期刊
JOURNAL OF CLINICAL MEDICINE
卷 10, 期 4, 页码 -出版社
MDPI
DOI: 10.3390/jcm10040691
关键词
bariatric surgery; arterial stiffness; renin-angiotensin axis
资金
- Spanish Society of Nephrology
- Spanish Ministry of Health ISCIII RedinRen [RD16/0009/0013]
The study revealed an improvement in AS one month post-bariatric surgery, which correlated with changes in blood pressure and RAAS components, but was less effective in patients with higher PWV.
Arterial stiffness (AS) is an independent predictor of cardiovascular risk. We aimed to analyze changes (Delta) in AS 1-month post-bariatric surgery (BS) and search for possible pathophysiological mechanisms. Patients with severe obesity (43% hypertensives) were prospectively evaluated before and 1-month post-BS, with AS assessed by pulse-wave velocity (PWV), augmentation index (AIx@75) and pulse pressure (PP). Ambulatory 24 h blood pressure (BP), anthropometric data, renin-angiotensin-aldosterone system (RAAS) components and several adipokines and inflammatory markers were also analyzed. Overall reduction in body weight was mean (interquartile range (IQR)) = 11.0% (9.6-13.1). A decrease in PWV, AIx@75 and PP was observed 1-month post-BS (all, p < 0.01). There were also significant Delta in BP, RAAS components, adipokines and inflammatory biomarkers. Multiple linear regression adjusted models showed that Delta aldosterone was an independent variable (B coeff.95%CI) for final PWV (B = -0.003, -0.005 to 0.000; p = 0.022). Angiotensin-converting enzyme (ACE)/ACE2 and ACE were independent variables for final AIx@75 (B = 0.036, 0.005 to 0.066; p = 0.024) and PP (B = 0.010, 0.003 to 0.017; p = 0.01), respectively. There was no correlation between Delta AS and anthropometric changes nor with Delta of adipokines or inflammatory markers except high-sensitivity C-reactive protein (hs-CRP). Patients with PWV below median decreased PWV (mean, 95%CI = -0.18, -0.25 to -0.10; p < 0.001) and both AIx@75 and PP at 1-month, but not those with PWV above median. In conclusion, there is an improvement in AS 1-month post-BS that correlates with Delta BP and Delta renin-angiotensin-aldosterone components. The benefit is reduced in those with higher PWV.
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