Abstract 19727: Improvements in Cardiometabolic Biomarkers Occur Early after Bariatric Surgery
Background: Weight loss, especially after bariatric surgery, has been associated with improvement in cardiovascular risk factors and reductions in pro-inflammatory biomarkers. Biomarker studies have typically focused on the time period 12 to 18 months after surgery, after maximal weight loss has occurred. Thus, it is not known whether early changes in biomarker profile are present, nor whether these changes relate to improvements in cardiac function.
Methods: We assessed changes in the adipokines adiponectin and resistin, the inflammatory marker high-sensitivity C-reactive protein (hsCRP), and the cardiac marker soluble ST2 in up to 166 patients undergoing bariatric surgery. Plasma samples were obtained pre-operatively, and at early (1-2 months) and intermediate (6 months) post-operative time points. Echocardiography with tissue Doppler imaging was performed in 15 patients at baseline and 6 months.
Results: The mean age was 50, and 75% of subjects were women. Baseline BMI was 47.1 kg/m2. Weight loss surgery resulted in significant weight loss (12% at 2 months, and 27% at 6 months). Relative changes in biomarker concentrations are shown in the Table. Significant early reductions in soluble ST2 (p=0.003) and hsCRP (p<0.001) and an increase in adiponectin concentrations (P<0.001) were noted. There was no significant change in resistin at any time point. In the echocardiographic subsample, those with a large early change in ST2 levels (ΔST2 > median) had a 61% increase (p=0.001) in LV radial strain, a sensitive measure of systolic function. Those with smaller early changes in ST2 (ΔST2 > median) had a non-significant improvement in LV radial strain (26%, p=0.46).
Conclusions: Favorable changes in cardiometabolic biomarkers occur early after bariatric surgery. These changes precede the bulk of the weight loss. Weight loss surgery may have cardiovascular benefits, including improved cardiac function, that occur via mechanisms distinct from reduction in fat mass.
- © 2010 by American Heart Association, Inc.