The effect of bariatric surgery in the early period of revers cholesterol transport

The aim of this study was to evaluate the lipoprotein subfractions, cholesteryl ester transfer protein (LCAT) and activity, lecithin cholesterol acyltransferase (LCAT) and activity, apolipoprotein A-I (apo A-I), apolipoprotein B (apo B) and paraoxonase levels in obes patients underwent sleeve gastrectomy (SG) and in control group preoperatively, at 1st day after surgery and after oral feeding, and to investigate the effect of these parameters in the revers cholesterol transport. Serum levels of CETP, LCAT apo A-I and apo B were determined by ELISA. CETP and LCAT activity were measured by fluorometric method. The activity of PON was assessed from the rate of enzymatic hydrolysis of phenyl acetate to phenol formation. HDL and LDL subfractions analysis were done by continuous disc polyacrylamide gel electrophoresis. Total cholesterol (TC), glucose, HDL and triglyceride (TG) were assessed by enzymatic colometric method. Levels of insulin was evaluated by immunoassay method, LDL by Friedewald formula while inulin resistance was determined by HOMA-IR. Levels of HDL-1 and HDL-large subfractions were significantly higher, while HDL-8, HDL-9, HDL-10 and HDL-small subfraction levels, TC, LDL and CETP were significantly lower at 1st day after surgery compared to preoperative levels in patient group. A significant increase was observed in TG and VLDL levels after oral feeding compared to 1st day after surgery. There was a significant decrease in PON, insulin and HOMA-IR levels after oral feeding compared to preoperative levels in patient group. HDL levels were significantly decreased while apo A-I levels were significantly increased after oral feeding compared to both preoperative and 1st day after surgery in patients underwent SG. The anti-atherogenic HDL subfractions HDL-1 and HDL-large were increased and atherogenic HDL subfractions HDL-8, HDL-9, HDL-10 and HDL-small were decreased due to lower levels at 1st day after surgery compared to preoperative measurements. Additonally, apo A-I levels were increased due to insulin resistance improvement clearance and increased HDL catabolism after SG surgery.