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Effects of bariatric surgery on HDL structure and functionality: results from a prospective trial
Evangelia Zvintzou1, George Skroubis2, Angelika Chroni3
1Department of Pharmacology, University of Patras, School of Medicine, Rio Achaias, Greece.
Insights
Rapid weight loss from bariatric surgery significantly improves high-density lipoprotein (HDL) quality and antioxidant function. This enhanced HDL structure may explain the cardiovascular benefits observed after malabsorptive procedures.
Area of Science:
- Cardiovascular Science
- Metabolic Health
- Bariatric Surgery Research
Background:
- High-density lipoprotein cholesterol (HDL-C) levels and quality are crucial for preventing atherosclerosis.
- Obesity and metabolic syndrome are linked to reduced HDL-C and increased coronary heart disease risk.
- The impact of weight loss on HDL quality and function remains understudied.
Purpose of the Study:
- To examine the effects of rapid weight loss on HDL structure and antioxidant capacity.
- To investigate HDL changes in patients undergoing malabsorptive bariatric procedures.
Main Methods:
- Collected plasma samples from 20 morbidly obese patients (BMI >50) before and 6 months after bariatric surgery.
- Isolated and analyzed high-density lipoprotein (HDL) using biochemical techniques.
Main Results:
- Observed significant alterations in HDL apolipoprotein ratios, increased mature HDL subspecies, and enhanced HDL antioxidant potential.
- Identified two patient subgroups based on pre-surgery HDL composition (apoA-I, apoCIII, apoE).
- Demonstrated a post-surgery shift from apoE- to apoA-I-containing HDL particles in both subgroups.
Conclusions:
- Rapid weight loss via malabsorptive bariatric procedures substantially improves HDL structure and functionality.
- These HDL improvements may contribute to the cardiovascular health benefits of bariatric surgery.
Background:
In addition to high-density lipoprotein cholesterol (HDL-C) levels, HDL quality appears also very important for atheroprotection. Obese patients with metabolic syndrome have significantly reduced HDL-C levels and are usually at increased risk for coronary heart disease. Despite that weight loss benefits these patients, its effects on HDL quality and functionality is currently poorly studied.
Objectives:
We investigated how rapid weight loss affects HDL structure and its antioxidant potential in patients undergoing a malabsorptive bariatric procedure.
Methods:
Fasting plasma samples were collected the day before and 6 months after the bariatric procedure from 20 morbidly obese patients with body mass index >50, then HDL was isolated and analyzed by biochemical techniques.
Results:
We report a dramatic alteration in the apolipoprotein ratio of HDL that was accompanied by the presence of more mature HDL subspecies and a concomitant increase in the antioxidant potential of HDL. Interestingly, our obese cohort could be distinguished into 2 subgroups. In 35% of patients (n = 7), HDL before surgery had barely detectable apolipoprotein (apo) A-I and apoCIII, and the vast majority of their HDL cholesterol was packed in apoE-containing HDL particles. In the remaining 65% of patients (n = 13), HDL before surgery contained high levels of apoA-I and apoCIII, in addition to apoE. In both subgroups, surgical weight loss resulted in a switch from apoE to apoA-I-containing HDL.
Conclusions:
Rapid weight loss exerts a significant improvement in HDL structure and functionality that may contribute to the documented beneficial effect of malabsorptive bariatric procedures on cardiovascular health.
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