Department of General Surgery, University of Harran, Sanliurfa, Turkey.
Department of Cardiology, Private Meydan Hospital, Sanliurfa, Turkey.
J Interv Cardiol. 2022 Jul 8;2022:6152571. doi: 10.1155/2022/6152571. eCollection 2022.
Thrombomodulin, an integral membrane protein functioning as a cofactor in the anticoagulant pathways, has recently emerged as a marker of endothelial dysfunction. This study aimed to investigate the impact of laparoscopic sleeve gastrectomy (LSG) on thrombomodulin concentration and early markers of atherosclerosis.
Forty-four subjects undergoing LSG were prospectively examined. The change in thrombomodulin concentration from baseline (preoperative) to the sixth postoperative month following the LSG and the relationship between the change in thrombomodulin concentration and BMI, CIMT, ABI, and blood lipids were examined.
The medical records were available for 44 patients (mean age: 37.2 ± 10.9 years, 65.9% male). LSG led to significant reductions in total body weight and body mass index (BMI) at postoperative six months (37.0 ± 5.6 kg/m vs. 47.1 ± 5.8 kg/m, < 0.001). Markers of early atherosclerotic events, including carotid intima-media thickness (CIMT) and ABI, improved. The change in thrombomodulin concentration (Δ TMD) was significantly correlated with the change in Δ BMI ( = 0.500, =0.011), Δ LDL ( = 0.389, =0.032), Δ systolic blood pressure ( = 0.384, =0.012), and Δ CIMT ( = 0.327, =0.012) and was negatively correlated with Δ HDL ( = -0.344, =0.020) and Δ ABI ( = -0.357, =0.020).
LSG leads to significant improvements in blood lipids, systolic and diastolic blood pressure, and in surrogate markers of atherosclerotic burden and endothelial function, including thrombomodulin, ABI, and CIMT, at postoperative six months. LSG might prevent or reduce atherogenesis in the early stages by stopping endothelial dysfunction.
血栓调节蛋白是一种整合膜蛋白，作为抗凝途径的辅助因子，最近已成为血管内皮功能障碍的标志物。本研究旨在探讨腹腔镜胃袖状切除术（LSG）对血栓调节蛋白浓度和早期动脉粥样硬化标志物的影响。
前瞻性检查了 44 名接受 LSG 的患者。从基线（术前）到 LSG 后 6 个月，检查了血栓调节蛋白浓度的变化，以及血栓调节蛋白浓度变化与 BMI、CIMT、ABI 和血脂之间的关系。
共获得 44 例患者的病历（平均年龄：37.2±10.9 岁，65.9%为男性）。LSG 可显著降低术后 6 个月的体重和 BMI（37.0±5.6kg/m 比 47.1±5.8kg/m，<0.001）。包括颈动脉内膜中层厚度（CIMT）和 ABI 在内的早期动脉粥样硬化事件标志物均有所改善。血栓调节蛋白浓度的变化（ΔTMD）与ΔBMI（ = 0.500，=0.011）、ΔLDL（ = 0.389，=0.032）、Δ收缩压（ = 0.384，=0.012）和ΔCIMT（ = 0.327，=0.012）显著相关，与ΔHDL（ = -0.344，=0.020）和ΔABI（ = -0.357，=0.020）呈负相关。
LSG 可显著改善术后 6 个月的血脂、收缩压和舒张压，以及血栓调节蛋白、ABI 和 CIMT 等动脉粥样硬化负担和血管内皮功能的替代标志物。LSG 可能通过阻止内皮功能障碍，在早期阶段预防或减少动脉粥样发生。
