Bariatric Surgery-induced High-density Lipoprotein Functionality Enhancement Is Associated With Reduced Inflammation.

Area of Science:

• Metabolic Surgery
• Cardiovascular Health
• Lipid Metabolism

Background:

• Impaired high-density lipoprotein (HDL) functionality is linked to cardiovascular disease (CVD).
• HDL plays a crucial role in reverse cholesterol transport (RCT), reducing inflammation and oxidative stress.
• RCT efficiency depends on HDL's cholesterol efflux capacity (CEC) and specific transporter proteins (ABCA1, ABCG1, SR-B1).

Purpose of the Study:

• To investigate the impact of Roux-en-Y gastric bypass (RYGB) on RCT and HDL functionality in morbidly obese individuals.
• To assess changes in CVD risk biomarkers and adipose tissue characteristics post-RYGB.

Main Methods:

• Measured CVD risk biomarkers (TNF-α, hsCRP, MPO, PON1 activity, CEC) in 44 patients before and after RYGB.
• Analyzed gene expression (ABCA1, ABCG1, SR-B1, TNF-α) and histological features of adipose tissue (adipocyte size, macrophage density) pre- and post-RYGB.

Main Results:

• RYGB led to significant improvements in BMI, HDL-cholesterol, hsCRP, TNF-α, MPO mass, PON1 activity, and CEC.
• Increased expression of ABCA1 and ABCG1 genes was observed post-RYGB.
• Reduced adipocyte size, macrophage density, and TNF-α staining in adipose tissue correlated with improved gene expression and reduced inflammation.

Conclusions:

• RYGB significantly enhances HDL functionality and cholesterol efflux capacity in morbidly obese patients.
• These improvements are associated with a reduction in both adipose tissue and systemic inflammation.
• RYGB represents a potential therapeutic strategy for improving cardiovascular health by enhancing HDL function.