Department of Biochemistry and Molecular Biomedicine, Biology Faculty, University of Barcelona, Barcelona, Spain.
Gastrointestinal Surgery Department, Arnau de Vilanova University Hospital, IRB Lleida, University of Lleida, Lleida, Spain.
Surg Obes Relat Dis. 2020 Sep;16(9):1258-1265. doi: 10.1016/j.soard.2020.04.040. Epub 2020 May 11.
Morbid obesity is associated with accelerated atherosclerosis, a chronic vascular disease related to oxidative stress (OS) and endothelial dysfunction.
We aimed to evaluate the effect of bariatric surgery (BS) on oxidative stress as a cardiovascular risk factor in patients with and without atheromatous plaques.
Arnau de Vilanova University Hospital and University of Barcelona.
Plasma samples from 66 patients with morbid obesity were obtained before BS and 6 and 12 months after. Patients were divided into 2 groups based on the presence of atheromatous plaques (detected by ultrasonography). OS parameters were measured by enzyme-linked immunosorbent assay.
Patients with morbid obesity had OS independently of the presence of an atheroma, but oxidized low-density lipoprotein levels were higher in patients with plaques throughout the study (P = .0430). After surgery, oxidized low-density lipoprotein and malondialdehyde levels decreased significantly (P < .0001 in both cases). At the beginning of the study, antioxidant enzyme levels were the same between the groups. After surgery, paraoxonase 1 levels were increased (P < .0001) in the group without plaque, being significantly higher (P = .0147). Superoxide dismutase 2 levels were only decreased in patients without plaque (P < .0010), while catalase activity was higher in patients with plaque.
Morbid obesity may lead to chronic OS, which increases predisposition to atherogenesis. BS improves the antioxidant profile and reduces OS and co-morbidities in both groups. However, the benefits are greater for patients without plaque. Therefore, BS may prevent atheroma formation and also could prevent plaque rupture by decreasing OS.
病态肥胖与动脉粥样硬化加速有关，动脉粥样硬化是一种与氧化应激（OS）和内皮功能障碍有关的慢性血管疾病。
我们旨在评估肥胖症手术（BS）对伴有和不伴有动脉粥样斑块患者心血管风险因素氧化应激的影响。
阿瑙德维罗纳大学医院和巴塞罗那大学。
从 66 例病态肥胖患者中获取 BS 前和 BS 后 6 个月和 12 个月的血浆样本。根据是否存在动脉粥样斑块（通过超声检测）将患者分为 2 组。通过酶联免疫吸附试验测量 OS 参数。
病态肥胖患者存在 OS，与动脉粥样斑块的存在无关，但整个研究过程中斑块患者的氧化型低密度脂蛋白水平更高（P =.0430）。手术后，氧化型低密度脂蛋白和丙二醛水平显著降低（两种情况均 P <.0001）。在研究开始时，两组的抗氧化酶水平相同。手术后，无斑块组的对氧磷酶 1 水平升高（P <.0001），明显更高（P =.0147）。超氧化物歧化酶 2 水平仅在无斑块患者中降低（P <.0010），而斑块患者的过氧化氢酶活性更高。
病态肥胖可能导致慢性 OS，增加动脉粥样硬化形成的易感性。BS 改善了抗氧化谱，降低了两组的 OS 和合并症。然而，对于无斑块的患者，益处更大。因此，BS 可能预防动脉粥样斑块形成，并通过降低 OS 预防斑块破裂。
