Manzato E, Zambon S, Zambon A, Digito M, Carraro R, Crepaldi G, Enzi G
Department of Internal Medicine, University of Padua, Italy.
Int J Obes Relat Metab Disord. 1992 Aug;16(8):573-8.
Obesity is frequently associated with several alterations of plasma lipid levels and lipoprotein metabolism. To evaluate the effects of severe obesity and weight loss on plasma lipoprotein sub-class levels and composition 11 grossly obese patients were examined before and six and 12 months after gastroplasty. Plasma lipoproteins were isolated by ultracentrifugation in a zonal rotor under rate flotation conditions. Mean body weight was 121.9 kg before gastroplasty, 97.6 kg after six months, and 90.7 kg after 12 months. Total plasma cholesterol was not affected by the weight reduction. Obese patients were characterized by increased levels of IDL and small dense LDL (LDL3). LDL levels, but not LDL3, were reduced following weight reduction. Plasma apo B levels of obese patients were always higher than in controls and were not affected by the weight reduction. After 12 month's weight loss total HDL cholesterol increased without modification of HDL sub-class cholesterol distribution, which was similar to that of normal controls. Plasma apo AI in obese patients was not affected by changes in body weight, and remained below normal. The percentage protein-lipid composition of LDL2 and HDL3 in obese patients was characterized by a decreased cholesterol ester content before gastroplasty which was normalized 12 months after gastroplasty. The presence of IDL and LDL3 in increased concentrations in severely obese patients may represent a vascular risk factor since similar abnormalities were recently observed in non-obese patients affected with vascular diseases.
肥胖常常与血浆脂质水平和脂蛋白代谢的多种改变相关。为了评估重度肥胖及体重减轻对血浆脂蛋白亚类水平和组成的影响，对11例严重肥胖患者在胃成形术前以及术后6个月和12个月进行了检查。在速率浮选条件下，使用区带转子通过超速离心法分离血浆脂蛋白。胃成形术前平均体重为121.9千克，6个月后为97.6千克，12个月后为90.7千克。体重减轻并未影响总血浆胆固醇。肥胖患者的特点是中间密度脂蛋白（IDL）和小而密低密度脂蛋白（LDL3）水平升高。体重减轻后，低密度脂蛋白水平降低，但LDL3未降低。肥胖患者的血浆载脂蛋白B水平始终高于对照组，且不受体重减轻的影响。体重减轻12个月后，总高密度脂蛋白胆固醇增加，而高密度脂蛋白亚类胆固醇分布未改变，与正常对照组相似。肥胖患者的血浆载脂蛋白AI不受体重变化的影响，仍低于正常水平。肥胖患者中LDL2和HDL3的蛋白质 - 脂质组成百分比的特点是胃成形术前胆固醇酯含量降低，胃成形术后12个月恢复正常。严重肥胖患者中IDL和LDL3浓度升高可能代表一种血管危险因素，因为最近在患有血管疾病的非肥胖患者中也观察到了类似异常。
