What is the clinical evidence from this study?

Study design: Cohort. Population: Obesity (n=93). Intervention: Sleeve Gastrectomy. Primary outcome: Carotid Intima-Media Thickness (CIMT) (p=<0.001).

What question did this study set out to answer?

This research aims to investigate the effects of sleeve gastrectomy on carotid intima-media thickness and associated biomarkers.

March 13, 2026Open Access

Carotid Intima–media Thickness is Lower after Sleeve Gastrectomy, with Concurrent Changes in Oxidized LDL and PAI-1

Q: What are the key findings of this study?

Sleeve gastrectomy reduced carotid intima-media thickness from 1.0 mm to 0.6 mm after one year, indicating significant improvement in vascular health.

Q: What question did this study set out to answer?

This research aims to investigate the effects of sleeve gastrectomy on carotid intima-media thickness and associated biomarkers.

Key Result

Sleeve gastrectomy reduced carotid intima-media thickness from 1.0 mm to 0.6 mm after one year, indicating significant improvement in vascular health.

Key Points

This research aims to investigate the effects of sleeve gastrectomy on carotid intima-media thickness and associated biomarkers.
Employed assessments of carotid intima-media thickness (CIMT) before and after sleeve gastrectomy (SG)
Measured levels of oxidative and inflammatory biomarkers, including oxidized LDL (Ox-LDL) and PAI-1
Evaluated the relationship between CIMT and various fibrinolysis biomarkers post-SG
CIMT decreased significantly after sleeve gastrectomy
Oxidized LDL showed a stronger correlation with CIMT compared to PAI-1
Improvements were observed in inflammatory and oxidative biomarkers post-weight loss

Study Design

Type

Cohort (n=93)

Multicenter

Structured PICO

Does sleeve gastrectomy improve carotid intima-media thickness and oxidative/fibrinolytic biomarkers in adults with obesity?

Population

93 adults with obesity (BMI > 35 kg/m² or BMI > 30 kg/m² with at least one obesity-associated disease), mean age 39.6, 82.8% female. Excluded: history of clinically manifest atherosclerotic cardiovascular disease, known coagulopathies, or current malignancy.

Intervention

Laparoscopic sleeve gastrectomy (SG)

Outcome

Changes in carotid intima-media thickness (CIMT), oxidized LDL (ox-LDL), and PAI-1 at 12 months postoperativelysurrogate

Sleeve gastrectomy significantly reduces subclinical atherosclerosis (CIMT) and improves cardiometabolic biomarkers, with ox-LDL serving as a better predictor of vascular risk than PAI-1.

Main Result

Absolute Event Rate: 0.6% vs 1%

p-value: p=<0.001

Limitations

Single-center study
Modest sample size limits generalizability
No control group without obesity
Medications during follow-up not systematically recorded

Abstract

Weight loss following SG was associated with improvement in inflammatory, oxidative, and fibrinolytic biomarkers. Ox-LDL was more strongly linked to CIMT than PAI-1, which showed limited predictive value. Further studies are needed to evaluate the relationship between CIMT and other fibrinolysis biomarkers such as thrombin-activatable fibrinolysis inhibitor (TAFI) and D-dimer in the context of MBS.

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