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Microcirculatory Improvement Induced by Laparoscopic Sleeve Gastrectomy Is Related to Insulin Sensitivity Retrieval

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Abstract

Aims

Microvascular dysfunction is a potential factor explaining the association of obesity, insulin resistance, and vascular damage in morbidly obese subjects. The purpose of the study was to evaluate possible determinants of microcirculatory improvement 1 year after laparoscopic sleeve gastrectomy (LSG) intervention.

Methods

Thirty-seven morbidly obese subjects eligible for bariatric surgery were included in the study. Post-occlusive reactive hyperemia (PORH) of the forearm skin was measured as area of hyperemia (AH) by laser-Doppler flowmetry before LSG and after a 1-year follow-up.

Results

After intervention, we observed a significant reduction in BMI, HOMA index, HbA1c, and a significant increase of AH in all patients after surgery; this variation was significant only in those patients having insulin resistance or prediabetes/diabetes. Although significant correlation between the increase of AH and the reduction of both BMI, HOMA index, and HbA1c was observed, BMI was the only independent predictor of AH variation after LSG at the linear regression analysis.

Conclusions

Our study shows that LSG intervention is correlated with a significant improvement in the microvascular function of morbidly obese subjects; this improvement seems to be related to the baseline degree of insulin-resistance and to the retrieval of insulin-sensitivity post-intervention.

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Acknowledgements

Miss Helen Walsh is thanked for her editorial assistance.

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Authors and Affiliations

  1. Department of Medicine, Università degli Studi di Perugia, Perugia, Italy

    Stefano Ministrini, Chiara Fattori, Maria Anastasia Ricci, Vanessa Bianconi, Rita Paltriccia, Gaetano Vaudo, Graziana Lupattelli & Leonella Pasqualini

  2. General Surgery, ASL Umbria2, “S.Giovanni Battista” Hospital, Foligno, PG, Italy

    Marcello Boni

  3. General and Emergency Surgery, “S. Maria della Misericordia” Hospital, Perugia, Italy

    Maria Teresa Paganelli

Authors
  1. Stefano Ministrini
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  2. Chiara Fattori
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  3. Maria Anastasia Ricci
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  4. Vanessa Bianconi
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  5. Rita Paltriccia
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  6. Marcello Boni
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  8. Gaetano Vaudo
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  9. Graziana Lupattelli
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  10. Leonella Pasqualini
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Correspondence to Stefano Ministrini.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethics and Consent

The study protocol was approved by the Ethics Committee of our Institution and carried out in accordance with the World Medical Association, Code of Ethics (Declaration of Helsinki - 1964) for experiments involving humans. Informed consent was obtained from all individual participants included in the study.

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Ministrini, S., Fattori, C., Ricci, M.A. et al. Microcirculatory Improvement Induced by Laparoscopic Sleeve Gastrectomy Is Related to Insulin Sensitivity Retrieval. OBES SURG 28, 3151–3158 (2018). https://doi.org/10.1007/s11695-018-3290-0

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  • DOI: https://doi.org/10.1007/s11695-018-3290-0

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