Lambert G, et al. – Bariatric surgery (BS) seemed to promote carotid intima–media thickness (C–IMT) regression as early as 6 months post–surgery. This study aimed at assessing whether C–IMT regression occurs even earlier, by determining the effect of Roux–en–Y gastric bypass (RYGBP) and biliopancreatic diversion (BPD) on C–IMT 1–2 months and 12 months post–surgery. Findings revealed a remarkable C–IMT regression as early as 1–2 months after BS in obese patients either with or without type 2 diabetes, which was associated to the early reduction in leptin, (at least partially) independent of weight loss. Further investigation is recommended to assess whether this was a causative or correlative association.

Methods

• Prospective trial was undertaken.
• In this study, BS was performed on 109 patients either with (RYGBP = 42; BDP = 40) or without type 2 diabetes (RYGBP = 27).
• Control group included healthy volunteers.
• Follow-up was performed at: baseline, 1–2 months, 12 months post-surgery.
• Endpoints assessed were: changes (Δ) in C-IMT, weight, body mass index, fat mass, waist and neck circumferences, blood pressure, HbA1c, glucose, insulin, insulin sensitivity [HOMA-IR; OGIS, from meal tolerance test], lipids, C-reactive protein, leptin, adiponectin, MCP-1.

Results

• All surgery subgroups indicated similar levels of Δ-C-IMT.
• Reduction in C-IMT was evident in the pooled surgery group from [mean (95% confidence interval)] 0.81 (0.77-0.84) mm to 0.66 (0.63-0.69) mm, p<0.001 [-17.1 (-20.4 to -13.8)%] at 1-2 months, and to 0.63 (0.59-0.66) mm, p<0.001 [-21.8 (-25.3 to -18.4)%] at 12 months post-surgery.
• There appeared a correlation of Δ-C-IMT 1-2 months and 12 months post-surgery with baseline C-IMT, and with Δ-leptin at 1-2 months, but not at 12 months post-surgery.
• Linear regression analysis suggested Δ-leptin and baseline C-IMT as predictors of Δ-C-IMT 1-2 months post-surgery.