Studies have shown that mortality was reduced by 31.6% in patients that underwent bariatric surgery compared with the non-operative control group. However, in most surgical series the majority of patients were women, and men had higher post-operative mortality rates and a higher postoperative morbidity, regardless of weight. Our primary end point was to study gender effects on vascular inflammation following bariatric surgery for weight loss. Methods. A prospective study evaluated vascular inflammation in obese patients before and three months after bariatric surgery. Markers of vascular inflammation were measured - before surgery and three months afterwards. Results. One hundred and two patients (73 women and 29 men, 40.5 ± 12.3 years old) underwent bariatric surgery. Correlation was found between BMI change and waist circumference change (r = 0.658, P<0.001). Three months post-surgery, BMI was significantly decreased (p<0.001) (a decrease of 8.82), waist circumference was reduced (p<0.001) (a decrease of 17.33 cm). ICAM-1 levels and hs-CRP levels were decreased (both P = 0.0001). Gender differences seem to be borderline significant with respect to the prevalence of type II diabetes mellitus (men > women; P = 0.05) and hypertension (men > women; P = 0.06). In women, following bariatric surgery, BMI was decreased (p<0.001) (a decrease of 9.25), waist circumference was reduced (p<0.001) (a decrease of 18.8cm). ICAM-1 levels were decreased (p = 0.002) and hs-CRP levels were also decreased (P = 0.0001). In men, following bariatric surgery, BMI was decreased (p = 0.001) (a decrease of 8.1), waist circumference was reduced (p<0.005) (a decrease of 14.6cm); however, although ICAM-1 levels and hs-CRP levels were decreased the decreases were non-significant (both P = 0.09). Discussion. Our study examined gender effects of bariatric surgery on vascular inflammation. Bariatric surgery had no significant effect on biochemical inflammatory markers in male patients, while females undergoing the same kind of bariatric surgery for weight loss showed a significant decrease in these markers of inflammation. These results may explain the epidemiological data that described higher morbidity and mortality among obese men undergoing bariatric operation for weight loss. This is the first study that has demonstrated a gender difference in the inflammatory responses that may affect clinical outcome, and cardiovascular morbidity and mortality.

中文翻译：

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减肥手术后对血管炎症的性别效应。

研究表明，与非手术对照组相比，进行减肥手术的患者的死亡率降低了31.6％。但是，在大多数外科手术系列中，大多数患者是女性，而无论体重如何，男性的术后死亡率均较高，且术后发病率较高。我们的主要终点是研究减肥手术减轻体重后性别对血管炎症的影响。方法。一项前瞻性研究评估了肥胖患者减肥手术前后的血管炎症。在手术前和术后三个月测量了血管炎症指标。结果。102例患者（73例女性和29例男性，40.5±12.3岁）接受了减肥手术。发现BMI变化与腰围变化之间存在相关性（r = 0。658，P ＜0.001）。术后三个月，BMI显着降低（p <0.001）（降低8.82），腰围降低（p <0.001）（降低17.33 cm）。ICAM-1水平和hs-CRP水平降低（均P = 0.0001）。在II型糖尿病（男性>女性； P = 0.05）和高血压（男性>女性； P = 0.06）的患病率方面，性别差异似乎是非常重要的。在减肥手术后的女性中，BMI降低（p <0.001）（降低9.25），腰围降低（p <0.001）（降低18.8cm）。ICAM-1水平降低（p = 0.002），hs-CRP水平也降低（P = 0.0001）。在男性中，减肥手术后，BMI下降（p = 0.001）（下降8.1），腰围下降（p <0.005）（下降14.6cm）；然而，尽管ICAM-1水平和hs-CRP水平降低，但降低幅度不显着（均P = 0.09）。讨论。我们的研究检查了减肥手术对血管炎症的性别影响。减肥手术对男性患者的生化炎症指标没有显着影响，而接受减肥的同类减肥手术的女性则显示这些炎症指标显着降低。这些结果可能解释了流行病学数据，该数据描述了因减肥而接受肥胖手术的肥胖男性中较高的发病率和死亡率。这是第一项证明可能影响临床结局以及心血管疾病发病率和死亡率的炎症反应存在性别差异的研究。