Jesús M Gómez-Martin1, Enrique Aracil2, María Insenser1,3, Gema de la Peña4,5, Miguel A Lasunción4,5, Julio Galindo6, Héctor F Escobar-Morreale1,3, José A Balsa1,5, José I Botella-Carretero7,8. 1. Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal and Universidad de Alcalá and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain. 2. Department of Vascular Surgery, Hospital Universitario Ramón y Cajal and Universidad de Alcalá and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain. 3. Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain. 4. Department of Biochemistry Research, Hospital Universitario Ramón y Cajal and Universidad de Alcalá and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain. 5. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain. 6. Department of General and Gastrointestinal Surgery, Hospital Universitario Ramón y Cajal and Universidad de Alcalá and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain. 7. Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal and Universidad de Alcalá and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain, joseignacio.botella@salud.madrid.org. 8. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain, joseignacio.botella@salud.madrid.org.
Abstract
BACKGROUND/AIM: Soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) and amyloid-β(1-40) (Aβ40) emerged as markers of cardiovascular risk because of their actions in the endothelium and their role in atherosclerotic progression. The aim of this study was to analyze the association of these two factors with the decrease in carotid intima-media thickness (cIMT) after bariatric surgery in obese women. METHODS: We studied 60 severely obese women, of whom 20 were submitted to laparoscopic Roux-en-Y gastric bypass (RYGB), 20 to sleeve gastrectomy (SG), and 20 to lifestyle modification therapy. Circulating sTWEAK, Aβ40, high-sensitivity C-reactive protein, plasminogen activator inhibitor type 1, insulin resistance (HOMA-IR), and cIMT were measured at baseline and after 1 year of follow-up. RESULTS: sTWEAK increased similarly after both surgical procedures, whereas the increase observed after lifestyle intervention did not reach statistical significance. Aβ40 showed no differences between groups of women, nor did it change during follow-up. The decrease in cIMT at 12 months correlated with the decrease in body mass index (BMI) (r = 0.45; p < 0.001) and fasting insulin (r = 0.30; p = 0.038), and also with the increase in sTWEAK (r = -0.43; p = 0.002). Multivariate linear regression showed that only the changes in BMI (β = 0.389; p = 0.005) and sTWEAK (β = -0.358; p = 0.009) were associated with the decrease in cIMT (R2 = 0.313; F = 9.348; p < 0.001). CONCLUSIONS: One year after bariatric surgery, RYGB and SG induced a similar increase in circulating sTWEAK that occurred in parallel to the decrease observed in cIMT.
BACKGROUND/AIM: Soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) and amyloid-β(1-40) (Aβ40) emerged as markers of cardiovascular risk because of their actions in the endothelium and their role in atherosclerotic progression. The aim of this study was to analyze the association of these two factors with the decrease in carotid intima-media thickness (cIMT) after bariatric surgery in obesewomen. METHODS: We studied 60 severely obesewomen, of whom 20 were submitted to laparoscopic Roux-en-Y gastric bypass (RYGB), 20 to sleeve gastrectomy (SG), and 20 to lifestyle modification therapy. Circulating sTWEAK, Aβ40, high-sensitivity C-reactive protein, plasminogen activator inhibitor type 1, insulin resistance (HOMA-IR), and cIMT were measured at baseline and after 1 year of follow-up. RESULTS: sTWEAK increased similarly after both surgical procedures, whereas the increase observed after lifestyle intervention did not reach statistical significance. Aβ40 showed no differences between groups of women, nor did it change during follow-up. The decrease in cIMT at 12 months correlated with the decrease in body mass index (BMI) (r = 0.45; p < 0.001) and fasting insulin (r = 0.30; p = 0.038), and also with the increase in sTWEAK (r = -0.43; p = 0.002). Multivariate linear regression showed that only the changes in BMI (β = 0.389; p = 0.005) and sTWEAK (β = -0.358; p = 0.009) were associated with the decrease in cIMT (R2 = 0.313; F = 9.348; p < 0.001). CONCLUSIONS: One year after bariatric surgery, RYGB and SG induced a similar increase in circulating sTWEAK that occurred in parallel to the decrease observed in cIMT.
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