The impact of weight loss after laparoscopic sleeve gastrectomy on early markers of atherosclerotic vascular disease: a prospective study

Abstract

Background: Considering the emerging role of aortic propagation velocity (APV) in determining the burden of the coronary artery disease, we hypothesized that laparoscopic sleeve gastrectomy (LSG) could improve APV in morbidly obese patients.

Aims: The aim of this study was to investigate the impact of LSG on surrogate markers of atherosclerotic vascular disease such as APV, carotid intima‑media thickness (CIMT), epicardial fat thickness (EFT), and ankle‑brachial index (ABI) in patients with morbid obesity.

Methods: We prospectively enrolled 71 patients who were scheduled for LSG for standard indications between December 2018 and June 2019 with accordance to the international guidelines. All patients underwent transthoracic echocardiography and carotid ultrasonography. Differences in the variables measured (Δ) were calculated by subtracting 6‑month follow-up results from the baseline results.

Results: Laparoscopic sleeve gastrectomy led to a significant reduction in body weight, and at 6‑month follow‑up, there was a reduction in systolic and diastolic blood pressure as well as in levels of triglycerides and low‑density lipoprotein cholesterol. Moreover, a reduction in EFT and CIMT as well as an increase in ABI and APV were noted at 6‑month follow‑up compared with the baseline measurements. The change in APV at 6-month follow-up was correlated with systolic blood pressure, diastolic blood pressure, EFT, ABI, and CIMT.

Conclusions: LSG leads to a significant improvement in BMI as well as CIMT, EFT, ABI, and APV, which are the surrogate markers of atherosclerotic vascular disease, in morbidly obese patients at 6‑month follow‑up after the procedure. The improvement in APV is correlated with the improvement in BMI, CIMT, EFT, and ABI.