Cardiovascular Risk Factors After Adolescent Bariatric Surgery

Area of Science:

• Pediatric Endocrinology
• Cardiovascular Health in Adolescents
• Bariatric Surgery Outcomes

Background:

• Severely obese adolescents commonly have multiple cardiovascular disease risk factors (CVD-RFs).
• Metabolic and bariatric surgery (MBS) is known to improve these CVD-RFs.
• Predictors for CVD-RF changes after MBS in adolescents remain largely unreported.

Purpose of the Study:

• To identify predictors of change in cardiovascular disease risk factors (CVD-RFs) in adolescents.
• To examine CVD-RFs 3 years after metabolic and bariatric surgery (MBS).
• To analyze the impact of weight loss, age, and sex on CVD-RF resolution.

Main Methods:

• Prospective data collection from 242 adolescents in the Teen-Longitudinal Assessment of Bariatric Surgery study.
• Assessment of CVD-RFs including blood pressure, lipids, glucose homeostasis, and inflammation.
• Analysis of predictors for CVD-RF changes following Roux-en-Y gastric bypass and vertical sleeve gastrectomy.

Main Results:

• Significant weight loss independently predicted normalization of dyslipidemia, elevated blood pressure (EBP), hyperinsulinemia, diabetes, and inflammation.
• Younger age at surgery correlated with better resolution of dyslipidemia; female sex predicted greater EBP improvement.
• Adolescents without baseline CVD-RFs still showed significant improvements in lipids and blood pressure post-MBS.

Conclusions:

• Metabolic and bariatric surgery (MBS) leads to substantial improvements in cardiovascular disease risk factors in adolescents.
• Predictors of CVD-RF resolution include increased weight loss, female sex, and younger age at the time of surgery.
• Identifying these predictors can refine patient selection and surgical timing to optimize outcomes for adolescent bariatric surgery.