Table 3.
Studies That Investigated Endothelial Function in Patients Treated with Bariatric Surgery
| Study | Cases (n) |
Controls (n) |
BMI (kg/m2) |
Inclusion Criteria | Exclusion Criteria | Procedure | Exam | FMD (%) | Follow-Up | |
|---|---|---|---|---|---|---|---|---|---|---|
| Before Surgery | After Surgery | |||||||||
| Williams et al,24 2005 | 8 | 9 | 52.2 (50.3–55.9); median (IQR) |
_ | Cigarette smoking, diabetes, CKD |
GB | FMD GTN |
5.3 (3.8–7.0) |
10.2 (7.6–13.3) (P = 0.01) |
6 months |
| Sturm et al,30 2009 | 37 | _ | 42.4 ± 3.9 | BMI > 40.0 or >35.0 + comorbidities |
Diabetes, hypertension, CVD, secondary obesity lipid lowering or antipsychotic medication, alcohol > 20 g/day |
GBP (n=8) or GB (n=29) | FMD GTN c-IMT |
5.8 ± 3.2 | 9.0 ± 2.9 (P <0.001) |
18 months |
| Lind et al,15 2009 | 19 | 19 (without obesity) |
43.8 ± 3.1 cases 23.1±2.0 controls |
Caucasian individuals | ND | GBP | FMD PWV |
7.9 ± 6.4 | 8.5 ± 6.2 (1 month) 9.3 ± 5.9 (1 year) (P= NS vs pre-surgical procedure) |
1 year |
| Bigornia et al,28 2010 | 43 (17 BS + 26 diet) |
_ | 45 ± 9 | _ | CKD, CHF, stroke | GBP or GB | FMD GTN |
6.8 ± 4.2 (cases with weight loss n =29, of which n=17 BS) |
10.0 ± 4.7 (P= 0.013 vs cases with no weight loss) |
1 year |
| Brethauer et al,16 2011 | 15 | _ | 48.1 ± 5.3 | BMI >40.0 or >35.0 + comorbidities; age (18–75 years) |
Diabetes, OSAS, Hypertension |
GBP | FMD GTN |
2.6 ± 2.0 (GTN 20.5 ± 6.7) |
4.4 ± 3.4 (P =0.21) (GTN 23.6 ± 6.4) (P =0.047) |
6 months |
| Saleh et al,25 2012 | 47 | _ | 47.1 ± 5.5 | BMI >40.0, age (18–65 years) |
Diabetes, use of thyroid hormones, CKD, CHF, atrial fibrillation |
GBP | FMD GTN c-IMT |
7.4 ± 5.8 | 18.9 ± 7.4 (P <0.001) |
10 months |
| Nerla et al,26 2012 | 50 | 20 (no on diet) |
47.1 ± 8.4 | _ | CKD, inflammatory bowel diseases, asthma, alcohol use disorder | GBP (n=47) or BPD (n=3) |
FMD GTN |
5.9 ± 2.7 | 8.8 ± 2.4 (P < 0.01) |
3 months |
| Tschoner et al,27 2013 | 52 (36 assessed for FMD) | _ | 43.6 ± 4.9 | BMI > 40.0 or >35.0 + comorbidities |
Diabetes, CKD, hypertension, acute or chronic liver diseases, alcohol use disorder | GBP (n=42) or GB (n=10) |
FMD c-IMT |
5.2 ± 3.3 | 6.6 ± 3.4 (P= 0.001) |
5 years |
| Flores et al,17 2014 | 33 | _ | 45 | Age 18–65 years, BMI >40.0 or >35.0 + comorbidities, normal renal function, hypertension on <3 medications |
Secondary hypertension or established CVD | GBP (n=18) or sleeve gastrectomy (n=15) | FMD | 9 ± 7 | 8 ± 6 (P= NS vs pre-surgical procedure) |
1 year |
| Tromba et al,31 2017 | 45 | _ | 44.3 ± 4.6 | BMI >30.0–57.7 | Diabetes and CVD | Sleeve gastrectomy | FMD c-IMT |
3 (median value) | 10 (median value, both at 3 and 6 months) (P= 0.001 3 months vs baseline; P= NS 6 months vs 3 months) |
6 months |
| Tarzia et al,29 2017 | 19 | _ | 47.7 ± 6.2 | _ | CKD, inflammatory bowel diseases, asthma, alcohol use disorder | GBP (n=18) or BPD (n=1) | FMD c-IMT |
6.4 ± 2.8 | 9.5 ± 2.6 (3 months; P< 0.01) 8.2 ± 1.7 (4 years; P< 0.05) (overall P< 0.01) |
4 years |
| de Assunção Machado et al,32 2018 | 56 (28 with OSAS and 28 without OSAS) | _ | 41.6 ± 3 (no OSAS) 43.2 ± 5.5 (OSAS) |
Age ≥ 16 years, BMI > 40.0 or BMI >35.0 + comorbidities, with or without OSAS |
Hyperthyroidism (TSH <0.01), neoplasms or immunosuppressive diseases, Cushing’s syndrome or chronic use of corticosteroids, COPD, diabetic nephropathy, RA, diabetes, smokers, normal endothelial function |
GBP | FMD GTN |
3.4 ± 2.9 (no OSAS) 3.2 ± 2.2 (OSAS) |
14.8 ± 4.6 (no OSAS) 11.1 ± 3.6 (OSAS) (P <0.001) |
6 months |
Abbreviations: BMI, body mass index; BPD, biliopancreatic diversion; CKD, chronic kidney disease; CHF, chronic heart failure; c-IMT, carotid intima-media thickness; COPD, chronic obstructive pulmonary disease; CVD, cardiovascular disease; FMD, flow-mediated dilation; GB, adjustable gastric banding; GBP, gastric by-pass; GTN, glyceryl-trinitrate dilation of the brachial artery; ND, not determined; NS, not significant; OSAS, obstructive sleep apnea syndrome; PWV, pulse-wave velocity; RA, rheumatoid arthritis.