Bariatric surgery in morbidly obese patients improves the atherogenic qualitative properties of the plasma lipoproteins.

Abstract

OBJECTIVE:

The purpose of this study was to evaluate the effect of weight loss induced in morbidly obese subjects by Roux-en-Y gastric bypass bariatric surgery on the atherogenic features of their plasma lipoproteins.

METHODS:

Twenty-one morbidly obese subjects undergoing bariatric surgery were followed up for up to 1 year after surgery. Plasma and lipoproteins were assayed for chemical composition and lipoprotein-associated phospholipase A2 (Lp-PLA2) activity. Lipoprotein size was assessed by non-denaturing polyacrylamide gradient gel electrophoresis, and oxidised LDL by ELISA. Liver samples were assayed for mRNA abundance of oxidative markers.

RESULTS:

Lipid profile analysis revealed a reduction in the plasma concentrations of cholesterol and triglycerides, which were mainly associated with a significant reduction in the plasma concentration of circulating apoB-containing lipoproteins rather than with changes in their relative chemical composition. All patients displayed a pattern A phenotype of LDL subfractions and a relative increase in the antiatherogenic plasma HDL-2 subfraction (>2-fold; P < 0.001). The switch towards predominantly larger HDL particles was due to an increase in their relative cholesteryl ester content. Excess weight loss also led to a significant decrease in the plasma concentration of oxidised LDL (∼-25%; P < 0.01) and in the total Lp-PLA2 activity. Interestingly, the decrease in plasma Lp-PLA2 was mainly attributed to a decrease in the apoB-containing lipoprotein-bound Lp-PLA2.

CONCLUSION:

Our data indicate that the weight loss induced by bariatric surgery ameliorates the atherogenicity of plasma lipoproteins by reducing the apoB-containing Lp-PLA2 activity and oxidised LDL, as well as increasing the HDL-2 subfraction.

• Authors: Josep Julve, Eva Pardina, Montserrat Pérez-Cuéllar, Roser Ferrer, Joana Rossell, Juan Antonio Baena-Fustegueras, José Manuel Fort, Albert Lecube, Francisco Blanco-Vaca, José Luis Sánchez-Quesada, Julia Peinado-Onsurbe
• Journal: Atherosclerosis (Atherosclerosis) Vol. 234 Issue 1 Pg. 200-5 (May 2014) ISSN: 1879-1484 [Electronic] Ireland
• PMID: 24674904 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Lipoproteins

Topics

• Adult
• Atherosclerosis (blood, etiology, prevention & control)
• Female
• Gastric Bypass
• Humans
• Lipoproteins (blood, physiology)
• Male
• Middle Aged
• Obesity, Morbid (blood, classification, surgery)
• Weight Loss
• Young Adult