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

Bariatric surgery prevents carotid wall thickness progression

Lukas Lunger  1   2 , Andreas Melmer  1   3 , Wolfgang Sturm  1 , Claudia Lamina  4 , Alexander Tschoner  1 , Julia Engl  1 , Armin Hönlinger  1 , Clemens Engler  1   5 , Peter Willeit  6 , Stefan Kiechl  6 , Johann Willeit  6 , Dietmar Öfner  7 , Heinz Wykypiel  7 , Markus Laimer  3 , Herbert Tilg  1 , Christoph Ebenbichler  8
Affiliations

Bariatric surgery prevents carotid wall thickness progression

Lukas Lunger et al. Wien Klin Wochenschr. 2023 Mar.

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.

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Conflict of interest statement

L. Lunger, A. Melmer, W. Sturm, C. Lamina, A. Tschoner, J. Engl, A. Hönlinger, C. Engler, P. Willeit, S. Kiechl, J. Willeit, D. Öfner, H. Wykypiel, M. Laimer, H. Tilg and C. Ebenbichler declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Individual C‑IMT changes after bariatric surgery during the 10-year observation period. C‑IMT carotid intima media thickness
Fig. 2
Fig. 2
Change in C‑IMT in mm to Baseline after 5 years and 10 years of follow-up in cases and controls; mean values are shown for cases and control group as horizontal lines; p-values are derived from paired t‑tests comparing the respective follow-up-values with baseline values. C‑IMT carotid intima media thickness
See this image and copyright information in PMC

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