Endocrine Abstracts (2006) 11 P331

Effects of weight loss on the coronary risk profile in obese patients two years after bariatric surgery

M Melo1, D Rodrigues1, MV Campos1, J Guimaraes1, A Fagulha1, J Figueiredo1, C Manso2, G Tralhão2, A Milheiro2, F Castro e Sousa2 & M Carvalheiro1

1Endocrinology Department, Coimbra University Hospital, Coimbra, Portugal; 2Surgery III Department, Coimbra University Hospital, Coimbra, Portugal.

Objective: To analyse the effects of bariatric surgery on the global coronary risk profile two years after the surgical procedure.

Methods: A total of 32 class III obese patients, 6 men and 26 women, mean age 34.3±8.5 years, were included. Total Cholesterol (TC), HDL, triglycerides, Blood Pressure (BP), presence of diabetes and smoking were evaluated before and two years after bariatric surgery. The 10 year Framingham coronary heart disease risk score was used to assess the global risk profile. Laparoscopic gastric banding was performed in nineteen (59.4%) patients and gastric bypass in eleven (34.4%); the other surgeries were a duodenal switch and a vertical gastroplasty.

Results: Mean weight loss was 35.0±26.4 Kg and mean percentage weight loss was 23.8±14.4%. The initial prevalence of diabetes, dyslipidemia, hypertension and smoking were 28.1%, 46.9%, 43.8% and 26.5%, respectively. Normalization of the metabolic alteration was observed in 55.6% of patients with diabetes, 26.7% of patients with dyslipidemia and 28.6% of patients with hypertension. None of the patients quit smoking. The changes in BP (systolic 136.3±14.1 vs 127.9±15.8 mmHg, P<0.005; diastolic 84.2±10.4 vs 80.5±8.2 mmHg, P<0.05), TC (201.4±55.7 vs 180.8±44.7 mg/dl, P<0.05), HDL (43.1±9.5 vs 47.6±12.7 mg/dl, P<0.05), triglycerides (170.7±86.9 vs 125.9±83.2 mg/dl, P<0.001) and fasting glucose levels (107.7±29.4 vs 91.3±18.1 mg/dl, P<0.001) were statistically significant. The 10 year Framingham risk score was significantly reduced (3.7±3.9% vs 2.6±3.1%, P<0.001). Percentage weight loss was only significantly related to the reduction of triglyceride values (rs=0.37; P<0.05) and was not related to 10 year Framingham risk score.

Conclusions: Weight loss observed in the first two years after bariatric surgery was associated with a significant improvement of single cardiovascular risk factors and global risk. However, the extent of weight loss was poorly related to the magnitude of improvement in cardiovascular risk. The continuous follow-up of these patients may elucidate the true meaning of these findings.