Impact of Obesity Surgery on Endothelial Dysfunction

Guide to Weight Loss Surgery - Research Into Gastric Reduction Surgery

Study Into Effects of Bariatric Surgery on Endothelial Function and Inflammation

Metabolic alterations such as insulin resistance are thought to underlie the endothelial dysfunction and low grade inflammation found in morbid obesity.

Method

Twenty six morbid obese patients, aged 39.0 ± 10.0 (SD), were evaluated before and 4.2 ± 0.8 months after bariatric surgery.

Results

A marked increment in insulin sensitivity index (SI) and endothelium-dependent vasodilatory response in a dorsal hand vein were observed after weight loss following bariatric surgery. Circulating levels of E-selectin, P-selectin, plasminogen activator inhibitor-1, and von Willebrand factor, which were higher than those in the control group, decreased significantly after surgery. Plasma vascular cell adhesion molecule-1, angiotensin-converting enzyme, intercellular adhesion molecule-1, thrombomodulin, and plasma and intraplatelet cGMP levels did not change after weight loss. All inflammatory markers were higher in morbid obese patients. After surgery, C-reactive protein (CRP) and sialic acid (SA) diminished whereas circulating levels of IL-6, TNF- and its soluble receptors did not. A positive correlations were found between changes in adiposity and SI with changes in CRP, and between changes in SA and changes in endothelial function.

Conclusion

A marked improvement in SI, endothelial function and low-grade inflammation were observed in the weight-losing morbid obese patients following bariatric surgery. SI and adiposity appear to play a role in obesity-related low-grade inflammation which contribute to the endothelial dysfunction observed in morbid obesity.

Authors:
Luis Alberto Vázquez MD,, Fernando Pazos MD*, José Ramón Berrazueta MD,, Carlos Fernández-Escalante MD,, María Teresa García-Unzueta MD,, Julio Freijanes MD,, and José Antonio Amado MD. Endocrine Unit (L.A.V., F.P., M.T.G.-U., J.F., J.A.A.), Cardiology Service (J.R.B.) and Surgery Service (C.F.-E.). University Hospital Marqués de Valdecilla. University of Cantabria. Santander. Spain

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Laparoscopic or open bariatric surgery, such as gastric banding or bypass is not an easy solution to morbid obesity and weight loss. It is a serious surgical procedure, involving health risks. To produce lasting weight loss it requires a long-term patient commitment to eating a healthy diet and following a regular program of physical exercise. Life-long use of nutritional supplements may also be necessary. So, before deciding, discuss your options fully with your doctor. © 2003-2008 Bariatric-Surgery.Info - Terms - Contact - Information - Resources - Add URL