Esophagogastric and Bariatric Surgery Unit, General and Digestive System Surgery Department, Royo Villanova University Hospital, Av. de San Gregorio, S/N, 50015, Zaragoza, Spain.
Healthcare Quality Unit, 12 de Octubre University Hospital, Av. de Córdoba, S/N, 28041, Madrid, Spain.
Obes Surg. 2023 Dec;33(12):3981-3987. doi: 10.1007/s11695-023-06904-9. Epub 2023 Oct 28.
Obesity is related to cardiovascular risk factors (CVRF) such as dyslipidemia, diabetes, and hypertension, which increase mortality. Basic lipid determinations could underestimate the true atherogenic risk of patients and the impact of bariatric surgery. The objective of the study is to demonstrate the change in the advanced molecular profile of lipoproteins determined by nuclear magnetic resonance spectroscopy in plasma after bariatric surgery, thus reducing the risk of cardiovascular disease.
Descriptive, observational, and prospective study in obese patients undergoing bariatric surgery. Advanced lipid profile was analyzed in plasma from the immediate preoperative period and at the 18th postoperative month by sending samples and performing plasma magnetic resonance spectroscopy in the BiosferTreslab® laboratory.
Fifty-two patients were included. Average age of 46.3 years; 63.46% were women, 36.54% men. The average BMI was 43.57; the abdominal perimeter 133.50 cm; 32.6% were diabetics under medical treatment, 44.23% hypertensive, and 19.23% smokers; 86.53% of the patients presented alterations in at least one of the analytical parameters in the lipid study. Twenty-nine (55.7%) underwent banded gastric bypass (PGB), 19.23% underwent GBP, and 17.31% vertical gastrectomy. The rest were revision surgeries, two BPG-A and two biliopancreatic diversions after GV. All patients presented some improvement in advanced molecular profile of lipoproteins. Twenty percent of the patients normalized all the parameters.
Bariatric surgery improves advanced molecular profile of lipoproteins, decreasing CVRF. Analysis of the characteristics of lipoprotein particles by NMR spectrometry is optimal for studying lipoprotein metabolism in patients undergoing bariatric surgery.
肥胖与心血管风险因素（CVRF）相关，如血脂异常、糖尿病和高血压，这些因素会增加死亡率。基本的血脂测定可能会低估患者的真实动脉粥样硬化风险和减重手术的影响。本研究的目的是展示通过磁共振光谱仪在血浆中测定脂蛋白的先进分子谱在减重手术后的变化，从而降低心血管疾病的风险。
对接受减重手术的肥胖患者进行描述性、观察性和前瞻性研究。通过发送样本并在 BiosferTreslab®实验室进行血浆磁共振光谱分析，在手术前即刻和术后第 18 个月分析血浆中的先进脂质谱。
共纳入 52 例患者。平均年龄为 46.3 岁；63.46%为女性，36.54%为男性。平均 BMI 为 43.57；腰围 133.50cm；32.6%为正在接受药物治疗的糖尿病患者，44.23%为高血压患者，19.23%为吸烟者；86.53%的患者在脂质研究的至少一个分析参数中存在异常。29 例（55.7%）接受了带式胃旁路手术（PGB），19.23%接受了胃旁路手术（GBP），17.31%接受了垂直胃切除术。其余的是修正手术，2 例 PGB-A 和 2 例 GV 后的胰胆分流术。所有患者的脂蛋白先进分子谱均有所改善。20%的患者所有参数均恢复正常。
减重手术可改善脂蛋白的先进分子谱，降低 CVRF。通过 NMR 光谱仪分析脂蛋白颗粒的特征，是研究减重手术后脂蛋白代谢的最佳方法。
