Bariatric surgery prevents carotid wall thickness progression

Wien Klin Wochenschr. 2023 Mar;135(5-6):151-157. doi: 10.1007/s00508-022-02090-3. Epub 2022 Oct 7.

Abstract

Background: Bariatric surgery is a treatment option for patients with severe obesity and improves parameters of cardiovascular and/or metabolic disease. Carotid intima media thickness (C-IMT) is a surrogate measure of subclinical atherosclerosis. Previous studies showed short to mid-term arrest and even regression of C‑IMT progression following bariatric surgery. We aimed to investigate the long-term effect of weight loss on C‑IMT progression 10 years after bariatric surgery in comparison to a population-based control cohort.

Methods: In total, 21 eligible patients were examined preoperatively, at 5 and 10 years after bariatric surgery. Anthropometric parameters, plasma triglycerides, total cholesterol, high-density lipoprotein cholesterol (HDL-C), insulin, and glucose were assessed at all three study visits. C‑IMT was measured via B‑mode scans of the common carotid artery. C‑IMT progression was measured in an age-matched and BMI-matched cohort selected from the population-based Bruneck study to compare with changes in C‑IMT progression after bariatric surgery.

Results: C‑IMT remained stable over the 10-year observation period after bariatric surgery. The control cohort showed a significant C‑IMT progression over 10 years. The difference in C‑IMT progression over 10 years was significant (p < 0.01) between both cohorts.

Conclusion: Weight loss induced by bariatric surgery halts the natural progression of C‑IMT over a 10-year observation period.

Keywords: Bariatric surgery; Carotid intima-media thickness; Carotid wall thickness progression; Subclinical atherosclerosis; Weight loss.

MeSH terms

  • Adult
  • Atherosclerosis* / diagnostic imaging
  • Atherosclerosis* / pathology
  • Atherosclerosis* / prevention & control
  • Bariatric Surgery*
  • Carotid Artery Diseases* / diagnostic imaging
  • Carotid Artery Diseases* / pathology
  • Carotid Artery Diseases* / prevention & control
  • Carotid Intima-Media Thickness* / trends
  • Disease Progression
  • Female
  • Humans
  • Male
  • Middle Aged
  • Treatment Outcome
  • Weight Loss / physiology