stanford, CA, 94305, USA

    Eric M. Changchien, Shushmita Ahmed, Francesca Betti, Jennifer Higa, Kate Kiely, Tina Hernandez-Boussard & John Morton

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  1. Eric M. Changchien
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  2. Shushmita Ahmed
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  3. Francesca Betti
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  4. Jennifer Higa
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  6. Tina Hernandez-Boussard
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  7. John Morton
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Correspondence to John Morton.

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Changchien, E.M., Ahmed, S., Betti, F. et al. B-type natriuretic peptide increases after gastric bypass surgery and correlates with weight loss. Surg Endosc 25, 2338–2343 (2011). https://doi.org/10.1007/s00464-010-1565-1

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  • DOI: https://doi.org/10.1007/s00464-010-1565-1

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