AUTHOR=Yadav Rahul , Hama Salam , Liu Yifen , Siahmansur Tarza , Schofield Jonathan , Syed Akheel A. , France Michael , Pemberton Philip , Adam Safwaan , Ho Jan Hoong , Aghamohammadzadeh Reza , Dhage Shaishav , Donn Rachelle , Malik Rayaz A. , New John P. , Jeziorska Maria , Durrington Paul , Ammori Basil A. , Soran Handrean 

TITLE=Effect of Roux-en-Y Bariatric Surgery on Lipoproteins, Insulin Resistance, and Systemic and Vascular Inflammation in Obesity and Diabetes

JOURNAL=Frontiers in Immunology

VOLUME=8

YEAR=2017

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2017.01512

DOI=10.3389/fimmu.2017.01512

ISSN=1664-3224

ABSTRACT=<sec id="ST1"><title>Purpose</title><p>Obesity is a major modifiable risk factor for cardiovascular disease. Bariatric surgery is considered to be the most effective treatment option for weight reduction in obese patients with and without type 2 diabetes (T2DM).</p></sec><sec id="ST2"><title>Objective</title><p>To evaluate changes in lipoproteins, insulin resistance, mediators of systemic and vascular inflammation, and endothelial dysfunction following Roux-en-Y bariatric surgery in obese patients with and without diabetes.</p></sec><sec id="ST3"><title>Materials and methods</title><p>Lipoproteins, insulin resistance, mediators of systemic and vascular inflammation, and endothelial dysfunction were measured in 37 obese patients with (<italic>n</italic> = 17) and without (<italic>n</italic> = 20) T2DM, before and 6 and 12 months after Roux-en-Y bariatric surgery. Two way between subject ANOVA was carried out to study the interaction between independent variables (<italic>time since surgery</italic> and <italic>presence of diabetes</italic>) and all dependent variables.</p></sec><sec id="ST4"><title>Results</title><p>There was a significant effect of <italic>time since surgery</italic> on (large effect size) weight, body mass index (BMI), waist circumference, triglycerides (TG), small-dense LDL apolipoprotein B (sdLDL ApoB), HOMA-IR, CRP, MCP-1, ICAM-1, E-selectin, P-selectin, leptin, and adiponectin. BMI and waist circumference had the largest impact of <italic>time since surgery</italic>. The effect of <italic>time since surgery</italic> was noticed mostly in the first 6 months. Absence of diabetes led to a significantly greater reduction in total cholesterol, low-density lipoprotein cholesterol, and non-high-density lipoprotein cholesterol although the effect size was small to medium. There was a greater reduction in TG and HOMA-IR in patients with diabetes with a small effect size. No patients were lost to follow up.</p></sec><sec id="ST5"><title>Conclusion</title><p>Lipoproteins, insulin resistance, mediators of systemic and vascular inflammation, and endothelial dysfunction improve mostly 6 months after bariatric surgery in obese patients with and without diabetes.</p></sec><sec id="ST6"><title>Clinical Trial Registration</title><p><uri xlink:href="https://www.ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">www.ClinicalTrials.gov</uri>, identifier: NCT02169518. <uri xlink:href="https://clinicaltrials.gov/ct2/show/NCT02169518?term=paraoxonase&amp;cntry1=EU%3AGB&amp;rank=1" xmlns:xlink="http://www.w3.org/1999/xlink">https://clinicaltrials.gov/ct2/show/NCT02169518?term=paraoxonase&amp;cntry1=EU%3AGB&amp;rank=1</uri>.</p></sec>