Bariatric Surgery Improves HDL Function Examined by ApoA1 Exchange Rate and Cholesterol Efflux Capacity in Patients with Obesity and Type 2 Diabetes

• Published in: Biomolecules (Basel, Switzerland) Vol. 10; no. 4; p. 551
• Main Authors: Lorkowski, Shuhui Wang, Brubaker, Gregory, Rotroff, Daniel M., Kashyap, Sangeeta R., Bhatt, Deepak L., Nissen, Steven E., Schauer, Philip R., Aminian, Ali, Smith, Jonathan D.
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 04.04.2020; MDPI
• Subjects: apoA1 exchange rate; Apolipoprotein A-I - metabolism; Bariatric Surgery; Cholesterol - blood; Cholesterol - metabolism; cholesterol efflux capacity; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - metabolism; Diabetes Mellitus, Type 2 - surgery; Female; HDL function; Health aspects; High density lipoproteins; Humans; Lipoproteins, HDL - blood; Lipoproteins, HDL - metabolism; Male; Middle Aged; Obesity; Obesity - complications; Patient outcomes; Physiological aspects; Treatment Outcome; Type 2 diabetes; HDL function; apoA1 exchange rate; bariatric surgery; cholesterol efflux capacity
• ISSN: 2218-273X; 2218-273X
• DOI: 10.3390/biom10040551

Bariatric surgery improves glycemic control better than medical therapy; however, the effect of bariatric surgery on HDL function is not well characterized. Serum samples were available at baseline, 1-, and 5-years post procedures, for 90 patients with obesity and type 2 diabetes who were randomized to intensive medical therapy (n = 20), Roux-en-Y gastric bypass (RYGB, n = 37), or sleeve gastrectomy (SG, n = 33) as part of the STAMPEDE clinical trial. We examined serum HDL function by two independent assays, apolipoprotein A-1 exchange rate (AER) and cholesterol efflux capacity (CEC). Compared with baseline, AER was significantly higher at 5 years for participants in all treatment groups, but only increased significantly at 1 year in the RYGB and SG groups. CEC was divided into ABCA1-dependent and independent fractions, and the later was correlated with AER. ABCA1-independent CEC increased significantly only at 5 years in both surgical groups, but did not significantly change in the medical therapy group. There was no significant change in ABCA1-dependent CEC in any group. The increase in AER, but not ABCA1-independent CEC, was correlated with the reduction in body mass index and glycated hemoglobin levels among all subjects at 5 years, indicating that AER as a measure of HDL function would be a better reflection of therapy versus CEC.