Effect of sleeve gastrectomy on postprandial lipoprotein metabolism in morbidly obese patients

Lipids in Health and Disease

Klaus G Parhofer³  Reinhold Lang¹  Burkhard Göke³  Thomas P Hüttl²  Elisa Waldmann³ 

[1] Current address: Department of Surgery, Kreisklinik Ottobeuren, Germany;Surgical Clinic, Bogenhausen, Munich, Germany;Medical Department II - Grosshadern, Ludwig-Maximilians University Munich, Munich, Germany

关键词: VLDL-triglycerides;    Dyslipidemia;    Chylomicron remnant;    Chylomicron;    Postprandial lipids;   

Others  :  834600
DOI  :  10.1186/1476-511X-12-82

 received in 2013-01-23, accepted in 2013-05-15,  发布年份 2013

【 摘 要 】

Background

Obesity is associated with abnormal fasting and postprandial lipids, which may link obesity with atherosclerosis. We explored fasting and postprandial lipids in morbidly obese patients treated with sleeve gastrectomy and in control subjects.

Methods

After fasting for 12 h 15 morbidly obese patients (BMI 51.4±6.5 kg/m², 43.7±12.6 years) received a standardized oral fat load before and 3 months after bariatric surgery (sleeve gastrectomy). Controls (n=9, BMI 23.1±1.4 kg/m²) were studied once. Plasma was obtained fasting and then postprandially every 2 h for 8 h. Triglycerides (TG), chylomicron-TG (CM-TG), VLDL/chylomicron-remnant (VLDL/CR)-TG, cholesterol, LDL-cholesterol, VLDL/CR-cholesterol and HDL-cholesterol were isolated by ultracentrifugation at each time point. Postprandial values were expressed as area under the curve (AUC) and incremental area under the curve (iAUC). In addition, fasting glucose and insulin values and HOMA-IR-Index was measured (n=14).

Results

Compared to controls morbidly obese patients had elevated TG and slightly altered postprandial lipids. Following surgery (weight loss 23.4 kg±6.2 kg; p<0.001) fasting TG (−19.1%; p=0.04), VLDL/CR-TG (−20.0%; p=0.05) decreased significantly, while fasting cholesterol, VLDL-, HDL- and LDL-cholesterol did not change. AUC and iAUC decreased significantly for VLDL/CR-TG (−20.4%, p=0.04 and −38.5%, p=0.04, respectively). Neither fasting nor postprandial changes correlated with the change in weight. In patients with preoperatively elevated TG (>150 mg/dl) a similar pattern was observed. Fasting insulin and HOMA were reduced significantly (−51.9%; p=0.004 and −47.9%; p=0.011).

Conclusions

Three months after sleeve gastrectomy fasting and postprandial lipoprotein metabolism and glucose metabolism is improved in morbidly obese patients. The potential mechanisms may relate to decreased caloric intake but also to hormonal changes.

【 授权许可】

   
2013 Waldmann et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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