Longitudinal Effect of Bariatric Surgery on Retinal Microcirculation and Target Organ Damage: the BASTOD Study

Eloi Debourdeau (1, 2) , Gabriel Gardes (1) , David Nocca (3) , Isabelle Carriere (2) , Christophe Chiquet (4) , Max Villain (1) , Camille Roubille (5, 6) , Guilhem Du Cailar (6, 7) , Mathieu Sardinoux (6, 7) , Vincent Daien (1, 2, 8) , Pierre Fesler (5, 6)

1 Hôpital Gui de Chauliac [CHU Montpellier]
2 INM - Institut des Neurosciences de Montpellier
3 CHU Montpellier
4 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
5 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
6 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
7 UM - Université de Montpellier
8 The University of Sydney

Purpose: Obesity is associated with increased cardiovascular risk. Bariatric surgery (BS) improves the clinical and metabolic profile. Retinal caliber changes could precede cardiovascular events. Different studies have shown an improvement in retinal caliber after BS. The aim of this study was to examine retinal caliber and other cardiovascular target organ damage before and after BS. Materials and methods: Monocentric, prospective cohort study at the Montpellier University Hospital. Biologic features, vessel stiffness, echocardiograph variables, and retinal caliber at baseline and 6 and 12 months were assessed in consecutive patients with class 2 or 3 obesity undergoing BS. A mixed linear model adjusted for age and sex was used. Results: We included 88 patients (75 women). The mean (SD) age was 43 years (11) and mean (SD) baseline weight 117 (21) Kg. Mean changes in the first year after BS were - 5.1 µm in central retinal vein equivalent (CRVE) (p < 0.0001), + 0.02 in arteriole-to-venule ratio (AVR) (p < 0.0001), - 1.4 mmol/L in glycemia (p < 0.0001), - 1.0 mg/L in natural logarithm of C-reactive protein (p < 0.0001), and - 54.0 g in left ventricular mass (p = 0.0005). We observed no significant improvement in arterial stiffness markers. Predictors of improvement in CRVE were high baseline weight (p = 0.030), male sex (p = 0.025), and no diabetes history (p Dynamic links between variations = 0.047). Conclusion: The retinal microvascular phenotype improved during the first year after bariatric surgery, with decreased CRVE and increased AVR. Factors associated with retinal microvascular plasticity were male sex, high baseline weight, and absence of diabetes. Longitudinal assessment of retinal vascular calibers may offer new insights into the pathophysiology of subclinical vascular processes.

Mots clés: Ankle Brachial Index; Bariatric surgery; Pulse wave analysis; Retinal vessels; Vascular stiffness; Weight loss

Domaines: Sciences du Vivant [q-bio]

Eloi Debourdeau, Gabriel Gardes, David Nocca, Isabelle Carriere, Christophe Chiquet, et al.. Longitudinal Effect of Bariatric Surgery on Retinal Microcirculation and Target Organ Damage: the BASTOD Study. Obesity Surgery, In press, ⟨10.1007/s11695-022-06064-2⟩. ⟨hal-03653974⟩