[PP.12.04] EARLY EFFECTS OF BARIATRIC SURGERY ON SKIN MICROCIRCULATION IN EXTREMELY OBESE PATIENTS

Objective: Bariatric surgery in extremely obese patients pays significant role in body weight loss and improvement in metabolic variables but little is known on its effects on small vessels and microcirculation. The aim of this study was to assess the changes of postoclusive hyperemic reaction in skin microcirculation in early period after bariatric surgery.Design and method: We included patients with severe obesity who met the eligibility criteria and underwent bariatric surgery (Sleeve Gastrectomy and Roux-en-Y Gastric Bypass). Microcirculation assessment, laboratory tests, ambulatory blood pressure measurement (Spacelabs 90207) and anthropometric variables were performed before and 10 days after the intervention. Resting skin blood flow (RF) and postoclusive reactive hyperemia (PORH) was measured using PeriFlux Laser Doppler Flowmetry (LDF). Statistical analysis was performed with Wilcoxon test and Spearman correlation. Results: Data from 109 patients (41.3% men, age 42.8 ± 11.6 years) were analyzed. Ten days after bariatric surgery, mean weight and BMI loss was 8 kg and 0,4 kg/m2 respectively. Glucose, total cholesterol, mean systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR), leptin, chemerin, urea significantly decreased, adiponectin and HDL cholesterol increase (table). Reduction in area of hyperemia (AH) to area of occlusion (AO) ratio (AH/AO) (median values: 1,14 ± 1,1 vs 1,73 ± 1,4) occurred. Negative correlation between AO (r = -0,2) and hsCRP and also between AH (r = -0,2), AH/AO (r = -0.3) and insulin was observed. There is no correlation between AH, AO, AH/AO and antropometric parameters. Conclusions: Significant changes in reactivity of skin microcirculation concomitant to the metabolic improvement were observed in early period after bariatric surgery in morbidly obese patients