Bariatric surgery improves atherogenic LDL profile by triglyceride reduction.
BACKGROUND
Small dense low-density lipoprotein (LDL) are atherogenic particles frequently observed in obese patients. Fatty acids modulate LDL. Objective of this study was to determine the relations between plasma phospholipid fatty acid composition and the presence of small dense LDL particles in morbidly obese patients treated with laparoscopic gastric banding (LAGB).


METHODS
Small dense LDL, plasma lipids, lipoproteins, apoproteins, and phospholipid fatty acid composition (a marker of dietary fatty acid intake) were quantified before and 12 months after surgery in four men and 11 women who were morbidly obese and (BMI > 40 kg/m(2)) eligible for surgery, consecutively treated with LAGB at the Department of Medical and Surgical Sciences of the University of Padova.


RESULTS
BMI was 48.3 +/- 4.8 kg/m(2) before and 36.1 +/- 5.5 kg/m(2) after LAGB. Plasma triglycerides and apoprotein E levels significantly decreased, while HDL cholesterol significantly increased after LAGB. A reduction of small dense LDL with an increase of LDL relative flotation (0.34 +/- 0.04 before vs 0.38 +/- 0.03 after LAGB, p < 0.001) was also observed. These modifications were neither related to weight reduction nor to changes in phospholipid fatty acid composition, but they were associated to triglyceride reduction, which explained 76.7% of the LDL relative flotation variation.


CONCLUSIONS
Weight loss obtained by LAGB in morbidly obese subjects was accompanied by triglyceride reduction, high-density lipoprotein increase, and an improvement of the atherogenic LDL profile. Triglyceride reduction, but not the extent of weight loss or dietary fatty acid modifications, is the determinant of modifications of LDL physical properties in these patients.
Zambon
Sabina
S
Department of Medical and Surgical Sciences, University of Padova, via Giustiniani, 2, 35128, Padova, Italy. sabina.zambon@unipd.it.
Romanato
Giovanna
G
Department of Medical and Surgical Sciences, University of Padova, via Giustiniani, 2, 35128, Padova, Italy.
Sartore
Giovanni
G
Department of Medical and Surgical Sciences, University of Padova, via Giustiniani, 2, 35128, Padova, Italy.
Marin
Raffaella
R
Department of Medical and Surgical Sciences, University of Padova, via Giustiniani, 2, 35128, Padova, Italy.
Busetto
Luca
L
Department of Medical and Surgical Sciences, University of Padova, via Giustiniani, 2, 35128, Padova, Italy.
Zanoni
Silvia
S
Department of Medical and Surgical Sciences, University of Padova, via Giustiniani, 2, 35128, Padova, Italy.
Favretti
Franco
F
Department of Surgery, Regional Hospital of Vicenza, Vicenza, Italy.
Sergi
Giuseppe
G
Department of Medical and Surgical Sciences, University of Padova, via Giustiniani, 2, 35128, Padova, Italy.
Fioretto
Paola
P
Department of Medical and Surgical Sciences, University of Padova, via Giustiniani, 2, 35128, Padova, Italy.
Manzato
Enzo
E
Department of Medical and Surgical Sciences, University of Padova, and CNR Institute of Neurosciences, Center on Aging, Padova, Italy.
D000328:Adult; D000368:Aged; D005260:Female; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000601:surgery*; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood*; D015431:Weight Loss; D055815:Young Adult
D008077:Lipoproteins, LDL; D014280:Triglycerides
Diabetes Metab Res Rev. 2006 May-Jun;22(3):226-31
16308886
Obes Surg. 2002 Feb;12(1):83-92
11868305
Int J Obes Relat Metab Disord. 1996 Jun;20(6):539-46
8782730
N Engl J Med. 2004 Dec 23;351(26):2683-93
15616203
Clin Chim Acta. 1993 Oct 15;219(1-2):57-65
8306464
Arterioscler Thromb. 1993 Feb;13(2):147-53
8427851
Int J Obes Relat Metab Disord. 1992 Aug;16(8):573-8
1326487
JAMA. 2001 May 16;285(19):2486-97
11368702
Lancet. 2004 Sep 11-17;364(9438):937-52
15364185
Curr Opin Lipidol. 2003 Feb;14(1):15-9
12544656
Circulation. 2004 Jun 15;109(23 Suppl 1):III2-7
15198959
Int J Obes Relat Metab Disord. 2004 Oct;28(10):1280-2
15365582
J Lipid Res. 1964 Oct;5:600-8
14221106
Arterioscler Thromb Vasc Biol. 2002 Sep 1;22(9):1465-9
12231567
Obes Res. 2004 Aug;12(8):1256-63
15340108
Arterioscler Thromb Vasc Biol. 2006 Feb;26(2):406-10
16306426
Methods Enzymol. 1986;128:181-209
3724502
J Biol Chem. 1957 May;226(1):497-509
13428781
Clin Chem. 1972 Jun;18(6):499-502
4337382
Obes Surg. 1997 Aug;7(4):352-8
9730523
Z Klin Chem Klin Biochem. 1974 Sep;12(9):403-7
4428856
J Intern Med. 1999 Aug;246(2):191-201
10447788
Obes Surg. 2000 Dec;10(6):569-77
11175968
Prog Lipid Res. 1998 Dec;37(6):353-70
10209653
Am J Clin Nutr. 1998 May;67(5):828-36
9583838
Obes Surg. 2002 Jun;12(3):385-90
12082893
JAMA. 2004 Oct 13;292(14):1724-37
15479938
Circulation. 2006 Jan 3;113(1):20-9
16380547
Am J Cardiol. 2002 Oct 17;90(8A):30i-47i
12419479