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Endothelial Function in Obese Patients Treated with Bariatric Surgery

Authors Borzì AM, Buscemi C, Corleo D, Randazzo C, Rosafio G, Pantuso G, Buscemi S

Received 12 September 2019

Accepted for publication 23 January 2020

Published 4 February 2020 Volume 2020:13 Pages 247—256


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Konstantinos Tziomalos

Antonio Maria Borzì,1,2,* Carola Buscemi,3,4,* Davide Corleo,3,4 Cristiana Randazzo,3,4 Giuseppe Rosafio,3,4 Gianni Pantuso,5 Silvio Buscemi3,4

1Department of Clinical and Experimental Medicine, Specialization School in Geriatrics, University of Catania, Catania, Italy; 2Specialization School in Geriatrics, Catania, Italy; 3Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, Palerno, Italy; 4Unit of Malattie Endocrine, del Ricambio e della Nutrizione, Policlinico University Hospital, Palermo, Italy; 5Dipartimento di Discipline Chirurgiche e Odontostomatologiche (DICHIRONS), Unit of Chirurgia Oncologica, Policlinico University Hospital, Palermo, Italy

*These authors contributed equally to this work

Correspondence: Silvio Buscemi
Unit of Malattie Endocrine, del Ricambio e della Nutrizione, Policlinico University Hospital, Piazza delle cliniche 2, Palermo 90127, Italy

Purpose: Bariatric surgery (BS) is becoming an increasingly frequent treatment option especially in people with morbid obesity, demonstrating that it is able to reduce total mortality and cardiovascular (CV) risk. Despite endothelial dysfunction is an essential requisite contributing to atherosclerosis and predicting CV events, only some studies have investigated the effects of BS on endothelial function with controversial results. In this study, the effects of weight loss on endothelial function were investigated in obese patients after BS and compared with patients after medical nutrition treatment (MNT).
Patients and Methods: Seventeen obese patients who underwent BS procedures (9 adjustable gastric bands, 3 gastric by-passes and 5 biliopancreatic diversions) were included in the study and compared with 18 obese individuals who underwent MNT. Endothelial function was investigated by flow-mediated dilation (FMD) of the brachial artery. Also, carotid intima-media thickness (c-IMT) was measured as a marker of subclinical atherosclerosis.
Results: At the end of follow-up, the mean weight loss was 18.8% in the BS group and 7.0% in the MNT group. After treatment, FMD significantly decreased in the BS group (mean ± SD before: 9.0 ± 4.7; after: 6.1 ± 2.9%; P= 0.04); however, no significant change was observed in the MNT group (before: 9.4 ± 5.8; after: 8.3 ± 5.3; P= 0.41). The modification of endothelial function was negatively correlated with c-IMT change in the BS group (r= − 0.63; P < 0.007).
Conclusion: A significant endothelial dysfunction occurred following BS but not after MNT. Furthermore, the decline of endothelial function observed in the BS group might have contributed to atherosclerosis.

Keywords: obesity, endothelial function, bariatric surgery, medical nutrition therapy

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