Bariatric Surgery Results in 'Fast' Regression of Subclinical Atherosclerosis

March 25, 2015

GLASGOW, SCOTLAND — Obese individuals undergoing bariatric surgery for weight reduction experienced a significant regression in subclinical atherosclerosis 1 month following the surgery, and this reduction in atherosclerosis, as measured by carotid intima-media thickness (IMT), remained significant at 1 year following the weight-loss surgery[1].

These were the main conclusions of a small study presented this week here at EAS 2015: the European Atherosclerosis Society 2015 Congress. Presenting the results, lead investigator Dr Jose Roberto Matos-Souza (State University of Campinas/UNICAMP Clinics, Brazil) said the reduction in carotid IMT was "more intense" or more pronounced over the first 6 months than the reduction in body weight.

To heartwire from Medscape, Matos-Souza said there is a long waiting list in Brazil for bariatric surgery. In his area, the wait is 2 to 3 months, but in other areas with fewer medical services the wait can be as long as 5 years. He noted that other studies have shown bariatric surgery can regress atherosclerosis, but those studies have shown the change occurs in approximately 3 to 6 months.

In their study, 54 women with a body-mass index (BMI) >40 kg/m2 or 35 to 40 kg/m2 with additional cardiovascular risk factors underwent sleeve gastrectomy. At baseline, the average BMI was 44.4, and patients had a mean waist circumference of 120 cm. The average LDL- and HDL-cholesterol levels at baseline were 110 and 42 mg/dL, respectively.

At 1 month following surgery, there was a statistically significant reduction in carotid IMT, down from 0.893 mm at baseline to 0.718 mm. At 2, 6, and 12 months, the mean carotid IMT measured 0.643 mm, 0.624 mm, and 0.657 mm, respectively (P<0.001 for all changes). The reduction in carotid IMT was significantly correlated with fasting plasma glucose levels, LDL cholesterol, BMI, and waist circumference.

At 1 month, LDL-cholesterol levels were reduced to 87.3 mg/dL. By 12 months, the reduction in LDL cholesterol was sustained at 83.5 mg/dL. HDL-cholesterol levels were also significantly increased to 46.2 mg/dL, 52.1 mg/dL, and 52.1 mg/dL at 2, 6, and 12 months, respectively.

At 1 month, HDL-cholesterol levels had dropped slightly, although the change was not statistically significant, and there was no change in C-reactive protein (CRP) levels. To heartwire , Matos-Souza said patients following surgery are in a high inflammatory state, as reflected by their CRP levels, and this likely had an impact on HDL-cholesterol levels. He noted the study included only women, but he suspects the same "fast" regression of subclinical atherosclerosis would be observed in men also.

Matos-Souza reports no relevant financial relationships.

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