1 Department of Clinical Medicine, Department of Clinical Medicine, Faculty of Health and Medical Sciences, Københavns Universitet2 Department of Immunology and Microbiology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, Københavns Universitet3 Education, Department of Nutrition, Exercise and Sports, Faculty of Science, Københavns Universitet4 unknown5 Graduate School of Health and Medical Sciences, Faculty of Health and Medical Sciences, Københavns Universitet6 Graduate School of Health and Medical Sciences, Faculty of Health and Medical Sciences, Københavns Universitet7 Department of Immunology and Microbiology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, Københavns Universitet
AIM: To investigate whether Roux-en-Y gastric bypass surgery (RYGB) - an in vivo model for normalisation of hyperglycaemia - improves carotid intima-media thickness (IMT) in patients with type 2 diabetes (T2D)/impaired glucose tolerance (IGT) and normal glucose tolerance (NGT). METHODS: Observational prospective study, 34 obese patients (T2D (n = 14)/IGT (n = 4), and NGT (n = 16)) were investigated before and six and 12months after RYGB. RESULTS: Mean carotid IMT was significantly reduced 12months after RYGB in patients with T2D/IGT (-0.041 mm (95% CI -0.069; -0.012, p = 0.005)) but not in patients with NGT (-0.010 mm (-0.039; 0.020, p = 0.52)). The between-group difference was not significant (p=0.13). Twelve months after RYGB, patients with respectively T2D/IGT and NGT demonstrated changes in weight: -29.9 kg, p<0.001/-30.6 kg, p < 0.001, HbA1c: -0.7%, p < 0.001/-0.1%, p = 0.33, systolic blood pressure: -2 mmHg, p = 0.68/-10 mmHg, p = 0.01 and diastolic blood pressure: -8 mmHg, p = 0.003/-11 mmHg, p < 0.001. 80% of T2D patients terminated antihyperglycaemic medication. CONCLUSION: Mean carotid IMT was significantly reduced 12months after RYGB in patients with T2D/IGT which provides evidence to support that the earliest atherosclerotic changes in the arterial wall are reversible. Although numerically different from the changes observed in patients with NGT, the between-group difference was not statistically significant.
Journal of Diabetes and Its Complications, 2014, Vol 28, Issue 4, p. 517-522
Adolescent; Adult; Body Mass Index; Carotid Intima-Media Thickness; Denmark; Diabetes Mellitus, Type 2; Diabetic Angiopathies; Down-Regulation; Female; Gastric Bypass; Glucose Intolerance; Hemoglobin A, Glycosylated; Humans; Hyperglycemia; Hypertension; Male; Middle Aged; Obesity, Morbid; Risk Factors; Vascular Diseases; Weight Loss; Young Adult