{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T23:43:08Z","timestamp":1791243788322,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2013,9,4]],"date-time":"2013-09-04T00:00:00Z","timestamp":1378252800000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["5R01HL048531-16"],"award-info":[{"award-number":["5R01HL048531-16"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["R01 HL085188-02"],"award-info":[{"award-number":["R01 HL085188-02"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["R01 HL090897-01A2"],"award-info":[{"award-number":["R01 HL090897-01A2"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["1R01HL110350-01A1"],"award-info":[{"award-number":["1R01HL110350-01A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["R01HL110350-01"],"award-info":[{"award-number":["R01HL110350-01"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["K24HL093218-01A1"],"award-info":[{"award-number":["K24HL093218-01A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["P01 HL 095491"],"award-info":[{"award-number":["P01 HL 095491"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"crossref","award":["0840159N"],"award-info":[{"award-number":["0840159N"]}],"id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2013,9]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n The mechanisms by which obesity and obstructive sleep apnoea (\n OSA<\/jats:styled-content>\n ) may contribute to endothelial dysfunction are unclear.\n <\/jats:p>\n <\/jats:sec>\n \n Aims<\/jats:title>\n \n We sought to follow up a sample of obese subjects undergoing either bariatric surgery or continuous positive airway pressure (\n CPAP<\/jats:styled-content>\n ) therapy to treat\n OSA<\/jats:styled-content>\n . We hypothesised improved vascular function with both therapeutic approaches, consistent with a reversible\n OSA<\/jats:styled-content>\n effect on the circulation.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Twenty\u2010seven obese (\n BMI<\/jats:styled-content>\n \u226530\u2009kg\/m\n 2<\/jats:sup>\n ) subjects with\n OSA<\/jats:styled-content>\n underwent either bariatric surgery without\n CPAP<\/jats:styled-content>\n (\n n<\/jats:italic>\n = 12, median\n BMI<\/jats:styled-content>\n 43.7\u2009kg\/m\n 2<\/jats:sup>\n IQR<\/jats:styled-content>\n 9.4) or\n CPAP<\/jats:styled-content>\n (\n n<\/jats:italic>\n = 15, median\n BMI<\/jats:styled-content>\n 33.8\u2009kg\/m\n 2<\/jats:sup>\n IQR<\/jats:styled-content>\n 6.6). Polysomnography and vascular testing (flow\u2010mediated dilation of the brachial artery measured with high\u2010resolution ultrasound, endothelium\u2010dependent change in skin blood flow measured with laser\n D<\/jats:styled-content>\n oppler flowmetry, and arterial stiffness measured with applanation tonometry) took place at baseline and after 6 months.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Both groups showed significant improvements in the apnoea\u2013hypopnea index and overnight oxygen saturation. Endothelium\u2010dependent microvascular reactivity was 45.6% (\n IQR<\/jats:styled-content>\n 37.5) at baseline in the\n CPAP<\/jats:styled-content>\n group, which increased to 69.1% (\n IQR<\/jats:styled-content>\n 62.3) post\u2010treatment (\n P<\/jats:italic>\n < 0.05). No significant changes were observed in the surgery group, despite significant weight loss (post\u2010surgery\n BMI<\/jats:styled-content>\n 32.7\u2009kg\/m2\n IQR<\/jats:styled-content>\n 8.6 (\n P<\/jats:italic>\n < 0.01); no change in\n BMI<\/jats:styled-content>\n was observed in the\n CPAP<\/jats:styled-content>\n group. There were no significant changes in brachial artery flow\u2010mediated dilation in either group.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n This pilot study demonstrates that 6 months of\n CPAP<\/jats:styled-content>\n may be sufficient to improve endothelium\u2010dependent microvascular reactivity, while substantial surgically induced weight loss did not result in improvements. Further research should be directed towards comparative effectiveness trials using these novel surrogate outcomes, as well as hard cardiovascular outcomes.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/imj.12224","type":"journal-article","created":{"date-parts":[[2013,6,26]],"date-time":"2013-06-26T05:34:37Z","timestamp":1372224877000},"page":"993-998","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Pilot study of the effects of bariatric surgery and continuous positive airway pressure treatment on vascular function in obese subjects with obstructive sleep apnoea"],"prefix":"10.1111","volume":"43","author":[{"given":"J. P.","family":"Bakker","sequence":"first","affiliation":[{"name":"Division of Sleep Medicine Brigham and Women's Hospital Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. S.","family":"Balachandran","sequence":"additional","affiliation":[{"name":"Sleep Disorders Center, Section of Pulmonary and Critical Care Department of Medicine University of Chicago Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Tecilazich","sequence":"additional","affiliation":[{"name":"Department of Surgery Beth Israel Deaconess Medical Center, Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. N.","family":"DeYoung","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine Brigham and Women's Hospital Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Smales","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine Brigham and Women's Hospital Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Veves","sequence":"additional","affiliation":[{"name":"Department of Surgery Beth Israel Deaconess Medical Center, Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine Brigham and Women's Hospital Boston Massachusetts 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