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Effect of one-anastomosis gastric bypass on cardiovascular risk factors in patients with vitamin D deficiency and morbid obesity: A secondary analysis
Institution:1. Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Austria;2. Division of Internal Medicine, General Public Hospital of the Order of Saint Elisabeth, Klagenfurt, Austria;3. Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Austria;4. Division of General Surgery, Department of Surgery, Medical University of Vienna, Austria;5. Special Institute for Preventive Cardiology and Nutrition – SIPCAN, Salzburg, Austria;6. Division of Internal Medicine, General Public Hospital of the Brothers of Saint John of God Salzburg, Austria;7. Clinical Institute for Medical and Chemical Laboratory Diagnostics, Department of Laboratory Medicine, Medical University of Vienna, Austria;8. Department of Medicine 1, Karl Landsteiner Institute for Obesity and Metabolic Disorders, Rudolfstiftung Hospital, Vienna, Austria
Abstract:Background and aimsBariatric patients often suffer from vitamin D (VD) deficiency, and both, morbid obesity and VD deficiency, are related to an adverse effect on cardiovascular disease (CVD) risk. Therefore, we assessed the change of known CVD risk factors and its associations during the first 12 months following one-anastomosis gastric bypass (OAGB).Methods and resultsIn this secondary analysis, CVD risk factors, medical history and anthropometric data were assessed in fifty VD deficient (25-hydroxy-vitamin D (25(OH)D) <75 nmol/l) patients, recruited for a randomized controlled trial of VD supplementation. Based on previous results regarding bone-mass loss and the association between VD and CVD risk, the study population was divided into patients with 25(OH)D ≥50 nmol/l (adequate VD group; AVD) and into those <50 nmol/l (inadequate VD group; IVD) at 6 and 12 months (T6/12) postoperatively. In the whole cohort, substantial remission rates for hypertension (38%), diabetes (30%), and dyslipidaemia (41%) and a significant reduction in CVD risk factors were observed at T12. Changes of insulin resistance markers were associated with changes of total body fat mass (TBF%), 25(OH)D, and ferritin. Moreover, significant differences in insulin resistance markers between AVD and IVD became evident at T12.ConclusionThese findings show that OAGB leads to a significant reduction in CVD risk factors and amelioration of insulin resistance markers, which might be connected to reduced TBF%, change in 25(OH)D and ferritin levels, as an indicator for subclinical inflammation, and an adequate VD status.Registered at clinicaltrials.gov(Identifier: NCT02092376) and EudraCT (Identifier: 2013-003546-16).
Keywords:Cardiovascular risk factors  Vitamin D  Obesity  One-anastomosis gastric bypass  Insulin resistance  Ferritin  ApoA1"}  {"#name":"keyword"  "$":{"id":"kwrd0045"}  "$$":[{"#name":"text"  "_":"Apolipoprotein A1  ApoB"}  {"#name":"keyword"  "$":{"id":"kwrd0055"}  "$$":[{"#name":"text"  "_":"Apolipoprotein B  ASMM"}  {"#name":"keyword"  "$":{"id":"kwrd0065"}  "$$":[{"#name":"text"  "_":"Appendicular skeletal muscle mass  AVD"}  {"#name":"keyword"  "$":{"id":"kwrd0075"}  "$$":[{"#name":"text"  "_":"Adequate vitamin d group  BMI"}  {"#name":"keyword"  "$":{"id":"kwrd0085"}  "$$":[{"#name":"text"  "_":"Body mass index  CEC"}  {"#name":"keyword"  "$":{"id":"kwrd0095"}  "$$":[{"#name":"text"  "_":"Cholesterol efflux capacity  CVD"}  {"#name":"keyword"  "$":{"id":"kwrd0105"}  "$$":[{"#name":"text"  "_":"Cardiovascular disease  CRP"}  {"#name":"keyword"  "$":{"id":"kwrd0115"}  "$$":[{"#name":"text"  "_":"C-reactive protein  DBP"}  {"#name":"keyword"  "$":{"id":"kwrd0125"}  "$$":[{"#name":"text"  "_":"Diastolic blood pressure  DEXA"}  {"#name":"keyword"  "$":{"id":"kwrd0135"}  "$$":[{"#name":"text"  "_":"Dual energy x-ray absorptiometry  eGFR"}  {"#name":"keyword"  "$":{"id":"kwrd0145"}  "$$":[{"#name":"text"  "_":"Estimated glomerular filtration rate  FFM"}  {"#name":"keyword"  "$":{"id":"kwrd0155"}  "$$":[{"#name":"text"  "_":"Fat free mass  FRS"}  {"#name":"keyword"  "$":{"id":"kwrd0165"}  "$$":[{"#name":"text"  "_":"ramingham 10 Year Risk of General Cardiovascular Disease Score  FXR"}  {"#name":"keyword"  "$":{"id":"kwrd0175"}  "$$":[{"#name":"text"  "_":"arnesoid X nuclear receptor  HbA1c"}  {"#name":"keyword"  "$":{"id":"kwrd0185"}  "$$":[{"#name":"text"  "_":"lycated haemoglobin  HDL-C"}  {"#name":"keyword"  "$":{"id":"kwrd0195"}  "$$":[{"#name":"text"  "_":"High-density lipoprotein cholesterol  HOMA-IR"}  {"#name":"keyword"  "$":{"id":"kwrd0205"}  "$$":[{"#name":"text"  "_":"Homeostatic model assessment for insulin resistance  IVD"}  {"#name":"keyword"  "$":{"id":"kwrd0215"}  "$$":[{"#name":"text"  "_":"Inadequate vitamin D group  LDL-C"}  {"#name":"keyword"  "$":{"id":"kwrd0225"}  "$$":[{"#name":"text"  "_":"Low-density lipoprotein  Lp(a)"}  {"#name":"keyword"  "$":{"id":"kwrd0235"}  "$$":[{"#name":"text"  "_":"Lipoprotein (a)  non-HDL-C"}  {"#name":"keyword"  "$":{"id":"kwrd0245"}  "$$":[{"#name":"text"  "_":"Non-HDL-cholesterol  OAGB"}  {"#name":"keyword"  "$":{"id":"kwrd0255"}  "$$":[{"#name":"text"  "_":"One-anastomosis gastric bypass  PCSK-9"}  {"#name":"keyword"  "$":{"id":"kwrd0265"}  "$$":[{"#name":"text"  "_":"Proprotein convertase subtilisin/kexin type 9  RYGB"}  {"#name":"keyword"  "$":{"id":"kwrd0275"}  "$$":[{"#name":"text"  "_":"Roux-en-Y-gastric bypass  SBP"}  {"#name":"keyword"  "$":{"id":"kwrd0285"}  "$$":[{"#name":"text"  "_":"Systolic blood pressure  SD"}  {"#name":"keyword"  "$":{"id":"kwrd0295"}  "$$":[{"#name":"text"  "_":"standard deviation  SG"}  {"#name":"keyword"  "$":{"id":"kwrd0305"}  "$$":[{"#name":"text"  "_":"Sleeve gastrectomy  TBF"}  {"#name":"keyword"  "$":{"id":"kwrd0315"}  "$$":[{"#name":"text"  "_":"Total body fat  TC"}  {"#name":"keyword"  "$":{"id":"kwrd0325"}  "$$":[{"#name":"text"  "_":"Total cholesterol  TG"}  {"#name":"keyword"  "$":{"id":"kwrd0335"}  "$$":[{"#name":"text"  "_":"Triglycerides  TNF-α"}  {"#name":"keyword"  "$":{"id":"kwrd0345"}  "$$":[{"#name":"text"  "_":"Tumor necrosis factor α  TSH"}  {"#name":"keyword"  "$":{"id":"kwrd0355"}  "$$":[{"#name":"text"  "_":"Thyroid-stimulating hormone  T0"}  {"#name":"keyword"  "$":{"id":"kwrd0365"}  "$$":[{"#name":"text"  "_":"baseline  T1"}  {"#name":"keyword"  "$":{"id":"kwrd0375"}  "$$":[{"#name":"text"  "_":"1 month  T3"}  {"#name":"keyword"  "$":{"id":"kwrd0385"}  "$$":[{"#name":"text"  "_":"3 months  T6"}  {"#name":"keyword"  "$":{"id":"kwrd0395"}  "$$":[{"#name":"text"  "_":"6 months  T12"}  {"#name":"keyword"  "$":{"id":"kwrd0405"}  "$$":[{"#name":"text"  "_":"12 months  T2DM"}  {"#name":"keyword"  "$":{"id":"kwrd0415"}  "$$":[{"#name":"text"  "_":"Type 2 diabetes mellitus  VD"}  {"#name":"keyword"  "$":{"id":"kwrd0425"}  "$$":[{"#name":"text"  "_":"vitamin D  25(OH)D"}  {"#name":"keyword"  "$":{"id":"kwrd0435"}  "$$":[{"#name":"text"  "_":"25-hydroxy-vitamin-D  WL"}  {"#name":"keyword"  "$":{"id":"kwrd0445"}  "$$":[{"#name":"text"  "_":"weight loss
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