Sarmento P L F A, Plavnik F L, Zanella M T, Pinto P E, Miranda R B, Ajzen S A
Department of Diagnostic Imaging, Federal University of São Paulo (UNIFESP), São Paulo (SP), Brazil.
Obes Surg. 2009 Mar;19(3):339-44. doi: 10.1007/s11695-008-9783-5. Epub 2008 Dec 13.
Obesity is associated with cardiovascular risk factors (CVRFs), such as hypertension, hypertriglyceridemia, and low levels of high-density cholesterol (HDL-C). In obese patients with a body mass index (BMI) of >or=40 kg/m2 or 35-40 kg/m2 associated with CVRFs, weight loss may be achieved more effectively by bariatric surgery on reducing several CVRFs. Carotid intima-media thickness (C-IMT) is an indicator of early atherosclerosis, and may be correlated with CVRFs. Our objective was to correlate C-IMT with CVRFs before (baseline data) and after surgery, and to observe whether weight loss is followed by a regression of C-IMT.
Eighteen women who had undergone bariatric surgery participated in this study. Assessments were carried out on the baseline date, and 3, 6, and 12 months after surgery. Some of the CVRFs analyzed were: total cholesterol (TC) levels, HDL-C, triglycerides to HDL-C ratio (TG/HDL-C) and fasting plasma glucose. C-IMT was measured by B-mode ultrasound.
A positive correlation was found between C-IMT and age and triglyceride level (p=0.002 and p=0.02, respectively). Six months after surgery, we found a significant reduction in C-IMT (p<0.05), which was significantly correlated with TG level and systolic pressure (p<0.05).
The weight loss achieved with bariatric surgery resulted in regression of C-IMT. This regression could be observed 6 months following surgery, with an additional benefit at 12 months. Also, this finding was correlated with a reduction in triglyceride levels and systolic blood pressure.
肥胖与心血管危险因素（CVRFs）相关，如高血压、高甘油三酯血症和低水平的高密度胆固醇（HDL-C）。对于体重指数（BMI）≥40 kg/m²或35 - 40 kg/m²且伴有CVRFs的肥胖患者，通过减肥手术减轻多种CVRFs可能更有效地实现体重减轻。颈动脉内膜中层厚度（C-IMT）是早期动脉粥样硬化的一个指标，可能与CVRFs相关。我们的目的是将手术前（基线数据）和手术后的C-IMT与CVRFs进行关联，并观察体重减轻后C-IMT是否会消退。
18名接受过减肥手术的女性参与了本研究。在基线日期以及手术后3个月、6个月和12个月进行评估。分析的一些CVRFs包括：总胆固醇（TC）水平、HDL-C、甘油三酯与HDL-C比值（TG/HDL-C）和空腹血糖。通过B型超声测量C-IMT。
发现C-IMT与年龄和甘油三酯水平呈正相关（分别为p = 0.002和p = 0.02）。手术后6个月，我们发现C-IMT显著降低（p < 0.05），这与TG水平和收缩压显著相关（p < 0.05）。
减肥手术实现的体重减轻导致C-IMT消退。这种消退在手术后6个月即可观察到，在12个月时还有额外益处。此外，这一发现与甘油三酯水平和收缩压的降低相关。
