Endothelial function in obesity and effects of bariatric and metabolic surgery

ABSTRACT

Introduction

Due to the lifestyle changes and the on-going urbanization waves there is obesity pandemic. The visceral fatty tissue of patients with obesity, in comparison with subcutaneous fat, has more gene expression related to inflammation, oxidative stress, cytokine production, and angiogenesis. The abovementioned leads to a decrease in arteriolar function and also an impaired endothelial vasodilatation and eventually endothelial dysfunction.

Areas covered

This review aims to provide an overview of the pathophysiology of obesity and endothelial dysfunction and the effects after bariatric and metabolic surgery and the consequences of surgery for the endothelial function. In this review, we focussed and searched for literature in Pubmed and The Cochrane library (from the earliest date of each database until February 2020) regarding endothelial function, obesity, and effects of bariatric and metabolic surgery.

Expert opinion

Within cardiovascular research, the endothelium and its function have a prominent role and it is the responsibility of the researchers to unravel the pathophysiological mechanisms and potential new targets for treatment of cardiovascular diseases.

KEYWORDS:

• Endothelial function
• bariatric surgery
• metabolic surgery
• cardiac remodeling
• postoperative complications
• cardiovascular remodeling

Article highlights

• The visceral fatty tissue of patients with obesity, in comparison with subcutaneous fat, has more gene expression related to inflammation, oxidative stress, cytokine production, and angiogenesis.

• This leads to a decrease in arteriolar function and also an impaired endothelial vasodilatation and eventually endothelial dysfunction.

• Obesity and endothelial dysfunction are a multifactorial complex pathophysiological process that might be influenced by weight reduction after bariatric surgery.

• Endothelial function tests can possibly be used to identify patients at risk for cardiovascular complications after (bariatric) surgery.

Declaration of interest

Please could you confirm if the following declaration of interests statement is correct. The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.