Key result
Bariatric surgery normalizes the atherogenic ApoB/ApoA1 ratio and improves apolipoprotein profiles over 12 months.
Why the study?
A knowledge gap remained in precisely characterizing apolipoprotein profiles across metabolically distinct individuals following bariatric surgery.
Does bariatric surgery improve the apolipoprotein profile in morbidly obese postmenopausal women?
Cohort (n=72)
No
Does bariatric surgery improve the apolipoprotein profile in morbidly obese postmenopausal women?
Bariatric surgery normalizes the atherogenic ApoB/ApoA1 ratio and favorably alters the apolipoprotein profile in morbidly obese postmenopausal women, suggesting improved cardiovascular fitness.
Bariatric surgery-associated apolipoprotein shifts should not yet change practice; hypothesis-generating and requires randomized trials for CV outcomes.
Background: Lipoproteins are molecules composed of phospholipids and apolipoproteins that transport triacylglycerol and cholesterol in blood and are implicated in the development of many diseases. Methods: In this study, we fill a knowledge gap by precisely characterizing the apolipoprotein profile (with Bio-Plex Human Apolipoprotein Assay) in three metabolically separate groups of individuals (lean individuals and obese individuals without and with metabolic syndrome) and at four distinct time points (0, 3, 6, and 12 months post bariatric surgery). Results: Obese patients had a higher baseline ApoB/ApoA1 ratio, which returned to the reference level over the follow-up period. The above is of clinical importance, as the ratio is a predictor of adverse cardiovascular events common in obese subjects. Interestingly, plasma concentrations of most of the investigated apolipoproteins appeared to be relatively stable at the onset of the experiment, with changes observed later in time. We detected significant drops in the levels of ApoC3, ApoD, and ApoH that occurred as early as three months post intervention. On the other hand, the levels of ApoA2, ApoE, and ApoJ increased with time. Of the above, ApoE is known to be involved in the removal of TAGs and cholesterol from the blood. Conversely, ApoJ appears to be one of the determinants of the tissues’ responsiveness to insulin. Thus, it may be an indicator of the reduced insulin resistance observed a few months after the surgery. Conclusions: Overall, the investigated proteins have a documented role in the development and progression of vascular pathologies. Hence, our results may be interpreted as a sign of improved cardiovascular fitness of our patients.
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Łukaszuk et al. (2026) conducted a cohort in Morbid obesity (n=72). Bariatric surgery (laparoscopic sleeve gastrectomy) vs. Lean healthy women and baseline values was evaluated on Changes in apolipoprotein concentrations (including ApoB/ApoA1 ratio) (p=<0.05). Bariatric surgery in morbidly obese women normalized the atherogenic ApoB/ApoA1 ratio and significantly reduced ApoC3, ApoD, and ApoH levels over 12 months, indicating improved cardiovascular fitness.
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