Gonen B, Halverson J D, Schonfeld G
Metabolism. 1983 May;32(5):492-6. doi: 10.1016/0026-0495(83)90012-4.
Abnormalities in lipoprotein metabolism are among the risk factors for atherosclerotic cardiovascular disease frequently present in patients with morbid obesity. We have examined the effects of dietary restriction induced by gastric bypass surgery on plasma lipoprotein levels in 22 morbidity obese patients. Operation induced weight loss in all patients. Postoperatively (12 +/- 7 mo), triglycerides decreased from 146.4 +/- 67 (mean +/- S.D. before operation) to 104 +/- 44 mg/dl (p less than 0.01), total cholesterol decreased from 187 +/- 52 to 166 +/- 39 mg/dl (p less than 0.025), LDL cholesterol levels decreased from 119 +/- 42 to 104 +/- 36 mg/dl (p less than 0.038), and HDL cholesterol levels increased from 40.1 +/- 10.1 to 45.2 +/- 9.5 mg/dl (p less than 0.012). HDL cholesterol to LDL cholesterol ratio increased from 0.37 +/- 0.13 to 0.48 +/- 0.21 (p less than 0.01). The results of apo A-1, A-2 and B determinations (n = 12) paralleled the changes in lipoprotein levels. Apo A1/Apo A2 ratio increased suggesting an increase in the concentration of HDL2. We conclude that weight loss following gastric bypass surgery is associated with favorable changes in lipoprotein metabolism which may help prevent or delay the development of atherosclerotic cardiovascular disease. The mechanism responsible for the lipoprotein changes remains to be determined.
脂蛋白代谢异常是病态肥胖患者中常见的动脉粥样硬化性心血管疾病的危险因素之一。我们研究了胃旁路手术引起的饮食限制对22例病态肥胖患者血浆脂蛋白水平的影响。手术使所有患者体重减轻。术后（12±7个月），甘油三酯从术前的146.4±67（平均值±标准差）降至104±44mg/dl（p<0.01），总胆固醇从187±52降至166±39mg/dl（p<0.025），低密度脂蛋白胆固醇水平从119±42降至104±36mg/dl（p<0.038），高密度脂蛋白胆固醇水平从40.1±10.1升至45.2±9.5mg/dl（p<0.012）。高密度脂蛋白胆固醇与低密度脂蛋白胆固醇的比值从0.37±0.13升至0.48±0.21（p<0.01）。载脂蛋白A-1、A-2和B的测定结果（n = 12）与脂蛋白水平的变化一致。载脂蛋白A1/载脂蛋白A2比值升高，提示HDL2浓度增加。我们得出结论，胃旁路手术后体重减轻与脂蛋白代谢的有利变化有关，这可能有助于预防或延缓动脉粥样硬化性心血管疾病的发展。脂蛋白变化的机制尚待确定。
