Impact of bariatric surgery on apolipoprotein C-III levels and lipoprotein distribution in obese human subjects

Abstract

BACKGROUND: Elevated apolipoprotein C-III (apoC-III) has been postulated to contribute to the atherogenic dyslipidemia seen in obesity and insulin-resistant states, mainly by impairing plasma triglyceride-rich lipoprotein (TRL) metabolism. Bariatric surgery is associated with improvements of several obesity-associated metabolic abnormalities, including a reduction in plasma triglycerides (TGs) and an increase in plasma high-density lipoprotein cholesterol (HDL-C).OBJECTIVES: We investigated the specific effect of bariatric surgery on apoC-III concentrations in plasma, non-HDL, and HDL fractions in relation to lipid profile parameters evolution.METHODS: A total of 132 obese subjects undergoing bariatric surgery, gastric bypass (n 5 61) or sleeve gastrectomy (n 5 71), were studied 1 month before surgery and 6 and 12 months after surgery.RESULTS: Plasma apoC-III, non-HDL-apoC-III, and HDL-apoC-III concentrations were markedly reduced after surgery and strongly associated with reduction in plasma TG. This decrease was E-mail address: rvalero@mail.ap-hm.fr accompanied by a redistribution of apoC-III from TRL to HDL fractions. In multivariate analysis, plasma apoC-III was the strongest predictor of TG reduction after surgery, and the increase of HDL-C was positively associated with plasma adiponectin and negatively with body mass index.CONCLUSION: Marked reduction of apoC-III and changes in its distribution between TRL and HDL consistent with a better lipid profile are achieved in obese patients after bariatric surgery. These apoC-III beneficial modifications may have implications in dyslipidemia improvement and contribute to cardiovascular risk reduction after surgery.

Correlation of Bariatric Surgery Effect on Lipid Profile Among Obese Patients

“…In concordance, other studies showed that associated risk factors of cardiovascular disease, hypertension (HTN), type 2 diabetes mellitus (DM), and dyslipidemia, are directly related to higher severity of obesity, mortality, and morbidity [2,6,7]. Bariatric surgery is an effective treatment for morbid obesity, especially with comorbid diseases [2] as it leads to improvement in several cardiovascular risk factors such as DM, HTN, hypertriglyceridemia as well as raising the low HDL cholesterol [2,6]. While some researchers reported improvement in all parameters of the lipid profile after bariatric surgery, other researchers reported that the reduction was only in the levels of LDL cholesterol and serum TG, whereas there were non-significant changes in TC and HDL cholesterol levels [8,9].…”

“…A previous study showed that for every 1 kg body weight loss, serum LDL cholesterol level drops by 0.02 mmol/L, serum TC level drops by 0.05 mmol/L, and serum HDL cholesterol level increases by 0.009 mmol/L [5]. In concordance, other studies showed that associated risk factors of cardiovascular disease, hypertension (HTN), type 2 diabetes mellitus (DM), and dyslipidemia, are directly related to higher severity of obesity, mortality, and morbidity [2,6,7]. Bariatric surgery is an effective treatment for morbid obesity, especially with comorbid diseases [2] as it leads to improvement in several cardiovascular risk factors such as DM, HTN, hypertriglyceridemia as well as raising the low HDL cholesterol [2,6].…”

Beneficial changes on plasma apolipoproteins A and B, high density lipoproteins and oxidized low density lipoproteins in obese women after bariatric surgery: comparison between gastric bypass and sleeve gastrectomy

“…Two recent studies have compared the effects on lipid profiles after RYGB and SG: Heffron and coworkers showed a similar weight loss after these two surgical techniques but a higher increase in HDL and ApoA after SG [ 43 ]; on the other hand, Maraninchi and coworkers also showed a similar weight loss after these two surgical techniques, with similar increases in HDL and reductions in triglycerides, but they showed a higher decrease in total cholesterol, LDL and ApoB after RYGB [ 44 ]. Although the effects of bariatric surgery on lipid profiles are clearly beneficial, small differences between surgical techniques need further studies due to small discrepancies which may be due to different selected populations and sample size of studies.…”

The dual glucose‐dependent insulinotropic peptide and glucagon‐like peptide‐1 receptor agonist, tirzepatide, improves lipoprotein biomarkers associated with insulin resistance and cardiovascular risk in patients with type 2 diabetes

“…8,36 Weight loss with bariatric surgery is consistently accompanied not only by HbA1c reduction, but has also resulted in markedly reduced plasma triglycerides and apoC-III, and this decrease was accompanied by a redistribution of apoC-III from triglyceride-rich lipoproteins to HDL. 39 However, although tirzepatide resulted in better glucose control and greater weight loss than dulaglutide, the multiple linear regression analysis indicated that tirzepatide-induced weight loss only explained a small portion of the variability in triglycerides.…”