Main Article Content
Objective: Atherosclerosis is a chronic inflammatory process characterized by the accumulation of lipid and inflammatory cells in the walls of medium and large arteries. Metabolic effects of splenectomy are less known, especially the effects on lipid metabolism is a debate. In this study, we aimed to investigate the effects of splenectomy on atherosclerosis in humans.
Methods: The data of 280 patients who underwent a splenectomy at a tertiary center between 2009-2016 were analyzed. The 50 patients were included in the study as a splenectomy group. In addition, 50 patients who applied to our outpatient clinic between January 2021 and August 2021 with similar characteristics to those in the splenectomy group except for splenectomy were included in the study as a non-splenectomy group. Atherosclerosis was evaluated by measuring the right, left, and the mean carotid artery intima-media thickness (CAIMT).
Results: All measurements were significantly higher in the splenectomy group (p=0.010 for left CAIMT, p=0.011 for right CAIMT and p=0.008 for mean CAIMT).
Conclusion: The CAIMT measurements were higher and therefore atherosclerosis risk was increased in patients with splenectomy. For this reason, it should be kept in mind that these patients may develop cardiovascular and cerebrovascular problems due to atherosclerosis and should be followed up in this respect.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Kattoor AJ, Pothineni NVK, Palagiri D, et al. Oxidative Stress in Atherosclerosis. Curr Atheroscler Rep. 2017 Nov;19:42.
Ross R. The Pathogenesis of Atherosclerosis — An Update. N Engl J Med. 1986 Feb 20;314:488–500.
Nordestgaard BG. Triglyceride-Rich Lipoproteins and Atherosclerotic Cardiovascular Disease. Circ Res. 2016 Feb 19;118:547–63.
Ketelhuth DFJ, Hansson GK. Cellular immunity, low-density lipoprotein and atherosclerosis: Break of tolerance in the artery wall. Thromb Haemost. 2011;106:779–86.
Steffen Y, Vuillaume G, Stolle K, et al. Cigarette smoke and LDL cooperate in reducing nitric oxide bioavailability in endothelial cells via effects on both eNOS and NADPH oxidase. Nitric Oxide. 2012 Oct 15;27:176–84.
Senders ML, Que X, Cho YS, et al. PET/MR Imaging of Malondialdehyde-Acetaldehyde Epitopes With a Human Antibody Detects Clinically Relevant Atherothrombosis. J Am Coll Cardiol. 2018 Jan 23;71:321–35.
Colantonio LD, Bittner V, Reynolds K, et al. Association of Serum Lipids and Coronary Heart Disease in Contemporary Observational Studies. Circulation. 2016 Jan 19;133:256–64.
Schmidt HH, Wagner S, Manns M. The spleen as a storage pool in lipid metabolism. Am J Gastroenterol. 1997;92:1072–1072.
Caligiuri G, Nicoletti A, Poirier B, et al. Protective immunity against atherosclerosis carried by B cells of hypercholesterolemic mice. J Clin Invest. 2002;109:745–53.
Robinette CD, Fraumeni JR J. Splenectomy and subsequent mortality in veterans of the 1939-45 war. The Lancet. 1977;310:127–9.
Ai XM, Ho LC, Han LL, et al. The role of splenectomy in lipid metabolism and atherosclerosis (AS). Lipids Health Dis. 2018;17:1–8.
Asai K, Kuzuya M, Naito M, et al. Effects of splenectomy on serum lipids and experimental atherosclerosis. Angiology. 1988;39:497–504.
Petroianu A, Veloso DFM, Costa GR, et al. Effects of splenic surgeries on lipidogram of rats. Rev Assoc Médica Bras. 2006;52:56–9.
Aviram M, Brook JG, Tatarsky I, et al. Increased low-density lipoprotein levels after splenectomy: a role for the spleen in cholesterol metabolism in myeloproliferative disorders. Am J Med Sci. 1986;291:25–8.
Fatouros M, Bourantas K, Bairaktari E, et al. Role of the spleen in lipid metabolism. J Br Surg. 1995;82:1675–7.
Altinel Y, Kose E, Karacaglar A, et al. Systemic Amelioration via Curcumin in Rats following Splenectomy: Lipid Profile, Endothelial and Oxidative Damage. J Invest Surg. 2020 Oct 20;1–10.
Gunes O, Turgut E, Bag YM, et al. The impact of splenectomy on human lipid metabolism. Ups J Med Sci. 2022;127.
Li Y, Stone JR. The impact of splenectomy on human coronary artery atherosclerosis and vascular macrophage distribution. Cardiovasc Pathol. 2016;25:453–60.
Rezende AB, Nunes SI, Farias RE, et al. Influência do baço, da asplenia e do implante esplênico autógeno no metabolismo lipídico de camundongos. Rev Colégio Bras Cir. 2007;34:177–82.
Lammers B, Zhao Y, Foks AC, et al. Leukocyte ABCA1 remains atheroprotective in splenectomized LDL receptor knockout mice. PloS One. 2012;7:e48080.
Demuner BL, Pinho GZ, Thomaz JC, et al. Effect of total splenectomy in the lipid profile in mice. Acta Cir Bras. 2015;30:306–12.
Zhang Y, An X, Lin Q, et al. Splenectomy had no significant impact on lipid metabolism and atherogenesis in Apoe deficient mice fed on a severe atherogenic diet. Cardiovasc Pathol. 2018;36:35–41.
Kristinsson SY, Gridley G, Hoover RN, et al. Long-term risks after splenectomy among 8,149 cancer-free American veterans: a cohort study with up to 27 years follow-up. Haematologica. 2014.
Ross R. The pathogenesis of atherosclerosis: a perspective for the 1990s. Nature. 1993;362:801–9.
Libby P, Ridker PM, Hansson GK. Progress and challenges in translating the biology of atherosclerosis. Nature. 2011 May;473:317–25.