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J Clin Lipidol. 2014 Jul-Aug;8(4):408-17. doi: 10.1016/j.jacl.2014.05.001. Epub 2014 May 21.

Effects of bariatric surgery on HDL structure and functionality: results from a prospective trial.

Author information

1
Department of Pharmacology, University of Patras, School of Medicine, Rio Achaias, Greece.
2
Morbid Obesity Unit, Department of Surgery, University of Patras, School of Medicine, Rio Achaias, Greece.
3
Institute of Biosciences and Applications, National Center for Scientific Research Demokritos, Agia Paraskevi, Athens, Greece.
4
Department of Medical Physics, University of Patras, School of Medicine, Rio Achaias, Greece.
5
Department of Physiology and Biophysics, Boston University School of Medicine, Boston, MA, USA.
6
Department of Pharmacology, University of Patras, School of Medicine, Rio Achaias, Greece. Electronic address: kkypreos@med.upatras.gr.

Abstract

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.

KEYWORDS:

Bariatric surgery; Function; High-density lipoprotein; Morbid obesity; Structure

PMID:
25110222
DOI:
10.1016/j.jacl.2014.05.001
[Indexed for MEDLINE]

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