• Stefanie R van Mil, L Ulas Biter, Gert Jan M van de Geijn, Erwin Birnie, Martin Dunkelgrun, Ijzermans Jan N M JNM Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, the Netherlands., Noelle van der Meulen, Mannaerts Guido H H GHH Department of Surgery, Tawam Hospital, Al Ain, United Arab Emirates., and Castro Cabezas Manuel M Internal Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands..
• Departments of Surgery, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands.
• Eur. J. Clin. Invest. 2019 Jul 1; 49 (7): e13118.

BackgroundWomen are relatively protected from cardiovascular disease compared with men. Since morbid obesity is an independent risk factor for cardiovascular disease, the current study investigated whether the association between sex and cardiovascular risk factors and outcomes can be demonstrated in subjects suffering from morbid obesity.Materials And MethodsTwo hundred subjects enrolled in a study on cardiovascular risk factors in morbid obesity underwent extensive laboratory screening, carotid intima-media thickness (cIMT) and pulse wave velocity (PWV) measurements. Gender differences were analysed using univariate and multivariable linear regression models. In addition, the effect of menopause on cIMT and PWV was analysed. Results of these models were reported as B coefficients with 95% confidence intervals.ResultsThe group consisted of 52 men and 148 women, with a mean age of 41 (±11.8) years and a mean body mass index (BMI) of 42.7 (±5.2) kg/m2 . Both, cIMT and PWV were significantly higher in men than in women, although the difference in cIMT disappeared after adjustment for covariables such as waist circumference, age, high-density lipoprotein cholesterol and mean arterial pressure. PWV was associated with sex after adjustments for covariables in morbidly obese patients. Postmenopausal women had significantly increased cIMT and PWV when compared with premenopausal women.ConclusionSex differences in PWV persist in subjects suffering from morbid obesity. However, no difference was found in cIMT between morbidly obese men and women after adjustment for classic cardiovascular risk factors. Premenopausal morbidly obese women are protected for cardiovascular disease when compared with postmenopausal morbidly obese women.© 2019 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.

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