Carotid intima-media thickness is reduced 12 months after gastric bypass surgery in obese patients with type 2 diabetes or impaired glucose tolerance

TY - JOUR

T1 - Carotid intima-media thickness is reduced 12 months after gastric bypass surgery in obese patients with type 2 diabetes or impaired glucose tolerance

AU - Lundby-Christensen, Louise

AU - Tarnow, Lise

AU - Hansen, Dorte L

AU - Worm, Dorte

AU - Naver, Lars S

AU - Hvolris, Lisbeth E

AU - Wiinberg, Niels

AU - Vaag, Allan

AU - Almdal, Thomas P

N1 - Copyright © 2014 Elsevier Inc. All rights reserved.

PY - 2014/4/2

Y1 - 2014/4/2

N2 - Aim To investigate whether Roux-en-Y gastric bypass surgery (RYGB) - an in vivo model for normalisation of hyperglycaemia - improves carotid intima-media thickness (IMT) in patients with type 2 diabetes (T2D)/impaired glucose tolerance (IGT) and normal glucose tolerance (NGT). Methods Observational prospective study, 34 obese patients (T2D (n = 14)/IGT (n = 4), and NGT (n = 16)) were investigated before and six and 12 months after RYGB. Results Mean carotid IMT was significantly reduced 12 months after RYGB in patients with T2D/IGT (- 0.041 mm (95% CI - 0.069; - 0.012, p = 0.005)) but not in patients with NGT (- 0.010 mm (- 0.039; 0.020, p = 0.52)). The between-group difference was not significant (p = 0.13). Twelve months after RYGB, patients with respectively T2D/IGT and NGT demonstrated changes in weight: - 29.9 kg, p < 0.001/- 30.6 kg, p < 0.001, HbA1c: - 0.7%, p < 0.001/- 0.1%, p = 0.33, systolic blood pressure: - 2 mmHg, p = 0.68/- 10 mmHg, p = 0.01 and diastolic blood pressure: - 8 mmHg, p = 0.003/- 11 mmHg, p < 0.001. 80% of T2D patients terminated antihyperglycaemic medication. Conclusion Mean carotid IMT was significantly reduced 12 months after RYGB in patients with T2D/IGT which provides evidence to support that the earliest atherosclerotic changes in the arterial wall are reversible. Although numerically different from the changes observed in patients with NGT, the between-group difference was not statistically significant.

AB - Aim To investigate whether Roux-en-Y gastric bypass surgery (RYGB) - an in vivo model for normalisation of hyperglycaemia - improves carotid intima-media thickness (IMT) in patients with type 2 diabetes (T2D)/impaired glucose tolerance (IGT) and normal glucose tolerance (NGT). Methods Observational prospective study, 34 obese patients (T2D (n = 14)/IGT (n = 4), and NGT (n = 16)) were investigated before and six and 12 months after RYGB. Results Mean carotid IMT was significantly reduced 12 months after RYGB in patients with T2D/IGT (- 0.041 mm (95% CI - 0.069; - 0.012, p = 0.005)) but not in patients with NGT (- 0.010 mm (- 0.039; 0.020, p = 0.52)). The between-group difference was not significant (p = 0.13). Twelve months after RYGB, patients with respectively T2D/IGT and NGT demonstrated changes in weight: - 29.9 kg, p < 0.001/- 30.6 kg, p < 0.001, HbA1c: - 0.7%, p < 0.001/- 0.1%, p = 0.33, systolic blood pressure: - 2 mmHg, p = 0.68/- 10 mmHg, p = 0.01 and diastolic blood pressure: - 8 mmHg, p = 0.003/- 11 mmHg, p < 0.001. 80% of T2D patients terminated antihyperglycaemic medication. Conclusion Mean carotid IMT was significantly reduced 12 months after RYGB in patients with T2D/IGT which provides evidence to support that the earliest atherosclerotic changes in the arterial wall are reversible. Although numerically different from the changes observed in patients with NGT, the between-group difference was not statistically significant.

KW - Adolescent

KW - Adult

KW - Body Mass Index

KW - Carotid Intima-Media Thickness

KW - Denmark

KW - Diabetes Mellitus, Type 2

KW - Diabetic Angiopathies

KW - Down-Regulation

KW - Female

KW - Gastric Bypass

KW - Glucose Intolerance

KW - Hemoglobin A, Glycosylated

KW - Humans

KW - Hyperglycemia

KW - Hypertension

KW - Male

KW - Middle Aged

KW - Obesity, Morbid

KW - Risk Factors

KW - Vascular Diseases

KW - Weight Loss

KW - Young Adult

U2 - 10.1016/j.jdiacomp.2014.03.005

DO - 10.1016/j.jdiacomp.2014.03.005

M3 - Journal article

C2 - 24685364

SN - 1056-8727

VL - 28

SP - 517

EP - 522

JO - Journal of Diabetes and its Complications

JF - Journal of Diabetes and its Complications

IS - 4

ER -