Bariatric surgery improves postprandial VLDL kinetics and restores insulin-mediated regulation of hepatic VLDL production

Figures

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  Figure 1. Plasma apoB and TG concentration time courses. (A–F) Presurgery (red) and postsurgery (blue) plasma VLDL1 and VLDL2 apoB (A and B), TG (C and D), plasma CM TG (E), and plasma TG (F) concentrations measured during the lipoprotein kinetics studies. Filled circles and error bars show data as mean ± SD. Solid curves show model simulations generated with model parameters estimated from average data (Supplemental Table 2). Dotted vertical lines mark mixed-meal ingestion time points. The box plots show the presurgery (red) and postsurgery (blue) AUCs calculated for the postprandial state (2–10 hours). Statistical significance was tested with a paired-sample t test. ****P < 0.0005.

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  Figure 2. Leucine and glycerol enrichment time-courses. Presurgery (red) and postsurgery (blue) population averages for enrichment data (filled circles with error bars) and the model simulations (solid lines). (A and B) VLDL1 and VLDL2 apoB [5,5,5-2H3]-leucine (Leu.) enrichments (Enr.). (C and D) VLDL1 and VLDL2 TG [1,1,2,3,3-2H5]-glycerol (Gly.) enrichments. (E) Plasma [5,5,5-2H3]-leucine enrichment. (F) Plasma [1,1,2,3,3-2H5]-glycerol enrichment. Data are presented as mean ± SD.

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  Figure 3. Relationship between pre- and postsurgery VLDL1 apoB and TG production rates and HOMA-IR. (A and B) The regression lines for pre- and postsurgery data and combined data are shown in red, blue, and black, respectively. Correlation coefficients (r) and associated P values are reported in each panel.

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  Figure 4. Relationship between lipoprotein lipolysis ISI and tissue specific insulin responsiveness indices. (A) Pre- and postsurgery lipoprotein lipolysis ISI. (B) Postsurgery insulin-mediated peripheral lipolysis suppression per insulin increased over basal level (Δ[%]insulin) from the clamp studies vs lipoprotein lipolysis ISI. (C) Postsurgery insulin-mediated EGP suppression per Δ(%)insulin versus lipoprotein lipolysis ISI. (D) Postsurgery insulin-mediated Rd stimulation per Δ(%)insulin versus lipolysis ISI. In each panel, the regression lines for the postsurgery data are shown in blue. Correlation coefficients (r) and associated P values are reported in each panel.