Effects of bariatric surgery on human small artery function

Evidence for reduction in perivascular adipocyte inflammation, and the restoration of normal anticontractile activity despite persistent obesity

Reza Aghamohammadzadeh, Adam S. Greenstein, Rahul Yadav, Maria Jeziorska, Salam Hama, Fardad Soltani, Phil W. Pemberton, Basil Ammori, Rayaz Malik, Handrean Soran, Anthony M. Heagerty

Research output: Contribution to journalArticle

78 Citations (Scopus)

Abstract

Objectives The aim of this study was to investigate the effects of bariatric surgery on small artery function and the mechanisms underlying this. Background In lean healthy humans, perivascular adipose tissue (PVAT) exerts an anticontractile effect on adjacent small arteries, but this is lost in obesity-associated conditions such as the metabolic syndrome and type II diabetes where there is evidence of adipocyte inflammation and increased oxidative stress. Methods Segments of small subcutaneous artery and perivascular fat were harvested from severely obese individuals before (n = 20) and 6 months after bariatric surgery (n = 15). Small artery contractile function was examined in vitro with wire myography, and perivascular adipose tissue (PVAT) morphology was assessed with immunohistochemistry. Results The anticontractile activity of PVAT was lost in obese patients before surgery when compared with healthy volunteers and was restored 6 months after bariatric surgery. In vitro protocols with superoxide dismutase and catalase rescued PVAT anticontractile function in tissue from obese individuals before surgery. The improvement in anticontractile function after surgery was accompanied by improvements in insulin sensitivity, serum glycemic indexes, inflammatory cytokines, adipokine profile, and systolic blood pressure together with increased PVAT adiponectin and nitric oxide bioavailability and reduced macrophage infiltration and inflammation. These changes were observed despite the patients remaining severely obese. Conclusions Bariatric surgery and its attendant improvements in weight, blood pressure, inflammation, and metabolism collectively reverse the obesity-induced alteration to PVAT anticontractile function. This reversal is attributable to reductions in local adipose inflammation and oxidative stress with improved adiponectin and nitric oxide bioavailability.

Original languageEnglish
Pages (from-to)128-135
Number of pages8
JournalJournal of the American College of Cardiology
Volume62
Issue number2
DOIs
Publication statusPublished - 9 Jul 2013
Externally publishedYes

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Bariatric Surgery
Adipocytes
Adipose Tissue
Arteries
Obesity
Inflammation
Adiponectin
Blood Pressure
Biological Availability
Nitric Oxide
Oxidative Stress
Myography
Glycemic Index
Adipokines
Catalase
Type 2 Diabetes Mellitus
Superoxide Dismutase
Insulin Resistance
Healthy Volunteers
Immunohistochemistry

Keywords

  • bariatric
  • cardiovascular
  • obesity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Effects of bariatric surgery on human small artery function : Evidence for reduction in perivascular adipocyte inflammation, and the restoration of normal anticontractile activity despite persistent obesity. / Aghamohammadzadeh, Reza; Greenstein, Adam S.; Yadav, Rahul; Jeziorska, Maria; Hama, Salam; Soltani, Fardad; Pemberton, Phil W.; Ammori, Basil; Malik, Rayaz; Soran, Handrean; Heagerty, Anthony M.

In: Journal of the American College of Cardiology, Vol. 62, No. 2, 09.07.2013, p. 128-135.

Research output: Contribution to journalArticle

Aghamohammadzadeh, Reza ; Greenstein, Adam S. ; Yadav, Rahul ; Jeziorska, Maria ; Hama, Salam ; Soltani, Fardad ; Pemberton, Phil W. ; Ammori, Basil ; Malik, Rayaz ; Soran, Handrean ; Heagerty, Anthony M. / Effects of bariatric surgery on human small artery function : Evidence for reduction in perivascular adipocyte inflammation, and the restoration of normal anticontractile activity despite persistent obesity. In: Journal of the American College of Cardiology. 2013 ; Vol. 62, No. 2. pp. 128-135.
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abstract = "Objectives The aim of this study was to investigate the effects of bariatric surgery on small artery function and the mechanisms underlying this. Background In lean healthy humans, perivascular adipose tissue (PVAT) exerts an anticontractile effect on adjacent small arteries, but this is lost in obesity-associated conditions such as the metabolic syndrome and type II diabetes where there is evidence of adipocyte inflammation and increased oxidative stress. Methods Segments of small subcutaneous artery and perivascular fat were harvested from severely obese individuals before (n = 20) and 6 months after bariatric surgery (n = 15). Small artery contractile function was examined in vitro with wire myography, and perivascular adipose tissue (PVAT) morphology was assessed with immunohistochemistry. Results The anticontractile activity of PVAT was lost in obese patients before surgery when compared with healthy volunteers and was restored 6 months after bariatric surgery. In vitro protocols with superoxide dismutase and catalase rescued PVAT anticontractile function in tissue from obese individuals before surgery. The improvement in anticontractile function after surgery was accompanied by improvements in insulin sensitivity, serum glycemic indexes, inflammatory cytokines, adipokine profile, and systolic blood pressure together with increased PVAT adiponectin and nitric oxide bioavailability and reduced macrophage infiltration and inflammation. These changes were observed despite the patients remaining severely obese. Conclusions Bariatric surgery and its attendant improvements in weight, blood pressure, inflammation, and metabolism collectively reverse the obesity-induced alteration to PVAT anticontractile function. This reversal is attributable to reductions in local adipose inflammation and oxidative stress with improved adiponectin and nitric oxide bioavailability.",
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AU - Soltani, Fardad

AU - Pemberton, Phil W.

AU - Ammori, Basil

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AU - Heagerty, Anthony M.

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N2 - Objectives The aim of this study was to investigate the effects of bariatric surgery on small artery function and the mechanisms underlying this. Background In lean healthy humans, perivascular adipose tissue (PVAT) exerts an anticontractile effect on adjacent small arteries, but this is lost in obesity-associated conditions such as the metabolic syndrome and type II diabetes where there is evidence of adipocyte inflammation and increased oxidative stress. Methods Segments of small subcutaneous artery and perivascular fat were harvested from severely obese individuals before (n = 20) and 6 months after bariatric surgery (n = 15). Small artery contractile function was examined in vitro with wire myography, and perivascular adipose tissue (PVAT) morphology was assessed with immunohistochemistry. Results The anticontractile activity of PVAT was lost in obese patients before surgery when compared with healthy volunteers and was restored 6 months after bariatric surgery. In vitro protocols with superoxide dismutase and catalase rescued PVAT anticontractile function in tissue from obese individuals before surgery. The improvement in anticontractile function after surgery was accompanied by improvements in insulin sensitivity, serum glycemic indexes, inflammatory cytokines, adipokine profile, and systolic blood pressure together with increased PVAT adiponectin and nitric oxide bioavailability and reduced macrophage infiltration and inflammation. These changes were observed despite the patients remaining severely obese. Conclusions Bariatric surgery and its attendant improvements in weight, blood pressure, inflammation, and metabolism collectively reverse the obesity-induced alteration to PVAT anticontractile function. This reversal is attributable to reductions in local adipose inflammation and oxidative stress with improved adiponectin and nitric oxide bioavailability.

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