부산대학교 도서관

Background: Obesity is linked with subclinical myocardial injury, even in those with metabolically healthy obesity (MHO). There is limited data on the impact of weight loss via bariatric surgery on myocardial injury, particularly at different levels of metabolic health.Methods: We prospectively evaluated 294 Geisinger Obesity Institute Registry participants undergoing bariatric surgery and 294 controls matched on age, sex, body mass index (BMI;± 5kg/m) and diabetes status. High-sensitivity cardiac troponin I (hs-cTnI) was measured pre-operatively and at 6-18 months post-operatively in bariatric surgery patients, and at similar intervals in controls. Using linear regression, we examined the association of bariatric surgery with change in log transformed hs-cTnI (ln-hs-cTnI), stratified by metabolic health status: MHO (metabolic syndrome absent), metabolically unhealthy obesity (MUO; metabolic syndrome present), and MUO with diabetes. We used logistic regression to characterize the association of weight change (modeled as a restricted cubic spline) with the OR of transitioning from detectable to undetectable hs-cTnI (limit of detection 1.2ng/L).Results: The mean age was 45 years with 83% female, 97% White, and mean BMI of 47 kg/m. Baseline characteristics of bariatric surgery patients and controls were similar. Bariatric surgery was associated with significant reduction in ln-hs-cTnI compared with controls in each stratum of metabolic health (P for interaction = 0.63; Panel A). Bariatric surgery was associated with an OR of 9.02 (95% CI 3.52-23.10) for transitioning from detectable to undetectable hs-cTnI, with a dose response association between weight loss and higher odds of developing undetectable hs-cTnI (Panel B).Conclusion: Bariatric surgery induced weight loss mitigates subclinical myocardial injury in graded fashion and across metabolic health strata, which may reflect one mechanism for the cardioprotective benefits of weight loss.