Improvement of Coronary Calcium Scores After Bariatric Surgery in People with Severe Obesity

Ahmed Abdallah Salman; Mohamed Matter; Nabil Ibrahim Fayad; Mohamed S Abd Elaziz Shehata; Mohamed Abd Al-Fattah; Mohamed Hassan Elkaseer; Marwan Mansour Borham; Hany A Balamoun; Ahmed Abd El Aal Sultan; Hani Maurice Sabri Mikhail; Haitham S E Omar; Nader Milad; Mohamed Sabry Tourky; Abd Al-Kareem Elias; Amir Mostafa; Ahmad Samir; Amr Mahmoud Hussein; Hossam El-Din Shaaban; Hazem Abd Allah Ali; Mohamed Abdalla Salman

doi:10.1007/s11695-021-05801-3

Improvement of Coronary Calcium Scores After Bariatric Surgery in People with Severe Obesity

Obes Surg. 2022 Feb;32(2):472-479. doi: 10.1007/s11695-021-05801-3. Epub 2021 Nov 22.

Authors

Ahmed Abdallah Salman¹, Mohamed Matter², Nabil Ibrahim Fayad³, Mohamed S Abd Elaziz Shehata³, Mohamed Abd Al-Fattah⁴, Mohamed Hassan Elkaseer⁴, Marwan Mansour Borham⁴, Hany A Balamoun⁵, Ahmed Abd El Aal Sultan⁴, Hani Maurice Sabri Mikhail⁵, Haitham S E Omar⁵, Nader Milad⁵, Mohamed Sabry Tourky⁶, Abd Al-Kareem Elias⁷, Amir Mostafa⁸, Ahmad Samir⁸, Amr Mahmoud Hussein⁹, Hossam El-Din Shaaban¹⁰, Hazem Abd Allah Ali¹¹, Mohamed Abdalla Salman⁵

Affiliations

¹ Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt. awea844@gmail.com.
² Radiodiagnosis Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
³ Radiology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
⁴ General Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
⁵ General Surgery Department, Faculty of Medicine, Cairo University, Giza, Egypt.
⁶ Department of Surgery, Great Western Hospitals NHS Foundation Trust, Swindon, UK.
⁷ Department of General Surgery, Faculty of Medicine, Al-Azhar University, Assuit Branch, Cairo, Egypt.
⁸ Cardiovascular Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
⁹ Internal Medicine Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
¹⁰ Gastroenterology Department, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt.
¹¹ Anesthesia and Intensive Care Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

PMID: 34806127
DOI: 10.1007/s11695-021-05801-3

Abstract

Background: Obesity is an independent risk factor for cardiovascular diseases. Coronary artery calcium (CAC) is a direct measure of coronary atherosclerosis. The study investigated the effect of bariatric surgery on CAC scores in people with severe obesity subjected to laparoscopic sleeve gastrectomy (LSG).

Methods: This prospective study included 129 people with severe obesity in two groups; the LSG group (n=74) subjected to surgery and the diet group (n=55), managed by a diet regimen and lifestyle modification. Cardiovascular risk was assessed by Framingham risk score (FRS) and coronary calcium score (CCS) measured by computed tomography initially and after 3 years.

Results: The two groups had a comparable CAD risk before treatment according to FRS or CCS. After treatment, CCS improved significantly in the LSG group (p=0.008) but not in the diet group (p=0.149). There was no correlation between FRS and CCS (r=0.005, p=0.952). Treatment resulted in significant weight reduction and improved fasting blood glucose and lipid profile in the two groups. The change of weight, blood glucose, and HDL, and remission of diabetes mellitus (DM) were significantly higher in the LSG group compared to the diet group.

Conclusion: LSG may reduce the risk of developing future cardiovascular comorbidities evidenced by reducing CAC scores. Significant weight reduction and improvement of cardiovascular risk factors may recommend LSG as a cardioprotective procedure in people with severe obesity.

Keywords: Bariatric surgery; Coronary calcium scores.

MeSH terms

Bariatric Surgery*
Blood Glucose
Calcium
Gastrectomy / methods
Humans
Laparoscopy* / methods
Obesity, Morbid* / surgery
Prospective Studies
Treatment Outcome
Weight Loss

Substances

Blood Glucose
Calcium