Bariatric surgery leads to a reduction in anti-apolipoprotein-A-1 IgG antibodies

The Effect of Metabolic Bariatric Surgery on Cardiovascular Risks: A Prospective Study Measuring Antibodies to Apolipoprotein A-1

BACKGROUND

Obesity is a chronic disease associated with other associated medical problems, including atherogenic dyslipidemia. Metabolic bariatric surgery (MBS) has been shown to reduce long-term cardiovascular risk (CVR). Anti-ApoA-1 antibodies (AAA1) are independently associated with cardiovascular disease, which remains a major cause of death in individuals with obesity. This study aimed to determine the effect of MBS on anti-ApoA-1 antibodies. We also looked for changes in lipid parameters, insulin resistance, inflammatory profile, and percentage of total weight loss (%TWL).

METHODS

We assessed 72 patients before surgery and 12 months postoperatively. Clinical history and measurements of body mass index (BMI), lipid profile (including non-HDL cholesterol, TG/HDL-C ratio, TG-Gly index, total cholesterol to HDL ratio), AAA1, CRP, fasting plasma glucose (FPG), HbA1c, and HOMA-IR were measured/calculated at each point.

RESULTS

MBS significantly improved BMI, %TWL, lipids, anti-ApoA-1 antibodies, CRP, HBA1c, FBG, and HOMA-IR. Baseline AAA1 antibodies were positive in 38.9% and were associated with higher CRP levels, total cholesterol, LDL-C, total cholesterol to HDL ratio, and non-HDL cholesterol. One year after MBS, there was a significant reduction in anti-ApoA-1 antibodies (p < 0.001). Furthermore, there was a significant postoperative correlation between anti-ApoA-1 antibodies with total cholesterol. Also, there were significant correlations between HBA1C (%), TG-Gly index, and HOMA-IR.

CONCLUSIONS

Antibodies to apolipoprotein A-1 levels are significantly reduced following MBS. Furthermore, there was a notable improvement in the HBA1C, CRP, and lipid profile.

Metabolic and cardiovascular outcomes of bariatric surgery

PURPOSE OF REVIEW

Bariatric surgery is an effective therapy for morbid obesity that also improves weight-related metabolic parameters and reduces morbidity and mortality. The purpose of this review is to consolidate our current understanding of metabolic, macrovascular and microvascular benefits of bariatric surgery and to provide an update.

RECENT FINDINGS

Early resolution of insulin resistance and type 2 diabetes mellitus (T2DM) varies by type of bariatric surgery and appears to be mediated by changes in secretion of gut hormones, metabolism of bile acids, expression of glucose transporters and the gut microbiome. Dyslipidaemia, atherosclerosis, microvascular complications of obesity and diabetes, systemic and tissue-level inflammation show evidence of regression and hypertension improves significantly after bariatric surgery.

SUMMARY

Bariatric surgery leads to improvements in obesity-related metabolic comorbidities such as dyslipidaemia, HDL functionality, hypertension, T2DM, insulin resistance and inflammation. It slows the atherosclerotic process and reduces cardiovascular and all-cause mortality. Recent data have demonstrated regression of the microvascular complications of obesity and diabetes including the regeneration of small nerve fibres. The magnitude of change in short-term metabolic effects depends on the surgical procedure whilst longer term effects are related to the amount of sustained excess weight loss.