Effects of bariatric surgery on HDL structure and functionality: results from a prospective trial
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Published on: November 14, 2020
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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