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March 13, 2026Obesity Surgery0 citationsOpen Access

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

MHMohamed HanyBTBart TorensmaRARamy E. Arida

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

No

Structured PICO

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

P
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.
I
Intervention
Laparoscopic sleeve gastrectomy (SG)
O
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
  • Association-based nature of analyses
  • Limited biomarker panel assessed (unmeasured inflammatory mediators/adipokines may also contribute)

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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Cite This Study

Hany et al. (2026) conducted a cohort in Obesity (n=93). Sleeve Gastrectomy was evaluated on Carotid Intima-Media Thickness (CIMT) (p=<0.001). Sleeve gastrectomy reduced carotid intima-media thickness from 1.0 mm to 0.6 mm after one year, indicating significant improvement in vascular health.

synapsesocial.com/papers/69b3ac6002a1e69014cce01bhttps://doi.org/10.1007/s11695-026-08538-z
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