Journal of International Medical Research (Nov 2022)

The metabolic phenotype of the patient influences the reduction in carotid intima-media thickness achieved following metabolic surgery

  • Alberto Melchor-López,
  • Juan Antonio Suárez-Cuenca,
  • Diana Zaineff Banderas-Lares,
  • Gustavo De la Peña-Sosa,
  • Moisés Salamanca-García,
  • Eduardo Vera-Gómez,
  • Alejandro Hernández-Patricio,
  • Juan Ariel Gutiérrez-Buendía,
  • Carlos Ramiro Zamora-Alemán,
  • Sofía Lizeth Alcaráz-Estrada,
  • Moisés Ortiz-Fernández,
  • Jesús Montoya-Ramírez,
  • Omar Felipe Gaytán-Fuentes,
  • Mónica Escamilla-Tilch,
  • Juan Antonio Pineda-Juárez,
  • Mario Antonio Téllez-González,
  • Martha Eunice Rodríguez-Arellano,
  • Alejandra Contreras-Ramos,
  • Rolando Efraín Hernández-Muñoz,
  • José Gutiérrez-Salinas,
  • Silvia García,
  • Paul Mondragón-Terán

DOI
https://doi.org/10.1177/03000605221137475
Journal volume & issue
Vol. 50

Abstract

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Objectives To determine whether metabolic phenotype is associated with the change in carotid intima-media thickness (CIMT) in patients undergoing bariatric /metabolic surgery (BMS). Methods We performed a case-control study of BMS candidates who had metabolically unhealthy obesity (MUO) or metabolically healthy obesity (MHO). We measured the change in CIMT during the 9 months following BMS. The plasma tumor necrosis factor-α, interleukin-1β, adiponectin, leptin, nitric oxide (NO), vascular endothelial growth factor A (VEGF-A), and malondialdehyde concentrations were determined, adipocyte area was measured histologically, and adipose tissue area was estimated using computed tomography. Results Fifty-six patients (mean age 44.5 years, mean body mass index 44.9 kg/m 2 , 53% women, and 53% had MUO) were studied. Nine months following BMS, the MUO phenotype was not associated with a significant reduction in CIMT, and that of the MHO group was larger. In addition, fewer participants achieved a 10% reduction in CIMT in the MUO group. A CIMT reduction was associated with lower VEGF-A and NO in the MUO group, while that in the MHO group was associated with a higher NO concentration. Conclusion The metabolic phenotype of patients may influence their change in CIMT following BMS, probably through circulating vasodilatory and pro-inflammatory molecules.