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Microvasculaire functie en glucosemetabolisme bij patiënten met obesitas voor en na bariatrische chirurgie

(2012) Kooistra, J. (Jelmer)

Background:
Obesity-related comorbidities are reflected in the metabolic syndrome, a clustering of risk factors for cardiovascular diseases and diabetes mellitus. The underlying pathophysiology of the metabolic syndrome is unknown. Microvascular dysfunction possibly plays a central role. The aim of this study was to investigate microvascular function and glucose metabolism in obese patients before and after bariatric surgery.
Methods:
Obese patients were studied 3 weeks before, 1 week before, 2 weeks after, 4 weeks after and 8 weeks after bariatric surgery. Microvascular function was studied with microvascular vasodilatation through laser Doppler flowmetry after iontophoresis of acetylcholine and sodiumnitroprusside and with microvascular vasomotion through a Fourier analysis of the laser Doppler signal. Glucose metabolism was studied with fasting glucose and glucose 2 hours after orally taken 75 grams of glucose through an oral glucose tolerance test.
Results:
Microvascular vasodilatation did not evidently improve after bariatric surgery, but few successful measurements were done. Microvascular vasomotion did not evidently improve after bariatric surgery. Fasting glucose and glucose 2 hours after orally taken 75 grams of glucose showed a clear but not statistic significant decrease after bariatric surgery.
Conclusion:
Our study does not support the hypothesis that shortly after bariatric surgery glucose metabolism improves because of an improvement in microvascular function. More research must be done in order to reject this hypothesis definitely





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