Key result
Roux-en-Y gastric bypass significantly reduced aortic pulse wave velocity from 7.8 m/s at baseline to 7.2 m/s at 2 years (P=0.006), an improvement predicted by subcutaneous adipocyte volume.
Why the study?
Does Roux-en-Y gastric bypass improve aortic pulse wave velocity in obese subjects?
Cohort (n=82)
Does Roux-en-Y gastric bypass improve aortic pulse wave velocity in obese subjects?
Absolute Event Rate: 7.2% vs 7.8%
p-value: p=0.006
Pronounced long-term weight loss following Roux-en-Y gastric bypass significantly improves arterial stiffness, an effect that can be predicted by baseline subcutaneous white adipose tissue characteristics.
May support long-term vascular benefit after bariatric surgery in obesity; leaves open predictive value of WAT phenotype for prospective trials.
BACKGROUND: Arterial stiffness, measured by pulse wave velocity (PWV), is linked to obesity, cardiovascular disease, and all-cause mortality. Short-term weight loss improves PWV, but the long-term effects are unknown. We investigated the effect of pronounced long-term weight loss on PWV and whether anthropometric/metabolic parameters and/or white adipose tissue (WAT) phenotype could predict this change in PWV. METHODS: Eighty-two obese subjects were examined before and 2 years after Roux-en-Y gastric bypass. Analyses included anthropometrics, routine clinical chemistry, and hyperinsulinemic-euglycemic clamp. Arterial stiffness was measured as aortic PWV (aPWV) using the Arteriograph device. WAT mass and distribution were assessed by dual-X-ray absorptiometry. Baseline visceral and subcutaneous WAT samples were obtained to measure adipocyte cell size. Transcriptomic profiling of subcutaneous WAT was performed in a subset of subjects (n = 30). RESULTS: At the 2-year follow-up, there were significant decreases in body mass index (39.4 ± 3.5 kg/m2 vs. 26.6 ± 3.4 kg/m2; P < 0.0001) and aPWV (7.8 ± 1.5 m/s vs. 7.2 ± 1.4 m/s; P = 0.006). Multiple regression analyses showed that baseline subcutaneous adipocyte volume was associated with a reduction in aPWV (P = 0.014), after adjusting for confounders. Expression analyses of 52 genes implicated in arterial stiffness showed that only one, COL4A1, independently predicted improvements in aPWV after adjusting for confounders (P = 0.006). CONCLUSIONS: Bariatric surgery leads to long-term reduction in aPWV. This improvement can be independently predicted by subcutaneous adipocyte volume and WAT COL4A1 expression, which suggests that subcutaneous WAT has a role in regulating aPWV. CLINICAL TRIALS REGISTRATION: Trial Number NCT01727245 (clinicaltrials.gov).
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Bäckdahl et al. (2017) conducted a cohort in Obesity (n=82). Roux-en-Y gastric bypass vs. Baseline (pre-surgery) was evaluated on Aortic pulse wave velocity (aPWV) (p=0.006). Roux-en-Y gastric bypass significantly reduced aortic pulse wave velocity from 7.8 m/s at baseline to 7.2 m/s at 2 years (P=0.006), an improvement predicted by subcutaneous adipocyte volume.
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