Louise Lundby-Christensen1, Lise Tarnow2, Dorte L Hansen3, Dorte Worm3, Lars S Naver4, Lisbeth E Hvolris4, Niels Wiinberg5, Allan Vaag6, Thomas P Almdal7. 1. Steno Diabetes Center, Niels Steensens Vej 2, 2820 Gentofte, Denmark; Department of Paediatrics, Copenhagen University Hospital Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark. Electronic address: louise.lundby.christensen@gmail.com. 2. Steno Diabetes Center, Niels Steensens Vej 2, 2820 Gentofte, Denmark; Nordsjællands University Hospital Hillerød, Dyrehavevej 29, 3400 Hillerød, Denmark. 3. Department of Endocrinology, Copenhagen University Hospital Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark. 4. The Gastro Unit, Department of Surgery, Copenhagen University Hospital Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark. 5. Department of Physiology and Nuclear Medicine, Copenhagen University Hospital Frederiksberg, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark. 6. Steno Diabetes Center, Niels Steensens Vej 2, 2820 Gentofte, Denmark; Department of Endocrinology, University of Copenhagen Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark. 7. Steno Diabetes Center, Niels Steensens Vej 2, 2820 Gentofte, Denmark; Department of Medicine F, Copenhagen University Hospital Gentofte, Niels Andersens Vej 65, 2900 Hellerup, Denmark.
Abstract
AIM: To investigate whether Roux-en-Y gastric bypass surgery (RYGB) - an in vivo model for normalisation of hyperglycaemia - improves carotid intima-media thickness (IMT) in patients with type 2 diabetes (T2D)/impaired glucose tolerance (IGT) and normal glucose tolerance (NGT). METHODS: Observational prospective study, 34 obese patients (T2D (n = 14)/IGT (n = 4), and NGT (n = 16)) were investigated before and six and 12months after RYGB. RESULTS: Mean carotid IMT was significantly reduced 12months after RYGB in patients with T2D/IGT (-0.041 mm (95% CI -0.069; -0.012, p = 0.005)) but not in patients with NGT (-0.010 mm (-0.039; 0.020, p = 0.52)). The between-group difference was not significant (p=0.13). Twelve months after RYGB, patients with respectively T2D/IGT and NGT demonstrated changes in weight: -29.9 kg, p<0.001/-30.6 kg, p < 0.001, HbA1c: -0.7%, p < 0.001/-0.1%, p = 0.33, systolic blood pressure: -2 mmHg, p = 0.68/-10 mmHg, p = 0.01 and diastolic blood pressure: -8 mmHg, p = 0.003/-11 mmHg, p < 0.001. 80% of T2D patients terminated antihyperglycaemic medication. CONCLUSION: Mean carotid IMT was significantly reduced 12months after RYGB in patients with T2D/IGT which provides evidence to support that the earliest atherosclerotic changes in the arterial wall are reversible. Although numerically different from the changes observed in patients with NGT, the between-group difference was not statistically significant.
AIM: To investigate whether Roux-en-Y gastric bypass surgery (RYGB) - an in vivo model for normalisation of hyperglycaemia - improves carotid intima-media thickness (IMT) in patients with type 2 diabetes (T2D)/impaired glucose tolerance (IGT) and normal glucose tolerance (NGT). METHODS: Observational prospective study, 34 obesepatients (T2D (n = 14)/IGT (n = 4), and NGT (n = 16)) were investigated before and six and 12months after RYGB. RESULTS: Mean carotid IMT was significantly reduced 12months after RYGB in patients with T2D/IGT (-0.041 mm (95% CI -0.069; -0.012, p = 0.005)) but not in patients with NGT (-0.010 mm (-0.039; 0.020, p = 0.52)). The between-group difference was not significant (p=0.13). Twelve months after RYGB, patients with respectively T2D/IGT and NGT demonstrated changes in weight: -29.9 kg, p<0.001/-30.6 kg, p < 0.001, HbA1c: -0.7%, p < 0.001/-0.1%, p = 0.33, systolic blood pressure: -2 mmHg, p = 0.68/-10 mmHg, p = 0.01 and diastolic blood pressure: -8 mmHg, p = 0.003/-11 mmHg, p < 0.001. 80% of T2D patients terminated antihyperglycaemic medication. CONCLUSION: Mean carotid IMT was significantly reduced 12months after RYGB in patients with T2D/IGT which provides evidence to support that the earliest atherosclerotic changes in the arterial wall are reversible. Although numerically different from the changes observed in patients with NGT, the between-group difference was not statistically significant.
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