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Sleeve gastrectomy reduces structural markers of atherosclerosis

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February 13, 2018

Patients with obesity who underwent laparoscopic sleeve gastrectomy experienced a marked reduction in the 6 months after the procedure in carotid intima-media thickness and epicardial fat thickness, both early markers of subclinical atherosclerosis, according to findings published in Nutrition, Metabolism & Cardiovascular Diseases.

“In addition to significant improvements in insulin resistance, hypertension and dyslipidemia, we showed that sustained weight loss results in significant regression of [carotid intima-media thickness] and [epicardial fat thickness],” Cihan Altin, MD, assistant professor in the department of cardiology at Baskent University in Ankara, Turkey, and colleagues wrote. “Our results indicate that early atherosclerotic structural changes may be reversed by weight loss in clinically asymptomatic obese patients.”

In a prospective study, Altin and colleagues analyzed data from 105 patients with obesity who underwent laparoscopic sleeve gastrectomy between February 2015 and February 2017 (79 women; mean age, 44 years; 35 with family history of coronary artery disease). All participants underwent a physical exam and standard two-dimensional echocardiographic exam, including carotid intima-media thickness and epicardial fat thickness, both before and 6 months after the procedure.

Within the cohort, mean weight loss was 36.09 kg at 6 months after surgery. From baseline to 6 months, researchers did not observe changes in ejection fraction, thickness of interventricular septum or posterior wall (P < .05 for all). However, from baseline to 6 months, epicardial fat thickness decreased from a mean of 8.68 mm to 7.41 mm (P < .001), and carotid intima-media thickness decreased from a mean of 0.74 mm to 0.67 mm (P < .001).

In correlation analyses, researchers observed an association between the change in epicardial fat thickness and change in BMI (r = 0.431; P < .001), whereas change in carotid intima-media thickness was associated with change in epicardial fat thickness (r = 0.31), change in BMI (r = 0.285) and change in systolic blood pressure (r = 0.231; P < .05 for all).

In stepwise linear regression analysis to determine the independent predictors of epicardial fat thickness and carotid intima-media thickness, researchers found that only a change in BMI is an independent predictor of change in epicardial fat thickness (beta = 0.153; P = .001). Only change in epicardial fat thickness is an independent predictor of change in carotid intima-media thickness (beta = 0.02; P = .001).by Regina Schaffer

Disclosures: The authors report no relevant financial disclosures.