Rapid Perioperative Changes in the Quantitative Properties of Plasma Lipases and Lipoproteins in Morbidly Obese Surgical Patients
Journal Title: Journal of Diabetes and Obesity - Year 2017, Vol 4, Issue 2
Abstract
Background: The impact of bariatric surgery on abnormalities in blood lipids and lipoprotein metabolism during the perioperative period has been poorly studied. Objective: We studied the impact of bariatric surgery on the composition and quantitative properties of lipoproteins and the activity of lipases in the plasma of perioperative morbidly obese patients. Methods: We examined the plasma lipoproteins and lipolytic activities of 34 morbidly obese patients one month before surgery (OB), pre-anaesthesia (-S), post-anaesthesia (+S), and one day and one month after open Roux-en-Y gastric bypass (RYGB) surgery. Results: Surgical injury induced acute stress, as evidenced by transitory hyperglycaemia and elevated plasma levels of stress hormones. Lipid profiles revealed a significant reduction during surgery and the day after in the plasma levels of total cholesterol (p < 0.0001), which was mainly due to a decrease in low-density lipoprotein cholesterol (cLDL) and was confirmed with a significant reduction in the plasma levels of LDL (approximately 26% reduction). Significant (p < 0.0001) changes were detected in the plasma levels of high-density lipoprotein cholesterol (cHDL) as well as a significant decrease (approximately 19% reduction) in the plasma levels of HDL. A significant (p < 0.0001) rise was noted in the plasma levels of both Lipoprotein Lipase (LPL) (approximately 2.6- fold increase) and hepatic lipase (HL) (approximately 2.2-fold increase) on the day after surgery, occurring simultaneously with the maximum increase in C-reactive protein (CRP) and a day after the peak values for non-esterified fatty acid (NEFA), adrenocorticotropin hormone (ACTH), cortisol and glucose. Conclusion: The present study reveals unreported quantitative perioperative changes in plasma lipases and lipoproteins and related metabolic determinants that may contribute to the adaptive metabolic response to RYGB-induced stress. Summary: There was a significant rise in the plasma levels of plasma lipases on the day after surgery in morbidly obese patients, co-occurring with the maximum increase in C-reactive protein. Lipid profiles revealed a significant reduction during surgery and the day after in the plasma levels of cholesterol. Stress pre-/post-surgery caused important changes in NEFA, ketone bodies and other related parameters that could be used as markers of surgery risk.
Authors and Affiliations
Julia Peinado-Onsurbe
Keywords
Related Articles
- EP ID EP417858
- DOI 10.15436/2376-0494.17.1333
- Views 106
- Downloads 0
Risk of Type 2 Diabetes among US - Foreign Born Non-Hispanic Asians: Evidence from NHANES 2011-12
Aims/Introduction: The purpose of this study was to compare risks for metabolic dysfunction and type 2diabetes among Non-Hispanic Asian and Non-Hispanic white adults using new nationally representative data in the U.S. W...
Hyperinsulineamia as Risk Factor for Early Breast Cancer Recurrence Linked to Hormone Receptors and Human Epidermal Growth Factor Receptor 2
Background: Hyperinsuliunemia is a condition with excess levels of circulating insulin in the blood among non-diabetics. Hyperinsuliunemia may increase breast cancer developing probability. Purpose: to investigate the ro...
Relationships between Weight, Adiposity, Functional Status, and Left Ventricle Characteristics in Overweight and Obese Patients with Heart Failure
Aims: This study was conducted to examine the relationship between adiposity and functional status (i.e. peak oxygen consumption [VO2max]), and left ventricular (LV) structural characteristics (i.e., LV ejection fraction...
Amelioration of Diabetic Dyslipidemia by GTF – 231 (Gymnemic acid, Trigonelline and Ferulic acid- 2:3:1), a phytochemical preparation Studied in High Fat Diet Fed-Low Dose STZ Induced Experimental Type 2 Diabetes in Rats
Background Persistent hyperglycemia in diabetes is associated with profound changes in lipid and lipoprotein abnormalities which result in particle distribution within lipoprotein classes Recently we have reported...
The Different Association between Metformin and Sulfonylurea Derivatives and the Risk of Cancer May be Confounded by Body Mass Index
Aim: Several studies in large databases suggest that in comparison to glucose-lowering sulfonylurea derivatives, metformin is associated with a reduced risk of cancer in patients with diabetes. As many databases miss rel...