Improvement of Microvascular Function in Patients with Morbid Obesity After Bariatric Surgery Revealed by Imaging Photoplethysmography.

BACKGROUND

Morbid obesity leads to serious complications such as diabetes mellitus, arterial hypertension, and atherosclerosis. Bariatric surgery aims to reduce body weight and correct metabolic disorders and associated macro- and microvascular dysfunction. Metabolic disturbances can be assessed by biochemical markers, whereas microvascular function can be assessed by the response to provocative stimuli. The aim of this work is to quantitatively assess the cutaneous microcirculatory change caused by bariatric surgery using imaging photoplethysmography.

METHODS

The study included 20 patients with obesity whose body mass index (BMI) was greater than 40 kg/m2 who underwent bariatric surgery and 20 control subjects. Microvascular function was assessed twice, before and 6 months after surgery, by measuring the perfusion response to local forearm heating up to 40 °C using imaging photoplethysmography.

RESULTS

The perfusion response to local heating was found to be significantly lower in patients with obesity before surgery compared to the control group, but 6 months after surgery, it approaches indicators of the control group, along with a decrease in BMI from 48 ± 5 to 36 ± 5 kg/m2, P < 0.001. Besides, bariatric surgery improves biochemical markers of metabolic syndrome (glycated hemoglobin decreases from 6.3 ± 1.0 to 5.2 ± 0.4% and cholesterol from 5.2 ± 1.4 to 4.2 ± 0.8 mmol/l).

CONCLUSION

Based on these results, we conclude that microvascular abnormalities caused by obesity could be repaired after bariatric surgery and subsequent conservative treatment.