Department of Cardiology, SBÜ Mehmet Akif İnan Education and Research Hospital, Esentepe Neighborhood, Ertuğrul Street, 132A., 63040, Haliliye, Şanlıurfa, Turkey.
Department of General Surgery, Şanlıurfa Education and Research Hospital, Yenice Neighborhood, D: 1, 63300, Haliliye, Şanlıurfa, Turkey.
Obes Surg. 2021 Feb;31(2):738-745. doi: 10.1007/s11695-020-05121-y. Epub 2020 Nov 14.
Cardiovascular diseases (CVD) are one of the leading causes of mortality in obese patients. In this study, we investigated the effects of laparoscopic sleeve gastrectomy (LSG) operation on carotid intima-media thickness (CIMT), epicardial fat thickness (EFT), and serum endocan levels, which are independent predictors of subclinical atherosclerosis.
A total of 47 patients (35 females and 12 males) with a mean age of 38 ± 10.48 with standard indications for LSG were prospectively included in the study. Mean CIMT values with B-mode duplex ultrasound, EFT measurements with standard transthoracic 2D echocardiography, and serum endocan levels were measured before the operation and 6 months after the operation. Delta (Δ) values were obtained by subtracting sixth month values from baseline values.
Body mass index (BMI) decreased significantly from an average of 47.31 ± 6.10 to 37.25 ± 5.61 kg/m in the sixth month after LSG (p < 0.001). EFT, CIMT, and serum endocan values decreased significantly in the sixth month after surgery (0.67 ± 0.15 vs. 0.60 ± 0.14 mm, p < 0.001; 1.07 ± 0.05 vs. 1.00 ± 0.14 mm, p < 0.001; and 89.18 ± 66.22 vs. 37.74 ± 15.37, p < 0.001, respectively). There were mild-moderate positive relationships between Δ-BMI and the values of EFT and CIMT (r = 0.386, p = 0.007 and r = 0.314, p = 0.024, respectively). We also found weak linear relationships between Δ-BMI and Δ-endocan (r = 0.267, p = 0.036), and between Δ-EFT and Δ-CIMT (r: 0.221; p: 0.046).
LSG can lead to reduction in the risk of cardiovascular disease by providing improvements in CIMT, EFT, and serum endocan values, which reflect early structural atherosclerotic changes in patients with severe obesity.
心血管疾病(CVD)是肥胖患者死亡的主要原因之一。本研究旨在探讨腹腔镜袖状胃切除术(LSG)对颈动脉内膜中层厚度(CIMT)、心外膜脂肪厚度(EFT)和血清内参水平的影响,这些都是亚临床动脉粥样硬化的独立预测因子。
共纳入 47 例(35 名女性和 12 名男性)患者,平均年龄 38±10.48 岁,具有 LSG 的标准适应证。使用 B 型超声双功能仪测量 CIMT 值,使用标准经胸二维超声心动图测量 EFT 值,使用酶联免疫吸附试验测量血清内参水平,在术前和术后 6 个月进行测量。通过从基线值中减去第六个月的值获得Δ(Δ)值。
LSG 术后 6 个月,体重指数(BMI)从平均 47.31±6.10kg/m2显著下降至 37.25±5.61kg/m2(p<0.001)。EFT、CIMT 和血清内参值在手术后第六个月显著下降(0.67±0.15 比 0.60±0.14mm,p<0.001;1.07±0.05 比 1.00±0.14mm,p<0.001;89.18±66.22 比 37.74±15.37pg/ml,p<0.001)。Δ-BMI 与 EFT 和 CIMT 的值之间存在轻度至中度的正相关关系(r=0.386,p=0.007 和 r=0.314,p=0.024)。我们还发现 Δ-BMI 与 Δ-内参(r=0.267,p=0.036)和 Δ-EFT 与 Δ-CIMT(r:0.221;p:0.046)之间存在弱线性关系。
LSG 可通过改善 CIMT、EFT 和血清内参值来降低心血管疾病的风险,这些值反映了严重肥胖患者早期结构性动脉粥样硬化的变化。