Chirugie cancérologique digestive et endocrinienne (CCDE), institut des maladies de l'appareil digestif (IMAD), CHU de Nantes-Hôtel Dieu, Nantes, France.
Department of Endocrinology, CHU de Nantes, Nantes, France; Inserm, CNRS, l'institut du thorax, Université Nantes, Nantes, France.
Ann Endocrinol (Paris). 2020 Feb;81(1):44-50. doi: 10.1016/j.ando.2020.01.002. Epub 2020 Feb 1.
Arterial stiffness (AS) is an independent predictor of cardiovascular risk, and could be used as a surrogate marker of improvement in cardiovascular risk following bariatric surgery. The aim of this study was to compare AS before and after surgery.
One hundred and thirty-four patients undergoing bariatric surgery between May 2016 and January 2019 were prospectively included. AS was measured on pulse wave velocity (PWV) with the pOpmètre® device pre- and postoperatively. The main endpoint was change in PWV between baseline and 3 months post-surgery.
Overall, mean PWV was 6.87m/s preoperatively and 6.71m/s at 3 months (P=0.7148). Patients with pathologic PWV (>2 standard deviations from expected value for age) showed significant improvement at 3 months (31 patients; 10.1m/s preoperatively vs 7.5m/s at 3 months; P=0.007). These results did not correlate with improvement in other clinical or biological parameters following surgery (excess weight loss, mean blood pressure, fasting blood glucose, waist circumference, body composition).
These results suggest that pathological arterial stiffness may resolve following bariatric surgery independently of the other factors influencing cardiovascular risk in obesity.
动脉僵硬度(AS)是心血管风险的独立预测因子,可作为减重手术后心血管风险改善的替代标志物。本研究旨在比较手术前后的 AS。
本研究前瞻性纳入了 2016 年 5 月至 2019 年 1 月期间接受减重手术的 134 名患者。术前和术后均使用 pOpmètre®设备测量脉搏波速度(PWV)以评估 AS。主要终点为手术前后 3 个月时 PWV 的变化。
总体而言,术前平均 PWV 为 6.87m/s,术后 3 个月时为 6.71m/s(P=0.7148)。PWV 异常(高于年龄预期值的 2 个标准差)的患者在术后 3 个月时明显改善(31 例患者;术前 10.1m/s 与术后 3 个月时 7.5m/s 相比,P=0.007)。这些结果与术后其他临床或生物学参数的改善无关(体重减轻量、平均血压、空腹血糖、腰围、体成分)。
这些结果表明,肥胖相关心血管风险的其他因素之外,减重手术后病理性动脉僵硬度可能会得到改善。