Effect of bariatric surgery on HDL-mediated cholesterol efflux capacity.

Bariatric surgery (BS) is the most effective intervention for severe obesity, leading to sustained weight loss, reduced obesity-related comorbidities, and cardiovascular mortality. To assess changes in high-density lipoprotein (HDL) functions [cholesterol efflux capacity (CEC) and anti-inflammatory capacity] at different follow-up times in patients with severe obesity undergoing BS. A prospective observational study within a cohort of consecutively enrolled patients with severe obesity scheduled to undergo BS. In total, 62 participants (77% women), with a mean age of 42.1 years (SD 9.33 years) underwent BS. Regarding the surgical procedure, 27 (43.5%) underwent sleeve gastrectomy and 35 (56.5%) Roux-en-Y gastric bypass. All patients were evaluated preoperatively and at 1, 3, 6, and 12 months after surgery. A decrease in body mass index and an improvement in the systemic lipid profile, indicated by reductions in total cholesterol, low-density lipoprotein cholesterol (LDLc), and remnant cholesterol, and an increase in HDL cholesterol (HDLc) was observed (all p trend < 0.001). Time-series comparisons vs. baseline showed that, in general, anthropometric measures, glycemia, total cholesterol, LDLc, and remnant cholesterol decreased at all follow-ups, whereas HDLc and triglyceride concentrations significantly improved vs. baseline from 6 months, reaching at 12 months the highest HDLc levels (29.6%, p < 0.001) and the lowest circulating triglycerides (-30%, p < 0.001). Although HDL's anti-inflammatory ability worsens after surgery, the HDL-mediated CEC linearly increased after surgery (for both p trend < 0.013). BS improves the lipid profile both quantitatively and qualitatively after 1 year, specifically enhancing HDL-mediated cholesterol efflux capacity, which may contribute to a reduced cardiovascular risk in individuals with severe obesity. © 2024 Castañer, Pérez-Vega, Álvarez, Vázquez, Casajoana, Blanchart, Gaixas, Schröder, Zomeño, Subirana, Muñoz-Aguayo, Fitó, Benaiges, Goday and Oliveras.

Citation

O Castañer, K A Pérez-Vega, S Álvarez, S Vázquez, A Casajoana, G Blanchart, S Gaixas, H Schröder, M D Zomeño, I Subirana, D Muñoz-Aguayo, M Fitó, D Benaiges, A Goday, A Oliveras. Effect of bariatric surgery on HDL-mediated cholesterol efflux capacity. Frontiers in cardiovascular medicine. 2024;11:1469433

PMID: 39574780

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