Improvement of Arterial Stiffness One Month after Bariatric Surgery and Potential Mechanisms
Oliveras i Serrano, Anna (Hospital del Mar (Barcelona, Catalunya))
Galceran, Isabel (Institut Hospital del Mar d'Investigacions Mèdiques)
Goday Arnó, Albert (Universitat Autònoma de Barcelona. Departament de Medicina)
Vázquez, Susana (Institut Hospital del Mar d'Investigacions Mèdiques)
Sans, Laia (Hospital del Mar (Barcelona, Catalunya))
Riera Oliva, Marta (Institut Hospital del Mar d'Investigacions Mèdiques)
Benaiges, David (Institut Hospital del Mar d'Investigacions Mèdiques)
Pascual, Julio (Institut Hospital del Mar d'Investigacions Mèdiques)

Date:	2021
Abstract:	Arterial stiffness (AS) is an independent predictor of cardiovascular risk. We aimed to analyze changes (Δ) in AS 1-month post-bariatric surgery (BS) and search for possible pathophysiological mechanisms. Patients with severe obesity (43% hypertensives) were prospectively evaluated before and 1-month post-BS, with AS assessed by pulse-wave velocity (PWV), augmentation index (AIx@75) and pulse pressure (PP). Ambulatory 24 h blood pressure (BP), anthropometric data, renin-angiotensin-aldosterone system (RAAS) components and several adipokines and inflammatory markers were also analyzed. Overall reduction in body weight was mean (interquartile range (IQR)) = 11. 0% (9. 6-13. 1). A decrease in PWV, AIx@75 and PP was observed 1-month post-BS (all, p < 0. 01). There were also significant Δ in BP, RAAS components, adipokines and inflammatory biomarkers. Multiple linear regression adjusted models showed that Δaldosterone was an independent variable (B coeff. 95%CI) for final PWV (B = -0. 003, -0. 005 to 0. 000; p = 0. 022). Angiotensin-converting enzyme (ACE)/ACE2 and ACE were independent variables for final AIx@75 (B = 0. 036, 0. 005 to 0. 066; p = 0. 024) and PP (B = 0. 010, 0. 003 to 0. 017; p = 0. 01), respectively. There was no correlation between ΔAS and anthropometric changes nor with Δ of adipokines or inflammatory markers except high-sensitivity C-reactive protein (hs-CRP). Patients with PWV below median decreased PWV (mean, 95%CI = -0. 18, -0. 25 to -0. 10; p < 0. 001) and both AIx@75 and PP at 1-month, but not those with PWV above median. In conclusion, there is an improvement in AS 1-month post-BS that correlates with ΔBP and Δrenin-angiotensin-aldosterone components. The benefit is reduced in those with higher PWV.
Grants:	Ministerio de Economía y Competitividad RD16/0009/0013
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Bariatric surgery ; Arterial stiffness ; Renin-angiotensin axis
Published in:	Journal of clinical medicine, Vol. 10 (february 2021) , ISSN 2077-0383

DOI: 10.3390/jcm10040691
PMID: 33578924

14 p, 509.9 KB

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