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代谢与减重手术对高体重指数个体载脂蛋白B100水平的影响:一项多中心前瞻性队列研究。

The Impact of Metabolic and Bariatric Surgery on Apo B100 Levels in Individuals with high BMI: A Multi-Centric Prospective Cohort Study.

作者信息

Jaliliyan Ali, Madankan Ahmad, Mosavari Hesam, Khalili Pantea, Pouraskari Bahador, Lotfi Saeed, Honarfar Andia, Fakhri Elham, Eghbali Foolad

机构信息

Department of Surgery, Surgery Research Center, School of Medicine, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

Department of Internal Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Obes Surg. 2024 Jul;34(7):2454-2466. doi: 10.1007/s11695-024-07258-6. Epub 2024 May 15.

Abstract

BACKGROUND

Metabolic and Bariatric surgery (MBS) leads to significant weight loss and improvements in obesity-related comorbidities. However, the impact of MBS on Apolipoprotein B100 (Apo-B100) regulation is unclear. Apo-B100 is essential for the assembly and secretion of serum lipoprotein particles. Elevated levels of these factors can accelerate the development of atherosclerotic plaques in blood vessels. This study aimed to evaluate changes in Apo-B100 levels following MBS.

METHODS

121 participants from the Iranian National Obesity and Metabolic Surgery Database (INOSD) underwent Laparoscopic Sleeve Gastrectomy (LSG) (n = 43), One-Anastomosis Gastric Bypass (OAGB) (n = 70) or Roux-en-Y Gastric Bypass (RYGB) (n = 8). Serum Apo-B100, lipid profiles, liver enzymes, and fasting glucose were measured preoperatively and six months postoperatively.

RESULTS

Apo-B100 levels significantly decreased from 94.63 ± 14.35 mg/dL preoperatively to 62.97 ± 19.97 mg/dL after six months (p < 0.01), alongside reductions in total cholesterol, triglycerides, LDL, VLDL, AST, and ALT (p < 0.05). Greater Apo-B100 reductions occurred in non-diabetics versus people with diabetes (p = 0.012) and strongly correlated with baseline Apo-B100 (r = 0.455, p < 0.01) and LDL levels (r = 0.413, p < 0.01). However, surgery type did not impact Apo-B100 changes in multivariate analysis (p > 0.05).

CONCLUSION

Bariatric surgery leads to a significant reduction in Apo-B100 levels and improvements in lipid profiles and liver enzymes, indicating a positive impact on dyslipidemia and cardiovascular risk in individuals with high BMI.

摘要

背景

代谢与减重手术(MBS)可显著减轻体重,并改善肥胖相关的合并症。然而,MBS对载脂蛋白B100(Apo-B100)调节的影响尚不清楚。Apo-B100对于血清脂蛋白颗粒的组装和分泌至关重要。这些因子水平升高会加速血管中动脉粥样硬化斑块的形成。本研究旨在评估MBS后Apo-B100水平的变化。

方法

来自伊朗国家肥胖与代谢手术数据库(INOSD)的121名参与者接受了腹腔镜袖状胃切除术(LSG)(n = 43)、单吻合口胃旁路术(OAGB)(n = 70)或 Roux-en-Y 胃旁路术(RYGB)(n = 8)。术前及术后六个月测量血清Apo-B100、血脂谱、肝酶和空腹血糖。

结果

Apo-B100水平从术前的94.63±14.35mg/dL显著降至术后六个月的62.97±19.97mg/dL(p < 0.01),同时总胆固醇、甘油三酯、低密度脂蛋白、极低密度脂蛋白、谷草转氨酶和谷丙转氨酶也有所降低(p < 0.05)。非糖尿病患者的Apo-B100降低幅度大于糖尿病患者(p = 0.012),且与基线Apo-B100(r = 0.455,p < 0.01)和低密度脂蛋白水平(r = 0.413,p < 0.01)密切相关。然而,在多变量分析中,手术类型并未影响Apo-B100的变化(p > 0.05)。

结论

减重手术可显著降低Apo-B100水平,并改善血脂谱和肝酶,表明对高BMI个体的血脂异常和心血管风险有积极影响。

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