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Research Article| Volume 234, ISSUE 1, P200-205, May 2014

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

  • Author Footnotes
    1 These authors contributed equally to this work.
    Josep Julve
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Institut d’Investigació Biomèdica de l'Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain

    CIBER de Diabetes y Enfermedades Metabólicas Asociadas, CIBERDEM, Barcelona, Spain

    Departament de Bioquímica i Biologia Molecular, Universitat Autònoma de Barcelona, Barcelona, Spain
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  • Author Footnotes
    1 These authors contributed equally to this work.
    Eva Pardina
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Departament de Bioquímica i Biologia Molecular, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
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  • Montserrat Pérez-Cuéllar
    Affiliations
    Institut d’Investigació Biomèdica de l'Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
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  • Roser Ferrer
    Affiliations
    Departament de Bioquímica i Unitat de Cirurgia, Institut de Recerca Hospital Universitari Vall d'Hebron, Barcelona, Spain
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  • Joana Rossell
    Affiliations
    Departament de Bioquímica i Biologia Molecular, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
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  • Juan Antonio Baena-Fustegueras
    Affiliations
    Unitat de Cirurgia, Hospital Arnau de Vilanova, Lleida, Spain
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  • José Manuel Fort
    Affiliations
    Departament de Bioquímica i Unitat de Cirurgia, Institut de Recerca Hospital Universitari Vall d'Hebron, Barcelona, Spain
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  • Albert Lecube
    Affiliations
    Departament d’Endocrinologia i Nutrició, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, Lleida, Spain

    Unitat de Recerca en Diabetes i Metabolisme, Institut de Recerca Hospital Universitari Vall d'Hebron, Barcelona, Spain

    CIBER de Diabetes y Enfermedades Metabólicas Asociadas, CIBERDEM, Barcelona, Spain

    Departament de Bioquímica i Biologia Molecular, Universitat Autònoma de Barcelona, Barcelona, Spain
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  • Francisco Blanco-Vaca
    Affiliations
    Institut d’Investigació Biomèdica de l'Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain

    CIBER de Diabetes y Enfermedades Metabólicas Asociadas, CIBERDEM, Barcelona, Spain

    Departament de Bioquímica i Biologia Molecular, Universitat Autònoma de Barcelona, Barcelona, Spain
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  • José Luis Sánchez-Quesada
    Affiliations
    Institut d’Investigació Biomèdica de l'Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
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  • Julia Peinado-Onsurbe
    Correspondence
    Corresponding author. Departament de Bioquímica. Facultat de Biologia. Universitat de Barcelona. Av. Diagonal 643, 08028 Barcelona, Spain. Tel.: +34 93 4021542; fax: +34 93 4021559.
    Affiliations
    Departament de Bioquímica i Biologia Molecular, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally to this work.

      Highlights

      • The proatherogenic apoB-containing lipoprotein-bound Lp-PLA2 activity was significantly reduced after bariatric surgery.
      • Bariatric surgery reduced the concentration of circulating oxidised LDL in plasma.
      • A switch towards predominantly larger HDL particles was observed in all patients after surgery.

      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.

      Keywords

      Abbreviations:

      apo (apolipoprotein), HDL (high-density lipoprotein), HDL-C (HDL cholesterol), LDL (low-density lipoprotein), LDL-C (LDL cholesterol), Lp-PLA2 (lipoprotein-associated phospholipase A2), MSR1 (scavenger receptor A (SRA) gene), non-HDL-C (non-HDL cholesterol), OLR1 (oxidised (lectin-like) LDL receptor-1 gene), oxLDL (oxidised LDL), PLA2G7 (group VII phospholipase A2 gene), PON1 (plasma paraoxonase-(PON)1 gene), RYGBP (Roux-en-Y gastric bypass), SCARB1 (scavenger receptor B type I (SR-BI) gene), VLDL (very-low-density lipoprotein)
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