Coimbra Susana, Reis Flávio, Ferreira Cátia, Nunes Sara, Viana Sofia, Catarino Alice, Rocha-Pereira Petronila, Belo Luís, Monteiro Luís, Catarino Cristina, Santos-Silva Alice
UCIBIO\REQUIMTE, Porto; CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, Gandra-Paredes, Portugal.
iCBR, Instituto de Investigação Clínica e Biomédica de Coimbra, Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal.
Clin Biochem. 2019 Jan;63:46-53. doi: 10.1016/j.clinbiochem.2018.10.007. Epub 2018 Oct 17.
OBJECTIVES: Weight loss achieved by laparoscopic adjustable gastric banding (LAGB) induces an increase in high-density lipoprotein cholesterol (HDLc) but a small effect on low-density lipoprotein (LDL), although changes in their quality (size and composition) are uncertain. Our aim was to study the impact of weight loss, achieved 13-months after LAGB, on inflammation and dyslipidemia, focusing on HDL and LDL subfractions, and oxidized LDL (oxLDL). DESIGN & METHODS: We evaluated standard lipid profile, HDL and LDL subfractions, oxLDL, interleukin (IL)-6 and C-reactive protein (CRP), in twenty obese patients, before (T0) and 13-months after LAGB (T1), and in seventeen healthy controls. RESULTS: At T1, patients showed lower body weight (12% median weight loss) and anthropometric indices; reduction in TG, atherogenic indices, oxLDL, oxLDL/LDL ratio, CRP and IL-6, and enhancement in HDLc; an increase in large HDL and intermediate HDL subfractions, and a decrease in small HDL subfraction; LDL subfractions were not modified. Percentual change (%Δ) of oxLDL, from T0 to T1, correlated significantly and positively with %Δ of small HDL subfraction and with %Δ of body mass index. CONCLUSIONS: Weight loss induced atheroprotective changes on inflammation, and lipid profile, enhancing larger HDL, the more atheroprotective subfraction, reducing the less protective subclass, small HDL, and reducing oxLDL and oxLDL/LDL ratio. Quality of lipoproteins appears useful cardiovascular risk biomarkers, deserving further studies.
目的:腹腔镜可调节胃束带术(LAGB)实现的体重减轻会导致高密度脂蛋白胆固醇(HDLc)升高,但对低密度脂蛋白(LDL)的影响较小,尽管其质量(大小和组成)的变化尚不确定。我们的目的是研究LAGB术后13个月实现的体重减轻对炎症和血脂异常的影响,重点关注HDL和LDL亚组分以及氧化LDL(oxLDL)。 设计与方法:我们评估了20名肥胖患者在LAGB术前(T0)和术后13个月(T1)以及17名健康对照者的标准血脂谱、HDL和LDL亚组分、oxLDL、白细胞介素(IL)-6和C反应蛋白(CRP)。 结果:在T1时,患者体重降低(体重中位数减轻12%),人体测量指标改善;甘油三酯、致动脉粥样硬化指数、oxLDL、oxLDL/LDL比值、CRP和IL-6降低,HDLc升高;大HDL和中间HDL亚组分增加,小HDL亚组分减少;LDL亚组分未改变。从T0到T1,oxLDL的百分比变化(%Δ)与小HDL亚组分的%Δ以及体重指数的%Δ显著正相关。 结论:体重减轻对炎症和血脂谱产生了抗动脉粥样硬化的变化,增加了更具抗动脉粥样硬化作用的大HDL亚组分,减少了保护性较差的小HDL亚类,降低了oxLDL和oxLDL/LDL比值。脂蛋白质量似乎是有用的心血管风险生物标志物,值得进一步研究。
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