Key result
Bariatric surgery is linked to a ~50% reduction in atherogenic index of plasma at 12 months.
Why the study?
Reliable, simple, and practical indicators for predicting progression of cardiovascular disease events have remained understudied in the context of bariatric surgery.
Does bariatric surgery improve atherogenicity and insulin resistance indicators in patients with obesity class II?
Cohort (n=443)
No
Does bariatric surgery improve atherogenicity and insulin resistance indicators in patients with obesity class II?
Absolute Event Rate: 0.23% vs 0.46%
p-value: p=<0.001
Bariatric surgery significantly improves surrogate markers of atherogenicity and insulin resistance in patients with class II obesity at 12 months, independent of the specific surgical procedure.
Supports bariatric surgery for improving atherogenic indices in class II obesity; hypothesis-generating and requires confirmation in randomized trials.
OBJECTIVE: Enormous efforts have been made to evaluate reliable, simple and practical indicators for predicting patients at risk of progression of cardiovascular disease events, whereby bariatric surgery has remained understudied. Thus, we performed this study to assess the effect of bariatric surgery procedures on atherogenicity and insulin resistance indicators. DESIGN: Cohort study. SETTING, PARTICIPANTS AND OUTCOME MEASURES: Four hundred and forty-three class II obese (severely obese) patients who underwent sleeve gastrectomy, Roux-en-Y gastric bypass, or one anastomosis gastric bypass were followed up for 12 months after surgery. Atherosclerosis-related indicators were evaluated at baseline, as well as 6 and 12 months after surgery. RESULTS: Atherogenic index of plasma, lipoprotein combine index, atherogenic coefficient, cholesterol index, Castelli's risk indices I and II, and triglyceride to high-density lipoprotein-cholesterol ratio (p<0.01) improved after 12 months. Additionally, bariatric surgery yielded a significantly reduced triglyceride glucose index. There was no significant difference between procedures in terms of indicators. The Spearman correlation test showed a significant inverse correlation between weight plus fat mass and atherosclerosis-related indicators as well as a positive correlation between percentage of excess weight loss and these indicators. CONCLUSIONS: This study demonstrated three bariatric surgery procedures' ability to improve atherogenicity and insulin resistance in patients with obesity class II. The anti-atherogenicity effects can be partly assigned to the reduction of body weight and adipose tissue. Nevertheless, further studies with larger sample sizes and longer follow-ups are required to confirm our results.
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Shadnoush et al. (2023) conducted a cohort in Obesity class II (n=443). Bariatric surgery vs. Baseline (pre-surgery) was evaluated on Atherogenic index of plasma (AIP) at 12 months (p=<0.001). Bariatric surgery significantly improved atherogenicity and insulin resistance in patients with class II obesity, reducing the atherogenic index of plasma from 0.46 to 0.23 at 12 months.
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