Impact of bariatric surgery on circulating PCSK9 levels as marker of cardiovascular disease risk: a meta-analysis

Jamialahmadi, Tannaz; Banach, Maciej; Almahmeed, Wael; Kesharwani, Prashant; Sahebkar, Amirhossein

doi:10.5114/aoms/152685

Cited by 5 publications

(3 citation statements)

References 26 publications

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“…Metabolic surgery results in weight loss and improvement of several cardiometabolic risk factors [29][30][31][32][33][34][35][36]. This modality also reduces the prevalence of liver fibrosis in patients with severe obesity [37,38].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of Non-invasive Liver Function Tests in Liver Fibrosis and Changes in These Parameters Post-metabolic Surgery

et al. 2022

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Background: Over the past few years, attempts have been made to uncover non-invasive investigative techniques for the determination of liver fibrosis which include serological markers, diagnostic scoring, and imaging modalities. Although these methods are safer, less expensive, and more readily available, they do not have the same diagnostic capacity as a liver biopsy. There remains a need to find an investigative method encompassing all the above qualities to determine liver fibrosis.Objective: This study aimed to ascertain the diagnostic accuracy of non-invasive liver function tests in liver fibrosis and assess their changes after metabolic surgery.Methods: 1005 individuals with severe obesity who were referred for metabolic surgery were analysed. All participants had blood samples taken for liver enzymes and lipid profile. In addition, hepatic indexes, including AAR, APRI, NFS and Fibrosis-4 (FIB4), were checked. Furthermore, all participants underwent two-dimensional shear wave elastography (2D-SWE).All investigations were repeated 6-8 months after metabolic surgery. The receiver operating characteristic (ROC) curve and the area under the ROC curve was utilised to determine the optimal cut-off values for baseline study parameters. Logistic regression was applied to predict the relationship between study parameters -as predictors-and change in 2D-SWE.Results: AST/ALT (AAR) was the most sensitive (79%) pre-operative non-invasive serological marker for detecting liver fibrosis, whereas NAFLD Fibrosis Score (NFS) was the most specific (84%). AST/upper limit of the normal AST range × 100 / Platelets (×10 9 /L) (APRI) showed a positive correlation with 2D-SWE post metabolic surgery (P-value=0.021).Regression analysis from both adjusted and unadjusted models showed that baseline AAR was a predictor of postoperative liver status in terms of hepatic fibrosis. Conclusion:AAR has a high sensitivity, whereas NFS exhibits a high specificity in diagnosing liver fibrosis. The authors recommend using both investigations in conjunction with 2D-SWE to increase the likelihood of detecting liver fibrosis.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Value of Non-invasive Liver Function Tests in Liver Fibrosis and Changes in These Parameters Post-metabolic Surgery

et al. 2022

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“…Improvement in the atherogenic profile of LDL particles has been shown to be independent of weight loss but related to reduction in triglyceride concentration [123]. Biomarkers of oxidised lipoprotein subfractions [124 & ] and PCSK9 concentration [125] have also been reported to improve after bariatric surgery (Table 1). In particular, we have shown a significant decrease in OxPL-ApoB levels after bariatric surgery, in keeping with an overall reduction in oxidative stress, which is further supported by a significant decrease in all indirect biomarkers of Ox-LDL [124 & ].…”

Section: Lipoproteinsmentioning

confidence: 99%

Established and potential cardiovascular risk factors in metabolic syndrome: Effect of bariatric surgery

Bashir,

Adam,

et al. 2023

Current Opinion in Lipidology

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Purpose of review The aim of this study was to provide an overview of the role of novel biomarkers in metabolic syndrome, their association with cardiovascular risk and the impact of bariatric surgery on these biomarkers. Recent findings Metabolic syndrome encompasses an intricate network of health problems, and its constituents extend beyond the components of its operational definition. Obesity-related dyslipidaemia not only leads to quantitative changes in lipoprotein concentration but also alteration in qualitative composition of various lipoprotein subfractions, including HDL particles, rendering them proatherogenic. This is compounded by the concurrent existence of obstructive sleep apnoea (OSA) and nonalcoholic fatty liver disease (NAFLD), which pave the common pathway to inflammation and oxidative stress culminating in heightened atherosclerotic cardiovascular disease (ASCVD) risk. Bariatric surgery is an exceptional modality to reverse both conventional and less recognised aspects of metabolic syndrome. It reduces the burden of atherosclerosis by ameliorating the impact of obesity and its related complications (OSA, NAFLD) on quantitative and qualitative composition of lipoproteins, ultimately improving endothelial function and cardiovascular morbidity and mortality. Summary Several novel biomarkers, which are not traditionally considered as components of metabolic syndrome play a crucial role in determining ASCVD risk in metabolic syndrome. Due to their independent association with ASCVD, it is imperative that these are addressed. Bariatric surgery is a widely recognized intervention to improve the conventional risk factors associated with metabolic syndrome; however, it also serves as an effective treatment to optimize novel biomarkers.

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“…Bariatric surgery is a surgical treatment primarily for obese patients, which improves metabolic and inflammatory processes as well as cardiometabolic risk factors beyond weight loss [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. The types of bariatric surgery are sleeve gastrectomy (SG), laparoscopic adjustable gastric band (LAGB), Roux-en-Y gastric bypass (RYGP), biliopancreatic diversion/duodenal switch (BPD/DS), and one anastomosis gastric bypass/mini gastric bypass (OAGB/MGB) [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Bariatric Surgery on Circulating Levels of Monocyte Chemoattractant Protein-1: A Systematic Review and Meta-Analysis

Jamialahmadi

Abbasifard

Reiner

et al. 2022

JCM

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Background: MCP-1 (monocyte chemoattractant protein) plays an important role in early phases of atherogenesis as well as in plaque destabilization, which causes cardiovascular events to play an important role in low-grade inflammation. Obesity, particularly extreme obesity, is a pivotal risk factor for atherosclerosis and many other diseases. In the early stages, bariatric surgery might stop or slow atherogenesis by suppressing inflammation, but also in later stages, preventing plaque destabilization. The aim of this meta-analysis was to provide an answer as to whether bariatric surgery has a significant effect on circulating MCP-1 level or not. Methods: A systematic literature search in PubMed, Scopus, Embase, and Web of Science was performed from inception to 1 January 2022. Meta-analysis was performed using Comprehensive Meta-Analysis (CMA) V2 software. In order to heterogeneity compensation of studies in terms of study design and treatment duration, the characteristics of the studied populations random-effects model and the generic inverse variance weighting method were used. To investigate the relationship with the estimated effect size, a random-effect meta-regression model was used. To assess the exitance of publication bias in the meta-analysis, the funnel plot, Begg’s rank correlation, and Egger’s weighted regression tests were used. Results: Meta-analysis of 25 studies with 927 subjects included demonstrated a significant decrease of MCP-1 concentration after bariatric surgery. The data of meta-regression did not indicate any association between the alterations in body mass index (BMI) and absolute difference in MCP-1 levels, but a linear relationship between the changes in MCP-1 and length of follow-up was proven. Conclusions: Bariatric surgery significantly decreases MCP-1 concentration, but there was no association between the changes in BMI and absolute difference in MCP-1 levels before and after the surgery.

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Impact of bariatric surgery on circulating PCSK9 levels as marker of cardiovascular disease risk: a meta-analysis

Cited by 5 publications

References 26 publications

Diagnostic Value of Non-invasive Liver Function Tests in Liver Fibrosis and Changes in These Parameters Post-metabolic Surgery

Diagnostic Value of Non-invasive Liver Function Tests in Liver Fibrosis and Changes in These Parameters Post-metabolic Surgery

Established and potential cardiovascular risk factors in metabolic syndrome: Effect of bariatric surgery

The Effect of Bariatric Surgery on Circulating Levels of Monocyte Chemoattractant Protein-1: A Systematic Review and Meta-Analysis

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