Department of Medicine, Manchester University NHS Foundation Trust, Manchester, UK; Lipid Research Group, Division of Medical Sciences, The University of Manchester, Manchester, UK.
Lipid Research Group, Division of Medical Sciences, The University of Manchester, Manchester, UK.
J Clin Lipidol. 2021 Mar-Apr;15(2):320-331. doi: 10.1016/j.jacl.2020.12.002. Epub 2020 Dec 11.
Obesity is associated with adverse cardiovascular outcomes and this is improved following bariatric surgery. Oxidised phospholipids (OxPL) are thought to reflect the pro-inflammatory effects of lipoprotein(a) [Lp(a)], and both are independent predictors of cardiovascular disease.
Our study sought to determine the impact of bariatric surgery on OxPL, biomarkers of oxidised LDL (OxLDL) and Lp(a).
This is a prospective, observational study of 59 patients with severe obesity undergoing bariatric surgery. Blood samples were obtained prior to surgery and at 6 and 12 months after. Sixteen patients attending the tertiary medical weight management clinic at the same centre were also recruited for comparison. Lipid and metabolic blood parameters, OxLDL, OxPL on apolipoprotein B-100 (OxPL-apoB), IgG and IgM autoantibodies to MDA-LDL, IgG and IgM apoB-immune complexes and Lp(a) were measured.
Reduction in body mass index (BMI) was significant following bariatric surgery, from median 48 kg/m at baseline to 37 kg/m at 6 months and 33 kg/m at 12 months. OxPL-apoB levels decreased significantly at 12 months following surgery [5.0 (3.2-7.4) to 3.8 (3.0-5.5) nM, p = 0.001], while contrastingly, Lp(a) increased significantly [10.2 (3.8-31.9) to 16.9 (4.9-38.6) mg/dl, p = 0.002]. There were significant post-surgical decreases in IgG and IgM biomarkers, particularly at 12 months, while OxLDL remained unchanged.
Bariatric surgery results in a significant increase in Lp(a) but reductions in OxPL-apoB and other biomarkers of oxidised lipoproteins, suggesting increased synthetic capacity and reduced oxidative stress. These biomarkers might be clinically useful to monitor physiological effects of weight loss interventions.
肥胖与不良心血管结局相关，而减重手术后这种情况会得到改善。氧化型磷脂（OxPL）被认为反映了脂蛋白（a）[Lp(a)]的促炎作用，且两者都是心血管疾病的独立预测因子。
本研究旨在确定减重手术对 OxPL、氧化型 LDL（OxLDL）和 Lp(a)生物标志物的影响。
这是一项对 59 例接受减重手术的严重肥胖患者进行的前瞻性、观察性研究。在手术前和手术后 6 个月和 12 个月采集血样。还招募了同一中心的三级医学体重管理诊所的 16 例患者进行比较。测量了血脂和代谢血液参数、OxLDL、载脂蛋白 B-100 上的 OxPL（OxPL-apoB）、MDA-LDL 的 IgG 和 IgM 自身抗体、IgG 和 IgM apoB-免疫复合物和 Lp(a)。
减重手术后体重指数（BMI）显著下降，从基线时的中位数 48 kg/m2降至 6 个月时的 37 kg/m2和 12 个月时的 33 kg/m2。手术后 12 个月时 OxPL-apoB 水平显著下降[5.0（3.2-7.4）至 3.8（3.0-5.5）nM，p=0.001]，而相反，Lp(a)显著升高[10.2（3.8-31.9）至 16.9（4.9-38.6）mg/dl，p=0.002]。手术后 IgG 和 IgM 生物标志物显著下降，特别是在 12 个月时，而 OxLDL 保持不变。
减重手术导致 Lp(a)显著增加，但 OxPL-apoB 和其他氧化脂蛋白生物标志物减少，提示合成能力增加和氧化应激减少。这些生物标志物可能对监测体重减轻干预的生理效应具有临床意义。
