Abstract: TH-PO1246
Vertical Sleeve Gastrectomy Is Associated with Improved Cardiac and Kidney Phenotypes in Youth with Obesity and Type 2 Diabetes
Session Information
- Late-Breaking Research Posters
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Narongkiatikhun, Phoom, Chiang Mai University, Chiang Mai, Thailand
- Choi, Ye Ji, University of Washington School of Medicine, Seattle, Washington, United States
- Miller, Kristen, University of Washington School of Medicine, Seattle, Washington, United States
- Nadeau, Kristen, University of Colorado Anschutz Medical Campus Department of Pediatrics, Aurora, Colorado, United States
- Inge, Thomas H., Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, United States
- Pyle, Laura, University of Washington School of Medicine, Seattle, Washington, United States
- Bjornstad, Petter, University of Washington School of Medicine, Seattle, Washington, United States
Background
Youth-onset type 2 diabetes (T2D) can lead to heart failure and kidney failure decades earlier than adult-onset disease. Which cardiac and kidney imaging phenotypes are perturbed, and whether they are reversible, are unresolved.
Methods
We harmonized baseline data from three cohorts (IMPROVE-T2D, ULTRA-T2D, and SWEET-HEART) into one dataset of 58 participants: 4 with normal weight, 10 with obesity without diabetes, and 44 with youth-onset T2D. All underwent cardiovascular magnetic resonance imaging (CMRI) with cine volumetry, wall thickness, strain, T1 and T2* mapping, and 4D flow–derived aortic pulse wave velocity (PWV) and wall shear stress, with urine albumin-to-creatinine ratio (UACR) and estimated and measured glomerular filtration rate. IMPROVE-T2D participants (N=19) repeated CMRI and underwent kidney MRI before and 12 months after vertical sleeve gastrectomy (VSG). Kidney MRI quantified total kidney volume (TKV) and cortical and medullary furosemide-induced suppression of oxygen consumption (FSOC), an index of tubular oxygen handling. Baseline group differences were assessed by ANOVA or Wilcoxon test. Post-VSG changes were estimated by linear mixed models with random participant intercepts and visit as a fixed effect.
Results
Compared with normal-weight controls, the obesity and T2D groups had greater left ventricular (LV) wall thickness (P<0.05 and P<0.01, respectively). Biventricular cardiac output was higher only in the obesity group, whereas aortic wall shear stress was higher only in T2D group. CMR phenotypes did not differ between the obesity and T2D groups. Participants with severely increased albuminuria (UACR ≥300 mg/g) had greater LV wall thickness (P<0.05) and higher resting heart rate (P<0.01). At 12 months after VSG, LV mass decreased by 12.3 g and heart rate by 12 beats/min (both P<0.01); aortic PWV decreased by 12% (P=0.02), TKV by 69.5 mL (P=0.04), and UACR by 28.2% (P=0.022). Medullary FSOC increased by 124% (P<0.01), whereas glomerular filtration rate remained stable.
Conclusion
Early cardiac perturbations in youth-onset T2D track kidney disease severity and largely reverse after metabolic surgery.