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Changes in plasma aldosterone level after weight loss by bariatric surgery in morbidly obese patients

Preaw Suwannasrisuk1,2, Patchaya Boonchaya-Anant3,4, Natnicha Houngngam3,4

  • 1Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. praw110@gmail.com.

BMC Endocrine Disorders
|April 8, 2020
PubMed
Abstract

Insights

Bariatric surgery significantly reduces plasma aldosterone concentration (PAC) in obese patients within 3 months. This reduction in PAC is linked to decreased body weight, waist circumference, and body fat, suggesting a connection to obesity-related hypertension.

Area of Science:

  • Endocrinology
  • Metabolic Surgery
  • Cardiovascular Disease

Background:

  • Obesity-associated hypertension is linked to overactivation of the renin-aldosterone-angiotensin system (RAS).
  • Weight loss interventions, including bariatric surgery, can lead to reductions in blood pressure and RAS activity.

Purpose of the Study:

  • To investigate the changes in plasma aldosterone concentration (PAC) following bariatric surgery in morbidly obese patients.
  • To explore the relationship between PAC reduction and anthropometric changes post-surgery.

Main Methods:

  • A prospective study involving 14 morbidly obese patients undergoing bariatric surgery.
  • Exclusion of patients on medications affecting PAC or renin levels.
  • Blood samples collected at baseline, 3 months, and 6 months post-surgery.

Main Results:

  • Mean BMI was 56.7 kg/m²; 4/14 patients had baseline hypertension.
  • PAC significantly decreased by 36% at 3 months (P<0.01) and 32% at 6 months (P<0.05).
  • PAC reduction at 3 months correlated with decreased body weight (r=0.46), waist circumference (r=0.73), and body fat percentage (r=0.58).

Conclusions:

  • Maximal reduction in PAC occurs within the first 3 months after bariatric surgery.
  • The observed decrease in PAC is associated with significant reductions in body weight, waist circumference, and body fat.
  • These findings support a link between the RAS and obesity-mediated hypertension, with bariatric surgery being an effective intervention.
Keywords:
Bariatric surgeryDirect renin concentrationObesityPlasma aldosterone concentrationRenin–angiotensin–aldosterone system

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