The effect of a rapid weight loss induced by laparoscopic adjustable gastric banding on arterial stiffness, metabolic and inflammatory parameters in patients with morbid obesity

Objective: To determine the effect of drastic weight loss on arterial compliance, inflammatory and metabolic parameters in patients with morbid obesity with and without cardiovascular risk factors who underwent laparoscopic adjustable gastric banding (LAGB). Design: Open prospective study, morbidly obese subjects divided into low- and high-risk group were evaluated before and 4 months after LAGB. Subjects: Forty-one Caucasian subjects aged between 16 and 55 years, with morbid (grade 3) obesity (20 low-risk and 21 high-risk subjects) who underwent LAGB and completed a 16-week follow-up. Measurments: Patients were evaluated at baseline and 4 months after LAGB for body mass index (BMI), arterial blood pressure (BP), metabolic factors including lipid profile, HbA1C, insulin, C-peptide, fibrinogen, hs-C reactive protein (CRP) and Homeostasis model assessment-insulin resistance (HOMA-IR). Arterial elasticity of large and small arteries was evaluated using pulse-wave contour analysis method (HDI CR 2000, Eagan, Minnesota) at baseline and after 4 months. Results: Body mass index reduction induced by LABG, from 43.55 +/- 5.11 to 35.10 +/- 4.87 in low-risk patients and from 42.90 +/- 3.22 to 35.00 +/- 3.24 in high-risk patients, significantly improved small artery elasticity (SAE) from 6.30 +/- 2.74 to 7.25 +/- 1.85, in morbidly obese patients with multiple cardiovascular risk factors (high-risk group). Improvement in SAE was accompanied by improvement of arterial BP, glucose and lipid metabolism, and reduction of CRP values. Conclusion: Although dramatic weight reduction induced by surgical intervention was associated with similar changes in body weight and significant improvement of metabolic and inflammatory parameters in two groups of obese patients, SAE improved only in high-risk patients.