Improvement in cardiovascular risk in women after bariatric surgery as measured by carotid intima-media thickness: comparison of sleeve gastrectomy versus gastric bypass

Surg Obes Relat Dis. 2017 May;13(5):848-854. doi: 10.1016/j.soard.2017.01.040. Epub 2017 Feb 3.

Abstract

Background: Bariatric surgery may diminish cardiovascular risk (CVR) and its associated mortality. However, studies that compare these effects with different techniques are scarce.

Objective: To evaluate the changes in CVR as estimated by carotid intima-media thickness (IMT) after obesity surgery in women with high CVR as defined by the presence of metabolic syndrome.

Setting: Academic hospital.

Methods: We studied 40 severely obese women, of whom 20 received laparoscopic Roux en Y gastric bypass (RYGB) and 20 received sleeve gastrectomy (SG). Twenty control women matched for age and cardiovascular risk were also included. Patients and controls were evaluated at baseline and 1 year after surgery or conventional treatment with diet and exercise, respectively. Only 18 of the 20 women in the control group were available for analysis after 1 year. None of the women who had bariatric surgery was lost to follow-up.

Results: Mean carotid IMT decreased 1 year after surgery irrespective of the surgical technique used, whereas no changes were observed in the control women who had conventional therapy (Wilks´ λ = .802, P = .002 for the interaction, P = .011 for RYGB versus controls, P = .002 for SG versus controls, P = .349 for RYGB versus SG).

Conclusion: Both RYGB and SG decrease CVR as measured by carotid IMT in obese women.

Keywords: Cardiovascular risk; Carotid intima-media thickness; Gastric bypass; Obesity surgery; Sleeve gastrectomy; Subclinical atherosclerosis.

Publication types

  • Comparative Study

MeSH terms

  • Cardiovascular Diseases / diagnostic imaging
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control*
  • Carotid Intima-Media Thickness
  • Female
  • Gastrectomy / methods*
  • Gastric Bypass / methods*
  • Humans
  • Middle Aged
  • Obesity, Morbid / complications
  • Obesity, Morbid / surgery*
  • Risk Factors
  • Treatment Outcome
  • Weight Loss / physiology