Roux-en-Y 胃旁路手术对病态肥胖患者脂蛋白代谢和高密度脂蛋白功能标志物的影响。
Effect of Roux-en-Y Gastric Bypass on Lipoprotein Metabolism and Markers of HDL Functionality in Morbid Obese Patients.
机构信息
Laboratorio de Lipidos y Aterosclerosis, Facultad de Farmacia y Bioquimica, Universidad de Buenos Aires, Av. Córdoba 2351, C1120, Buenos Aires, Argentina.
Laboratorio de Genetica, Facultad de Farmacia y Bioquimica, Universidad de Buenos Aires, Av. Córdoba 2351, C1120, Buenos Aires, Argentina.
出版信息
Obes Surg. 2021 Mar;31(3):1092-1098. doi: 10.1007/s11695-020-05076-0. Epub 2020 Oct 30.
PURPOSE
Morbid obesity represents the most severe form of obesity and surgical intervention would be its only successful treatment. Bariatric surgery could generate modifications in carbohydrate metabolism and in lipid profile plus lipoprotein-associated proteins and enzymes, such as lipoprotein-associated phoslipase A (Lp-PLA), cholesteryl ester transfer protein (CETP), and paraoxonase (PON) 1. The aim of the present study was to analyze changes in inflammation markers, carbohydrate metabolism, and lipid parameters in patients who underwent bariatric surgery.
METHODS
Thirty-seven patients with morbid obesity were recruited. Evaluations were performed before (T0) and 1 (T1) and 6 (T2) months after surgery. Glucose, insulin, high-sensitivity C-reactive protein (hsCRP), triglycerides, total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, apolipoproteins (apo) A-I, and B plus Interleukin 1β and 6 levels in addition to CETP, Lp-PLA2, and PON 1 activities were determined.
RESULTS
Body mass index decreased at T1 and T2 (p < 0.01). An improvement in all markers of insulin resistance (p < 0.05) was observed at T1. hsCRP levels diminished at T2 (p < 0.05). Triglyceride levels decreased at T1 and T2 (p < 0.05). HDL-C and apo A-I showed a decrease at T1 which was completely reversed at T2 (p < 0.05). Lp-PLA activity increased at T1, which was reversed at T2 (p < 0.05), and CETP activity was diminished at T2 (p < 0.05). PON and ARE activities decreased at T1 and partially recovered at T2 (p < 0.05).
CONCLUSIONS
These results would be indicative of a favorable effect of bariatric surgery on markers of carbohydrate metabolism and cardiovascular disease lipid risk factors.
目的
病态肥胖代表肥胖的最严重形式,手术干预是其唯一有效的治疗方法。减重手术可以改变碳水化合物代谢和脂质谱,以及脂蛋白相关蛋白和酶,如脂蛋白相关磷脂酶 A(Lp-PLA)、胆固醇酯转移蛋白(CETP)和对氧磷酶 1(PON)1。本研究旨在分析接受减重手术的患者炎症标志物、碳水化合物代谢和脂质参数的变化。
方法
招募了 37 名病态肥胖患者。在手术前(T0)、术后 1 个月(T1)和 6 个月(T2)进行评估。测定血糖、胰岛素、高敏 C 反应蛋白(hsCRP)、甘油三酯、总胆固醇、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇、载脂蛋白(apo)A-I 和 B 以及白细胞介素 1β和 6 水平,以及 CETP、Lp-PLA2 和 PON 1 活性。
结果
T1 和 T2 时体重指数下降(p<0.01)。T1 时所有胰岛素抵抗标志物均改善(p<0.05)。hsCRP 水平在 T2 时下降(p<0.05)。T1 和 T2 时甘油三酯水平下降(p<0.05)。HDL-C 和 apo A-I 在 T1 时下降,在 T2 时完全逆转(p<0.05)。Lp-PLA 活性在 T1 时增加,在 T2 时逆转(p<0.05),CETP 活性在 T2 时降低(p<0.05)。PON 和 ARE 活性在 T1 时下降,在 T2 时部分恢复(p<0.05)。
结论
这些结果表明,减重手术对碳水化合物代谢和心血管疾病脂质危险因素的标志物有有利影响。