Effects of weight loss, induced by gastric bypass surgery, on HDL remodeling in obese women

Plasma lipoproteins and glucose homeostasis were evaluated after marked weight loss before and over 12 months following Roux-en-Y gastric-bypass (RYGBP) surgery in 19 morbidly obese women. Standard lipids, remnant-lipoprotein cholesterol (RLP-C); HDL-triglyceride (TG); apolipoproteins (apo) A-I, A-II, E, and A-I-containing HDL subpopulations; lecithin-cholesterol acyltransferase (LCAT) and cholesteryl ester transfer protein (CETP) mass and activity; plasma glucose and insulin levels were measured before and at 1, 3, 6, and 12 months after GBP surgery. Baseline concentrations of TG, RLP-C, glucose, and insulin were significantly higher in obese than in normal-weight, age-matched women, whereas HDL cholesterol (HDL-C), apoA-I, apoA-II, α-1 and α-2 levels were significantly lower. Over 1 year, significant decreases of body mass index, glucose, insulin, TG, RLP-C, HDL-TG, and preβ-1 levels were observed with significant increases of HDL-C and α-1 levels (all P < 0.05). Changes of fat mass were correlated with those of LDL cholesterol (P = 0.018) and LCAT mass (P = 0.011), but not with CETP mass (P = 0.265). Changes of fasting plasma glucose concentrations were inversely correlated with those of CETP mass (P = 0.005) and α-1 level (P = 0.004). Changes of fasting plasma insulin concentrations were positively correlated with those of LCAT mass (P = 0.043) and inversely with changes of α-1 (P = 0.03) and α-2 (P = 0.05) concentrations. These results demonstrate beneficial changes in HDL remodeling following substantial weight loss induced by RYGBP surgery and that these changes are associated with improvement of glucose homeostasis in these patients. Plasma lipoproteins and glucose homeostasis were evaluated after marked weight loss before and over 12 months following Roux-en-Y gastric-bypass (RYGBP) surgery in 19 morbidly obese women. Standard lipids, remnant-lipoprotein cholesterol (RLP-C); HDL-triglyceride (TG); apolipoproteins (apo) A-I, A-II, E, and A-I-containing HDL subpopulations; lecithin-cholesterol acyltransferase (LCAT) and cholesteryl ester transfer protein (CETP) mass and activity; plasma glucose and insulin levels were measured before and at 1, 3, 6, and 12 months after GBP surgery. Baseline concentrations of TG, RLP-C, glucose, and insulin were significantly higher in obese than in normal-weight, age-matched women, whereas HDL cholesterol (HDL-C), apoA-I, apoA-II, α-1 and α-2 levels were significantly lower. Over 1 year, significant decreases of body mass index, glucose, insulin, TG, RLP-C, HDL-TG, and preβ-1 levels were observed with significant increases of HDL-C and α-1 levels (all P < 0.05). Changes of fat mass were correlated with those of LDL cholesterol (P = 0.018) and LCAT mass (P = 0.011), but not with CETP mass (P = 0.265). Changes of fasting plasma glucose concentrations were inversely correlated with those of CETP mass (P = 0.005) and α-1 level (P = 0.004). Changes of fasting plasma insulin concentrations were positively correlated with those of LCAT mass (P = 0.043) and inversely with changes of α-1 (P = 0.03) and α-2 (P = 0.05) concentrations. These results demonstrate beneficial changes in HDL remodeling following substantial weight loss induced by RYGBP surgery and that these changes are associated with improvement of glucose homeostasis in these patients. Cardiovascular disease (CVD) is the leading cause of death and disability in the United States. Obesity is associated with hypertension, diabetes, elevated triglyceride (TG) levels, and decreased HDL-cholesterol (HDL-C) levels, all acknowledged as independent CVD risk factors by the AHA (1.Poirier P. Giles T.D. Bray G.A. Hong Y. Stern J.S. Pi-Sunyer F.X. Eckel R.H. 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Plasma concentrations of HDL and were and RYGBP subjects at the significantly plasma level in RYGBP and not after of morbidly obese before and 12 months after gastric bypass surgery and of age-matched control = = mass in mass in in insulin in in in in mass in in in mass in in HDL in are as P as significantly indicate significant from to for by for TG, by in in in a are as P as significantly indicate significant from to for by for TG, by The of changes of the measured parameters from over 1, 3, 6, and 12 are in and M.M. Austrheim-Smith I.T. Stanhope K.L. Van Loan M.D. Ali M.R. Wolfe B.M. Havel P.J. Circulating concentrations of high-molecular-weight adiponectin are increased following Roux-en-Y gastric bypass surgery.Diabetologia. 2006; 49: 2552-2558Crossref PubMed Scopus (70) Google Scholar, M.M. Stanhope K.L. Austrheim-Smith I.T. Van Loan M.D. Ali M.R. Wolfe B.M. 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Plasma glucose decreased significantly at months and and decreased at 1 after surgery and decreased over the 12 LDL-C and TG and and and levels also improvement the decreased by at 1 and decreased by over 12 months after surgery. changes of HDL-C a a significant from at 1 by increases at significantly elevated levels with at 12 and levels decreased to levels at months and at that The level significantly decreased at months and significantly than for the CETP mass decreased at 1 increased with a level at 12 the CETP decreased after the surgery changes from and LCAT mass and decreased significantly at 1 and at that of all HDL were at 1 with the reduction in total plasma level at that 12 HDL concentrations not The changes of and from to were not whereas the changes of α-1 and α-2 from were significant at and increased by and at 12 1 changes in the HDL profile of a at and at 12 the α-1 level of obese subjects of an fat mass loss, the α-1 concentration increased to which than but the were significantly changes of of 19 severely obese following gastric bypass surgery with were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of were from of HDL were from of were from of were from of 30 were from of indicate significant 1 P < were from of in a indicate significant 1 P < changes from to 12 months for and glucose homeostasis on are in were significant changes of BMI and LDL-C = P = changes of fat mass and LDL-C = P = and changes of fat mass and LCAT mass = P = Changes of plasma insulin level were positively correlated with changes of LCAT mass = P = 0.043) and inversely with changes of α-1 = P = and α-2 = P = HDL Changes of plasma glucose concentration were inversely correlated with changes of CETP mass = P = 0.005) and α-1 HDL levels = P = 0.004). Changes of insulin resistance were inversely correlated with changes of CETP mass = P = and α-1 HDL levels = P = 0.018) and positively with changes of LCAT mass = P = The changes in TG were positively associated with = P = = P = and LCAT mass = P = and inversely with α-2 HDL = P = changes from to 12 months of lipoprotein parameters with fat TG, fasting glucose and insulin, and in significant with a < in a in significant with a < changes in were associated positively with changes in = P = 0.043) and to inversely associated with changes in HDL-C = Changes in a significant with changes in total TG = P = and with changes in HDL-C = = = and insulin = Changes in a to associated positively with changes in the levels of HDL = and inversely with changes in the α-1 HDL = for these are not The of and HDL also by and The of in obese subjects at to those in and not in the 12 not the other morbidly obese RYGBP patients more HDL at than and the of not plasma concentrations decreased significantly at 12 months have that obesity is an independent CVD risk M.J. 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Havel P.J. changes in and following Roux-en-Y gastric bypass surgery.Diabetologia. 2008; PubMed Scopus Google Scholar). observed significant decreases in plasma TG and HDL-TG, RLP-C, and significant increases in HDL-C levels, which resulted in marked improvement of the HDL profile in the α-1 The changes in HDL profile in a substantial improvement in HDL remodeling and in HDL HDL are in of cholesterol a metabolic in the of cholesterol from in the and to the HDL of apoA-II, and with cholesterol 1 to and from preβ-1 HDL and and lipid through the of LCAT and lipoprotein B.F. Schaefer E.J. Horvath K.V. S. M. G. L. of LCAT in HDL of LCAT Lipid Res. 2007; Full Text Full Text PDF PubMed Scopus Google Scholar). The HDL α-1 and cholesterol to the the type with the of CETP and LDL B.F. M. Dallal G.E. Horvath K.V. 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Schaefer E.J. of the of of on the of J. 2007; Full Text Full Text PDF PubMed Scopus Google Scholar). substantial weight loss by decreases of plasma TG and of the and levels and by increases of with the improvement of glucose these are of the cardiovascular in these patients. body mass index cholesteryl ester cholesteryl ester transfer protein cardiovascular disease cholesterol HDL cholesterol assessment of insulin resistance lecithin-cholesterol acyltransferase LDL cholesterol remnant-lipoprotein cholesterol Roux-en-Y gastric bypass triglyceride total cholesterol