Endocrine Abstracts

Background: Obesity is related to an increased cardiovascular risk, namely coronary heart disease risk (CHDr). Type 2 diabetes (T2D) is frequently associated with obesity and, by itself, is an important CHDr factor. Interventions that induce weight loss would be expected to attenuate CHDr in obese patients.

Aims: To evaluate variation in cardiovascular risk profile one year after adjustable gastric banding (AGB), in obese patients (with and without T2D); to correlate variation in CHDr estimate with variation in anthropometric parameters after surgery.

Methods: We studied 80 obese patients (11 men) that were characterized for BMI, waist circumference (Wc) and blood pressure levels; a fasting blood sample was collected for glucose, total cholesterol (t-cholesterol) and HDL-c. Smoking habits and previous diagnosis of diabetes was checked. We used the Framingham risk equation for CHDr assessment. Patients were submitted to AGB and all parameters were reassessed 12 months after.

Results: Before surgery, patients were characterized by mean age=43±10 years, weight=124.6±20.7 kg, BMI=48.2±6.3 kg/m², Wc=126.4±13.8 cm, systolic blood pressure (SBP)=135±21 mmHg, diastolic blood pressure (DBP)=87±11 mmHg, t-cholesterol=193.8±38.7 mg/dl, HDL-c=50.2±12.2 mg/dl and Framingham score=6.5±6.1%. Twelve patients were smokers and 26 were diabetic. Twelve months after AGB there was a significant decrease in BMI (P<0.001), Wc (P<0.001), DBP (P<0.001), fasting glucose (P<0.001), HbA1c (P<0.001), t-Cholesterol (P=0.043), T2D prevalence (P<0.001) and Framingham score (P=0.022) and a significant increase in HDL-c (P=0.009). No significant correlation was present between Framingham score and anthropometric variations. There was no significant difference in anthropometric or in Framingham score variations between patients with and without T2D.

Conclusions: There is an important amelioration of several cardiovascular risk factors and of CHDr estimate in obese patients one year after AGB. No major difference in CHDr variation is observed between diabetic and non-diabetic patients. The reduction observed in CHDr is independent from the direct effect of fat mass loss.