title: Effects of bariatric surgery on HDL structure and functionality: results from a prospective trial.
abstract: BACKGROUND
  In addition to high-density lipoprotein cholesterol (HDL-C) levels, HDL quality appears also very important for atheroprotection. Obese patients with metabolic syndrome have significantly reduced HDL-C levels and are usually at increased risk for coronary heart disease. Despite that weight loss benefits these patients, its effects on HDL quality and functionality is currently poorly studied.
  
  
  OBJECTIVE
  We investigated how rapid weight loss affects HDL structure and its antioxidant potential in patients undergoing a malabsorptive bariatric procedure.
  
  
  METHODS
  Fasting plasma samples were collected the day before and 6 months after the bariatric procedure from 20 morbidly obese patients with body mass index >50, then HDL was isolated and analyzed by biochemical techniques.
  
  
  RESULTS
  We report a dramatic alteration in the apolipoprotein ratio of HDL that was accompanied by the presence of more mature HDL subspecies and a concomitant increase in the antioxidant potential of HDL. Interestingly, our obese cohort could be distinguished into 2 subgroups. In 35% of patients (n = 7), HDL before surgery had barely detectable apolipoprotein (apo) A-I and apoCIII, and the vast majority of their HDL cholesterol was packed in apoE-containing HDL particles. In the remaining 65% of patients (n = 13), HDL before surgery contained high levels of apoA-I and apoCIII, in addition to apoE. In both subgroups, surgical weight loss resulted in a switch from apoE to apoA-I-containing HDL.
  
  
  CONCLUSIONS
  Rapid weight loss exerts a significant improvement in HDL structure and functionality that may contribute to the documented beneficial effect of malabsorptive bariatric procedures on cardiovascular health.
authors.affiliation: Department of Pharmacology, University of Patras, School of Medicine, Rio Achaias, Greece.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Zvintzou
authors.affiliation: Morbid Obesity Unit, Department of Surgery, University of Patras, School of Medicine, Rio Achaias, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Skroubis
authors.affiliation: Institute of Biosciences and Applications, National Center for Scientific Research Demokritos, Agia Paraskevi, Athens, Greece.
authors.forename: Angelika
authors.initials: A
authors.lastname: Chroni
authors.affiliation: Department of Pharmacology, University of Patras, School of Medicine, Rio Achaias, Greece.
authors.forename: Peristera-Ioanna
authors.initials: PI
authors.lastname: Petropoulou
authors.affiliation: Institute of Biosciences and Applications, National Center for Scientific Research Demokritos, Agia Paraskevi, Athens, Greece.
authors.forename: Christina
authors.initials: C
authors.lastname: Gkolfinopoulou
authors.affiliation: Department of Medical Physics, University of Patras, School of Medicine, Rio Achaias, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Sakellaropoulos
authors.affiliation: Department of Physiology and Biophysics, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Donald
authors.initials: D
authors.lastname: Gantz
authors.affiliation: Department of Pharmacology, University of Patras, School of Medicine, Rio Achaias, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Mihou
authors.affiliation: Morbid Obesity Unit, Department of Surgery, University of Patras, School of Medicine, Rio Achaias, Greece.
authors.forename: Fotios
authors.initials: F
authors.lastname: Kalfarentzos
authors.affiliation: Department of Pharmacology, University of Patras, School of Medicine, Rio Achaias, Greece. Electronic address: kkypreos@med.upatras.gr.
authors.forename: Kyriakos E
authors.initials: KE
authors.lastname: Kypreos
mesh_terms: D000328:Adult; D016632:Apolipoprotein A-I / Q000097:blood; D001057:Apolipoproteins E / Q000097:blood; D050110:Bariatric Surgery; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism* / Q000601:surgery*; D011446:Prospective Studies; D015431:Weight Loss
chemical_list: D016632:Apolipoprotein A-I; D001057:Apolipoproteins E; D008076:Cholesterol, HDL
keywords: Bariatric surgery; Function; High-density lipoprotein; Morbid obesity; Structure