Laparoscopic Sleeve Gastrectomy Significantly Increases Serum Lipoprotein Lipase Level in Obese Patients

Abstract

Objectives: Obesity is one of the causes of metabolic disorders. Laparoscopic sleeve gastrectomy (LSG) confers beneficial effects not only on body weight (BW) but also on metabolic disorders. The lipoprotein lipase (LPL) level in preheparin serum is associated with visceral adipose tissue and reflects insulin resistance. However, the change in serum preheparin LPL levels after LSG remains unclear. This study aimed to examine the effect of LSG on preheparin LPL level in obese patients compared with nonsurgical treatment. Methods: We retrospectively reviewed a total of 100 obese patients who were treated for obesity and had preheparin LPL levels measured before and 12 months after LSG or after 12 months of nonsurgical treatment. Fifty-six patients received LSG (LSG group), and 44 patients had no surgical treatment (nonsurgical group). We compared clinical parameters such as body mass index (BMI), hemoglobin A_1c (HbA_1c), and preheparin LPL level before and 12 months after treatment. Results: BMI and HbA_1c decreased significantly in both groups, but decreases in both parameters were greater in the LSG group than in the nonsurgical group. Estimated glomerular filtration was significantly improved only in the LSG group. Preheparin LPL level increased significantly only in the LSG group (from 45.8 ± 21.6 to 75.0 ± 34.9 ng/mL, p < 0.001). Multiple regression identified LSG and decreased BMI as independent predictors of preheparin LPL level increase. Conclusions: These results suggest that LSG independently increases pre­heparin LPL level beyond BW reduction in obese patients.

The Changes in Body Composition in Obese Patients with Polycystic Ovary Syndrome after Laparoscopic Sleeve Gastrectomy:a 12-Month Follow-up

“…Moreover, loss of VAT post-surgery was associated with the changes in fasting glucose and HOMA-IR levels at 3 months post-surgery in the PCOS group and with the changes in TC at 12 months postsurgery in the control group. This finding was generally consistent with those from previous studies reporting that decreased VAT may contribute to the improvement of IR and lipid metabolism [18,33]. Further analyses were performed to explore the factors that may predict changes in body fat distribution in PCOS patients after LSG.…”

Postoperative First-Month Biochemical Parameters in Patients Undergoing Laparoscopic Sleeve Gastrectomy

“…In a study, where biochemical analysis of obese patients undergoing SG and non-surgical medical treatments was performed, pre-and post-operative biochemical analysis results of patients were compared and BMI, AST, ALT, triglyceride, and HgA1c levels were found to be statistically significantly lower in SG group than the group receiving non-surgical treatment, however, HDL levels of SG group was found to be significantly higher. [19] In the literature, it has been suggested that deficiency in thyroid hormone secretion would lead to weight gain. Indeed, some weight gain has been observed in hypothyroid cases, however, less than 10% of individuals with obesity have hypothyroidism.…”

Decreased Triglyceride and Increased Serum Lipoprotein Lipase Levels Are Correlated to Increased High-Density Lipoprotein-Cholesterol Levels after Laparoscopic Sleeve Gastrectomy

“…Furthermore, a previous study has observed a relationship between pre-heparin LPL levels with serum TG and HDL-C levels [19]. An increase in pre-heparin LPL levels has been observed in obese patients who undergo LSG [10]. Therefore, one possible mechanism for the increase in HDL-C levels after LSG is the increase in LPL production.…”

“…Previous studies have shown the beneficial effect of bariatric surgery in increasing HDL-C levels in addition to improving weight reduction, type 2 diabetes mellitus, abnormal kidney function, hypertension, and dyslipidemia [6][7][8][9]. Additionally, laparoscopic sleeve gastrectomy (LSG), a surgical procedure of bariatric surgery, increases HDL-C levels more than nonsurgical management [10,11]. However, the mechanisms by which bariatric surgery increases serum HDL-C levels remain unelucidated.…”