Increased HDL, ApoA1 and decreased Atherogenic Indices after Sleeve Gastrectomy

Abstract PurposeOxidative stress (OS) and dysregulation of lipid metabolism are thought to be pathophysiological mechanisms linking high-density lipoprotein cholesterol (HDL-C) dysfunction to obesity. The aim of this study is to determine the dynamic changes in HDL-C functionality and possible changes in atherogenic risk indices in patients after sleeve gastrectomy (SG).MethodsThis is a prospective study in which 30 patients who underwent SG for morbid obesity were evaluated preoperatively (preop) and postoperatively (postop). Preoperative and postoperative atherogenic risk indices were calculated, and serum paraoxonase-1 (PON-1) and apolipoprotein-A1 (Apo-A1) and platelet activating factor acetyl hydrolase (PAF-AH) levels were measured to evaluate the change in HDL-C function. In addition, the amount of oxidized low-density lipoprotein (Ox-LDL), which is the indicator of OS, was measured.ResultsWe observed improvements in atherogenic risk indices after SG and dynamically measurements of HDL-C functionality. Most importantly, statistically significant increases in HDL-C and HDL-C-associated Apo-A1 levels were seen as early as 6 months after surgery. In addition, triglycerides (TGs), PON-1 levels and also atherogenic risk indices decreased statistically significantly within 6 months. While there was no statistically significant change in blood total cholesterol (TC) and Ox-LDL levels, similarly, PAF-AH levels in HDL-C structure did not show any statistically significant change after SG. ConclusionTo the best of our knowledge, there is no study in the literature that examines dynamic changes in atherogenic risk indices, PON-1, Apo-A1 and Ox-LDL parameters with SG. Presently, this preliminary study supports the role of SG in the treatment of obesity-related HDL-C dysfunctionality.