title: Effects of bariatric surgery on hepatic and intestinal lipoprotein particle metabolism in obese, nondiabetic humans.
abstract: OBJECTIVE
  The dyslipidemia of obesity and other insulin-resistant states is characterized by the elevation of plasma triglyceride-rich lipoproteins (TRL) of both hepatic (apoB-100-containing very low-density lipoprotein) and intestinal (apoB-48-containing chylomicrons) origin. Bariatric surgery is a well-established and effective modality for the treatment of obesity and is associated with improvements in several metabolic abnormalities associated with obesity, including a reduction in plasma triglycerides. Here, we have investigated the effect of bariatric surgery on TRL metabolism.
  
  
  RESULTS
  Twenty-two nondiabetic, obese subjects undergoing bariatric surgery: sleeve gastrectomy (n=12) or gastric bypass (n=10) were studied. Each subject underwent 1 lipoprotein turnover study 1 month before surgery followed by a second study, 6 months after surgery, using established stable isotope enrichment methodology, in constant fed state. TRL-apoB-100 concentration was significantly reduced after sleeve gastrectomy, explained by a decrease (P<0.05) in TRL-apoB-100 production rate and an increase (P<0.05) in TRL-apoB-100 fractional catabolic rate. TRL-apoB-48 concentration was also significantly reduced after sleeve gastrectomy, explained by reduction in TRL-apoB-48 production rate (P<0.05). For gastric bypass, although TRL-apoB-100 concentration declined after surgery (P<0.01), without a significant decline in TRL-apoB-48, there was no significant change in either TRL-apoB-100 or TRL-apoB-48 production rate or fractional catabolic rate. The reduction in TRL-apoB-100 concentration was significantly associated with a reduction in plasma apoC-III in the pooled group of patients undergoing bariatric surgery.
  
  
  CONCLUSIONS
  This is the first human lipoprotein kinetic study to explore the mechanism of improvement of TRL metabolism after bariatric surgery. These effects may contribute to the decrease of cardiovascular mortality after surgery.
  
  
  BACKGROUND
  http://www.ClinicalTrials.gov. Unique identifier: NCT01277068.
authors.affiliation: From the Aix-Marseille Université, UMR_S1062, UMR_A1260, NORT, F-13385, Marseille, France (N.P., M.M., S.B., E.W., A.N., R.V.); Department of Nutrition, Metabolic Diseases, Endocrinology (S.B., A.B., N.D., R.G., C.M., B.V., R.V.) and Department of Visceral Surgery (B.B.), AP-HM, La Timone Hospital, Marseille, France; Department of Endocrinology, Medico Moving Center Institute, Formosa, Argentina (J.P.N.); and Departments of Medicine and Physiology, and Banting and Best Diabetes Centre, University of Toronto, Ontario, Canada (G.F.L., C.X.).
authors.forename: Nadège
authors.initials: N
authors.lastname: Padilla
authors.affiliation: From the Aix-Marseille Université, UMR_S1062, UMR_A1260, NORT, F-13385, Marseille, France (N.P., M.M., S.B., E.W., A.N., R.V.); Department of Nutrition, Metabolic Diseases, Endocrinology (S.B., A.B., N.D., R.G., C.M., B.V., R.V.) and Department of Visceral Surgery (B.B.), AP-HM, La Timone Hospital, Marseille, France; Department of Endocrinology, Medico Moving Center Institute, Formosa, Argentina (J.P.N.); and Departments of Medicine and Physiology, and Banting and Best Diabetes Centre, University of Toronto, Ontario, Canada (G.F.L., C.X.).
authors.forename: Marie
authors.initials: M
authors.lastname: Maraninchi
authors.affiliation: From the Aix-Marseille Université, UMR_S1062, UMR_A1260, NORT, F-13385, Marseille, France (N.P., M.M., S.B., E.W., A.N., R.V.); Department of Nutrition, Metabolic Diseases, Endocrinology (S.B., A.B., N.D., R.G., C.M., B.V., R.V.) and Department of Visceral Surgery (B.B.), AP-HM, La Timone Hospital, Marseille, France; Department of Endocrinology, Medico Moving Center Institute, Formosa, Argentina (J.P.N.); and Departments of Medicine and Physiology, and Banting and Best Diabetes Centre, University of Toronto, Ontario, Canada (G.F.L., C.X.).
authors.forename: Sophie
authors.initials: S
authors.lastname: Béliard
authors.affiliation: From the Aix-Marseille Université, UMR_S1062, UMR_A1260, NORT, F-13385, Marseille, France (N.P., M.M., S.B., E.W., A.N., R.V.); Department of Nutrition, Metabolic Diseases, Endocrinology (S.B., A.B., N.D., R.G., C.M., B.V., R.V.) and Department of Visceral Surgery (B.B.), AP-HM, La Timone Hospital, Marseille, France; Department of Endocrinology, Medico Moving Center Institute, Formosa, Argentina (J.P.N.); and Departments of Medicine and Physiology, and Banting and Best Diabetes Centre, University of Toronto, Ontario, Canada (G.F.L., C.X.).
authors.forename: Bruno
authors.initials: B
authors.lastname: Berthet
authors.affiliation: From the Aix-Marseille Université, UMR_S1062, UMR_A1260, NORT, F-13385, Marseille, France (N.P., M.M., S.B., E.W., A.N., R.V.); Department of Nutrition, Metabolic Diseases, Endocrinology (S.B., A.B., N.D., R.G., C.M., B.V., R.V.) and Department of Visceral Surgery (B.B.), AP-HM, La Timone Hospital, Marseille, France; Department of Endocrinology, Medico Moving Center Institute, Formosa, Argentina (J.P.N.); and Departments of Medicine and Physiology, and Banting and Best Diabetes Centre, University of Toronto, Ontario, Canada (G.F.L., C.X.).
authors.forename: Juan-Patricio
authors.initials: JP
authors.lastname: Nogueira
authors.affiliation: From the Aix-Marseille Université, UMR_S1062, UMR_A1260, NORT, F-13385, Marseille, France (N.P., M.M., S.B., E.W., A.N., R.V.); Department of Nutrition, Metabolic Diseases, Endocrinology (S.B., A.B., N.D., R.G., C.M., B.V., R.V.) and Department of Visceral Surgery (B.B.), AP-HM, La Timone Hospital, Marseille, France; Department of Endocrinology, Medico Moving Center Institute, Formosa, Argentina (J.P.N.); and Departments of Medicine and Physiology, and Banting and Best Diabetes Centre, University of Toronto, Ontario, Canada (G.F.L., C.X.).
authors.forename: Estelle
authors.initials: E
authors.lastname: Wolff
authors.affiliation: From the Aix-Marseille Université, UMR_S1062, UMR_A1260, NORT, F-13385, Marseille, France (N.P., M.M., S.B., E.W., A.N., R.V.); Department of Nutrition, Metabolic Diseases, Endocrinology (S.B., A.B., N.D., R.G., C.M., B.V., R.V.) and Department of Visceral Surgery (B.B.), AP-HM, La Timone Hospital, Marseille, France; Department of Endocrinology, Medico Moving Center Institute, Formosa, Argentina (J.P.N.); and Departments of Medicine and Physiology, and Banting and Best Diabetes Centre, University of Toronto, Ontario, Canada (G.F.L., C.X.).
authors.forename: Alain
authors.initials: A
authors.lastname: Nicolay
authors.affiliation: From the Aix-Marseille Université, UMR_S1062, UMR_A1260, NORT, F-13385, Marseille, France (N.P., M.M., S.B., E.W., A.N., R.V.); Department of Nutrition, Metabolic Diseases, Endocrinology (S.B., A.B., N.D., R.G., C.M., B.V., R.V.) and Department of Visceral Surgery (B.B.), AP-HM, La Timone Hospital, Marseille, France; Department of Endocrinology, Medico Moving Center Institute, Formosa, Argentina (J.P.N.); and Departments of Medicine and Physiology, and Banting and Best Diabetes Centre, University of Toronto, Ontario, Canada (G.F.L., C.X.).
authors.forename: Audrey
authors.initials: A
authors.lastname: Bégu
authors.affiliation: From the Aix-Marseille Université, UMR_S1062, UMR_A1260, NORT, F-13385, Marseille, France (N.P., M.M., S.B., E.W., A.N., R.V.); Department of Nutrition, Metabolic Diseases, Endocrinology (S.B., A.B., N.D., R.G., C.M., B.V., R.V.) and Department of Visceral Surgery (B.B.), AP-HM, La Timone Hospital, Marseille, France; Department of Endocrinology, Medico Moving Center Institute, Formosa, Argentina (J.P.N.); and Departments of Medicine and Physiology, and Banting and Best Diabetes Centre, University of Toronto, Ontario, Canada (G.F.L., C.X.).
authors.forename: Noémie
authors.initials: N
authors.lastname: Dubois
authors.affiliation: From the Aix-Marseille Université, UMR_S1062, UMR_A1260, NORT, F-13385, Marseille, France (N.P., M.M., S.B., E.W., A.N., R.V.); Department of Nutrition, Metabolic Diseases, Endocrinology (S.B., A.B., N.D., R.G., C.M., B.V., R.V.) and Department of Visceral Surgery (B.B.), AP-HM, La Timone Hospital, Marseille, France; Department of Endocrinology, Medico Moving Center Institute, Formosa, Argentina (J.P.N.); and Departments of Medicine and Physiology, and Banting and Best Diabetes Centre, University of Toronto, Ontario, Canada (G.F.L., C.X.).
authors.forename: Rachel
authors.initials: R
authors.lastname: Grangeot
authors.affiliation: From the Aix-Marseille Université, UMR_S1062, UMR_A1260, NORT, F-13385, Marseille, France (N.P., M.M., S.B., E.W., A.N., R.V.); Department of Nutrition, Metabolic Diseases, Endocrinology (S.B., A.B., N.D., R.G., C.M., B.V., R.V.) and Department of Visceral Surgery (B.B.), AP-HM, La Timone Hospital, Marseille, France; Department of Endocrinology, Medico Moving Center Institute, Formosa, Argentina (J.P.N.); and Departments of Medicine and Physiology, and Banting and Best Diabetes Centre, University of Toronto, Ontario, Canada (G.F.L., C.X.).
authors.forename: Catherine
authors.initials: C
authors.lastname: Mattei
authors.affiliation: From the Aix-Marseille Université, UMR_S1062, UMR_A1260, NORT, F-13385, Marseille, France (N.P., M.M., S.B., E.W., A.N., R.V.); Department of Nutrition, Metabolic Diseases, Endocrinology (S.B., A.B., N.D., R.G., C.M., B.V., R.V.) and Department of Visceral Surgery (B.B.), AP-HM, La Timone Hospital, Marseille, France; Department of Endocrinology, Medico Moving Center Institute, Formosa, Argentina (J.P.N.); and Departments of Medicine and Physiology, and Banting and Best Diabetes Centre, University of Toronto, Ontario, Canada (G.F.L., C.X.).
authors.forename: Bernard
authors.initials: B
authors.lastname: Vialettes
authors.affiliation: From the Aix-Marseille Université, UMR_S1062, UMR_A1260, NORT, F-13385, Marseille, France (N.P., M.M., S.B., E.W., A.N., R.V.); Department of Nutrition, Metabolic Diseases, Endocrinology (S.B., A.B., N.D., R.G., C.M., B.V., R.V.) and Department of Visceral Surgery (B.B.), AP-HM, La Timone Hospital, Marseille, France; Department of Endocrinology, Medico Moving Center Institute, Formosa, Argentina (J.P.N.); and Departments of Medicine and Physiology, and Banting and Best Diabetes Centre, University of Toronto, Ontario, Canada (G.F.L., C.X.).
authors.forename: Changting
authors.initials: C
authors.lastname: Xiao
authors.affiliation: From the Aix-Marseille Université, UMR_S1062, UMR_A1260, NORT, F-13385, Marseille, France (N.P., M.M., S.B., E.W., A.N., R.V.); Department of Nutrition, Metabolic Diseases, Endocrinology (S.B., A.B., N.D., R.G., C.M., B.V., R.V.) and Department of Visceral Surgery (B.B.), AP-HM, La Timone Hospital, Marseille, France; Department of Endocrinology, Medico Moving Center Institute, Formosa, Argentina (J.P.N.); and Departments of Medicine and Physiology, and Banting and Best Diabetes Centre, University of Toronto, Ontario, Canada (G.F.L., C.X.).
authors.forename: Gary F
authors.initials: GF
authors.lastname: Lewis
authors.affiliation: From the Aix-Marseille Université, UMR_S1062, UMR_A1260, NORT, F-13385, Marseille, France (N.P., M.M., S.B., E.W., A.N., R.V.); Department of Nutrition, Metabolic Diseases, Endocrinology (S.B., A.B., N.D., R.G., C.M., B.V., R.V.) and Department of Visceral Surgery (B.B.), AP-HM, La Timone Hospital, Marseille, France; Department of Endocrinology, Medico Moving Center Institute, Formosa, Argentina (J.P.N.); and Departments of Medicine and Physiology, and Banting and Best Diabetes Centre, University of Toronto, Ontario, Canada (G.F.L., C.X.). RVALERO@mail.ap-hm.fr.
authors.forename: René
authors.initials: R
authors.lastname: Valéro
mesh_terms: D000328:Adult; D053299:Apolipoprotein B-100 / Q000097:blood; D053283:Apolipoprotein B-48 / Q000097:blood; D053305:Apolipoprotein C-III / Q000097:blood; D015415:Biomarkers / Q000097:blood; D050171:Dyslipidemias / Q000097:blood* / Q000209:etiology; D004734:Energy Metabolism; D005260:Female; D005743:Gastrectomy; D015390:Gastric Bypass; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism*; D007700:Kinetics; D008074:Lipoproteins / Q000097:blood*; D008099:Liver / Q000378:metabolism*; D008297:Male; D009765:Obesity / Q000097:blood / Q000150:complications / Q000601:surgery*; D019518:Postprandial Period; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
chemical_list: D053299:Apolipoprotein B-100; D053283:Apolipoprotein B-48; D053305:Apolipoprotein C-III; D015415:Biomarkers; D008074:Lipoproteins; D014280:Triglycerides
keywords: atherosclerosis; chylomicrons; general surgery; lipoproteins; obesity; triglycerides