Effects of intensive lifestyle intervention and gastric bypass on aortic stiffness: a 1-year nonrandomized clinical...

To compare the long-term effects of Roux-en-Y gastric bypass (GBS) and intensive lifestyle intervention (ILI) on aortic stiffness.

Nonrandomized clinical trial. Aortic stiffness was assessed by carotid-femoral pulse wave velocity (cf PWV) using high-fidelity applanation tonometry.

A total of 159 treatment-seeking morbidly obese patients were included, 82 (54 females) in the GBS-group and 77 (48 females) in the ILI-group. Participants in the GBS-group were younger (42.0 ± 9.9 vs. 46.4 ± 10.5 years), heavier (BMI 45.7 ± 5.3 vs. 42.0 ± 4.9 kg/m(2) ), and had lower systolic pressure (137 ± 19 vs. 145 ± 18 mm Hg) and pulse pressure (57 ± 16 vs. 65 ± 17 mm Hg), all P ≤ 0.006. Mean (SD) cf PWV at baseline was 8.6 ± 1.7 m/s in the GBS-group and 8.6 ± 1.9 m/s in the ILI-group, P = 0.959. At follow-up, mean (95% CI) weight loss was larger in the GBS-group than in the ILI-group -43.3 (-46.0 to -40.7) vs. -12.1 (-14.6 to -9.6) kg, P < 0.001. The mean change in cf PWV was -0.02 (-0.31 to 0.27) m/s in the GBS-group and 0.03 (-0.28 to 0.33) m/s in the ILI-group, both P ≥ 0.412; adjusted between-group difference (ANCOVA) 0.05 (-0.40 to 0.49) m/s, P = 0.836. The adjusted regression analysis showed that weight loss was associated with increased cf PWV in the GBS-group.

GBS and ILI had no significant long-term effects on aortic stiffness in treatment-seeking morbidly obese individuals.