Bariatric surgery improves HDL functionality and reduces inflammation, study suggests

Written By :  Medha Baranwal
Medically Reviewed By :  Dr. Kamal Kant Kohli
Published On 2022-09-10 05:45 GMT   |   Update On 2022-09-10 09:03 GMT
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UK: A recent study has shown the beneficial effects of Roux-en-Y gastric bypass (RYGB) on the high-density lipoprotein (HDL) functionality and the reverse cholesterol transport (RCT) among morbidly obese subjects.

The study, published in The Journal of Clinical Endocrinology & Metabolism, found that RYGB improves HDL functionality in association with a reduction in systemic and adipose tissue inflammation. 

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Emerging evidence has indicated an association between impaired HDL functionality and cardiovascular disease (CVD). HDL is crucial for reverse cholesterol transport and reduces oxidative stress and inflammation via paraoxonase-1 (PON1). RCT is dependent on the capacity of HDL to accept cholesterol (cholesterol efflux capacity [CEC]) and active transport through ATP-binding cassette (ABC) A1, G1, and scavenger receptor-B1 (SR-B1). 

Considering the above, Safwaan Adam, The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom, and colleagues investigated the impact of Roux-en-Y gastric bypass in morbidly obese subjects on RCT and HDL functionality.  

For this purpose, the researchers measured biomarkers associated with increased CVD risk including high-sensitivity C-reactive protein (hsCRP), tumor necrosis factor-α (TNF-α), PON1 activity, myeloperoxidase mass (MPO), and CEC in vitro. The measurement of these parameters was done in 44 patients before and 6 and 12 months after RYGB. 

Overweight but otherwise healthy (mean body mass index [BMI] 28 kg/m2) subjects were taken as controls. Twelve patients also underwent gluteal subcutaneous adipose tissue biopsies before and 6 months after RYGB for targeted gene expression (ABCA1, ABCG1, SR-B1, TNF-α) and histological analysis (adipocyte size, macrophage density, TNF-α immunostaining). 

Following were the study's key findings:

  • The researchers observed significant improvements in BMI, HDL-cholesterol, hsCRP, TNF-α, MPO mass, PON1 activity, and CEC in vitro after RYGB.
  • ABCG1 (fold-change, 2.24) and ABCA1 gene expression increased significantly (fold-change, 1.34).
  • Gluteal fat adipocyte size, macrophage density, and TNF-α immunostaining were reduced after RYBG and ABCG1 expression correlated inversely with TNF-α immunostaining.

The researchers conclude, "RYGB enhances HDL functionality in association with a reduction in adipose tissue and systemic inflammation."

Reference:

Safwaan Adam, Jan H Ho, Yifen Liu, Tarza Siahmansur, Kirk Siddals, Zohaib Iqbal, Shazli Azmi, Siba Senapati, John New, Maria Jeziorska, Basil J Ammori, Akheel A Syed, Rachelle Donn, Rayaz A Malik, Paul N Durrington, Handrean Soran, Bariatric Surgery-induced High-density Lipoprotein Functionality Enhancement Is Associated With Reduced Inflammation, The Journal of Clinical Endocrinology & Metabolism, Volume 107, Issue 8, August 2022, Pages 2182–2194, https://doi.org/10.1210/clinem/dgac244

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Article Source : Journal of Clinical Endocrinology & Metabolism

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