Impact of Bariatric Surgery on Pulse Wave Velocity as a Measure of Arterial Stiffness: a Systematic Review and Meta-analysis.

Tannaz Jamialahmadi, Željko Reiner, Mona Alidadi, Matthew Kroh, Luis E Simental-Mendia, Matteo Pirro, Amirhossein Sahebkar

Journal: Obesity surgery 2021;31(10):4461-4469

PMID: 34319469

Abstract

PURPOSE

Weight loss during post-bariatric surgery period has been linked to both reduced ASCVD mortality and overall mortality. Atherosclerosis causes arteries to lose their elasticity and become more stiff resulting in increased pulse wave velocity (PWV). It has been revealed that PWV favorably predicts subsequent ASCVDs. The goal of this systematic review and meta-analysis was to see how bariatric surgery affected PWV, an index of arterial stiffness.

MATERIALS AND METHODS

A systematic literature search in four databases was performed. Also, Cochrane guidelines were reviewed to determine bias possibility in the related studies. Comprehensive Meta-Analysis (CMA) V2 software is used to conduct the meta-analysis. Studies were evaluated regarding heterogeneity in design, populations under investigation, and treatment duration using random-effects model and the generic inverse variance weighting approach. A random-effect meta-regression approach was used to investigate the association with the estimated effect size. Evaluation of funnel plot, Egger's weighted regression, and Begg's rank correlation tests were utilized to estimate the presence of publication bias in the meta-analysis.

RESULTS

The results of meta-analysis on 13 trials including 1426 individuals demonstrated a remarkable decline of PWV after bariatric surgery (WMD: -0.652, 95% CI: -1.004, -0.301, p<0.001). The random-effects meta-regression revealed no evidence of significant correlation between the changes in PWV and initial BMI, BMI changes, or duration of follow-up.

CONCLUSION

The decrease of PWV might be utilized as an independent surrogate marker of improvement of ASCVD risk after bariatric surgery.

© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Address: Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.; Department of Internal Medicine, University Hospital Center Zagreb, University of Zagreb, Kišpatićeva 12, Zagreb, Croatia.; Cleveland Clinic Abu Dhabi, PO Box 112412, Al Maryah Island, Abu Dhabi, United Arab Emirates.; Biomedical Research Unit, Mexican Social Security Institute, Durango, Mexico.; Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy.; Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. [email protected].; School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. [email protected].; Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran. [email protected].; School of Medicine, The University of Western Australia, Perth, Australia. [email protected].

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