Background: Obesity is a major modifiable risk factor for cardiovascular disease. Bariatric surgery is considered to be the most effective treatment option for weight reduction in obese patients with and without type 2 diabetes.
Aims: To evaluate changes in lipoproteins, insulin resistance, mediators of systemic and vascular inflammation and endothelial dysfunction following Roux-en-Y bariatric surgery in obese patients with and without diabetes.
Methods: Lipoproteins, insulin resistance, mediators of systemic and vascular inflammation, and endothelial dysfunction were measured in 27 obese patients with (n=11) and without type 2 diabetes (n=16), before and, six and twelve months after Roux-en-Y bariatric surgery.
Results: There were significant reductions in body mass index, waist circumference, small dense LDL apoB, fasting glucose, HbA1c, insulin HOMA-IR, hsCRP, TNFα, IL-6, MCP-1, ICAM-1, E-selectin and leptin and a significant increase in adiponectin 6 months after surgery. HOMA-IR, resistin, MCP-1 and ICAM-1 were further significantly reduced at 12 months, only in the diabetic group.There is a positive correlation between the relative proportional reduction in change in insulin resistance and the proportional change in resistin levels and a positive correlation between the proportional change in BMI and proportional change in leptin.
Conclusion: Lipoproteins, insulin resistance, mediators of systemic and vascular inflammation, and endothelial dysfunction improve after bariatric surgery in obese patients with and without diabetes. Insulin resistance and mediators of vascular inflammation continue to improve beyond 6 months in patients with diabetes. For the first time, we report a positive correlation between a decrease in insulin resistance and change in resistin levels and also between change in BMI and proportional change in leptin.