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Open AccessArticle

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

1
Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic, Cleveland, OH 44195, USA
2
Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH 44195, USA
3
Endocrinology Institute, Cleveland Clinic, Cleveland, OH 44195, USA
4
Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic, Cleveland, OH 44195, USA
5
Brigham and Women’s Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA 02115, USA
6
Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH 44195, USA
*
Authors to whom correspondence should be addressed.
Current address: Bariatric and Metabolic Institute, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA.
Biomolecules 2020, 10(4), 551; https://doi.org/10.3390/biom10040551
Received: 28 February 2020 / Revised: 31 March 2020 / Accepted: 3 April 2020 / Published: 4 April 2020
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. View Full-Text
Keywords: bariatric surgery; HDL function; apoA1 exchange rate; cholesterol efflux capacity bariatric surgery; HDL function; apoA1 exchange rate; cholesterol efflux capacity
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Lorkowski, S.W.; Brubaker, G.; Rotroff, D.M.; Kashyap, S.R.; Bhatt, D.L.; Nissen, S.E.; Schauer, P.R.; Aminian, A.; Smith, J.D. Bariatric Surgery Improves HDL Function Examined by ApoA1 Exchange Rate and Cholesterol Efflux Capacity in Patients with Obesity and Type 2 Diabetes. Biomolecules 2020, 10, 551.

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