Early Postoperative Changes of HDL Subfraction Profile and HDL-Associated Enzymes After Laparoscopic Sleeve Gastrectomy
Early Postoperative Changes of HDL Subfraction Profile and HDL-Associated Enzymes After Laparoscopic Sleeve Gastrectomy
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DOI：
10.1007/s11695-013-1011-2
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发表时间：
2013-12-01
期刊：
影响因子：
2.9
通讯作者：
Aslan, Mutay
中科院分区：
文献类型：
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作者：
Dogan, Serdar;Aslan, Ibrahim;Aslan, Mutay
本研究旨在探讨腹腔镜袖状胃切除术(LSG)术后早期低密度脂蛋白/高密度脂蛋白亚组分及高密度脂蛋白相关酶的变化。13例肥胖患者(平均体重指数52.74+/-10.97 kg/m(2))接受LSG治疗，正常体重患者(平均体重指数23.56+/-1.92 kg/m(2))接受腹腔镜术。分别于手术前、术后第1天、术后进食后采集空腹血样。用连续盘状聚丙烯酰胺凝胶电泳法进行低密度脂蛋白和高密度脂蛋白亚组分分析。采用酶联免疫吸附试验检测血浆胆固醇酯转运蛋白(CETP)、卵磷脂-胆固醇酰基转移酶(LCAT)和载脂蛋白A-1(apoA-I)水平。CETP和LCAT活性的测定通过荧光分析进行。低密度脂蛋白亚组分分布在LSG组和对照组均无变化。对照组的高密度脂蛋白胆固醇、高密度脂蛋白亚组分分布和载脂蛋白A-I水平均无显著差异。LSG患者术后第1天与术前相比，大密度脂蛋白显著升高，小密度脂蛋白显著降低。与术前和术后第1天相比，术后第1天LSG患者的高密度脂蛋白胆固醇显著降低，apoA-I显著升高。术后第1天高密度脂蛋白亚组分的变化伴随着CETP蛋白、LCAT蛋白和LCAT活性的显著降低。LSG后高密度脂蛋白亚组分分布和高密度脂蛋白相关酶的早期变化表明，无论体重变化如何，外科手术都会影响胆固醇的反向运输。
This study aimed to determine early postoperative changes of LDL/HDL subfraction profile and HDL-associated enzymes following laparoscopic sleeve gastrectomy (LSG). Thirteen obese patients (mean body mass index (BMI) 52.74 +/- 10.97 kg/m(2)) underwent LSG and normal weight control patients (mean BMI 23.56 +/- 1.92 kg/m(2)) underwent laparoscopic abdominal surgery. Fasting blood samples were collected prior to surgery, at day 1 after surgery, and after postoperation oral feeding. LDL and HDL subfraction analysis was done by continuous disk polyacrylamide gel electrophoresis. Plasma levels of cholesteryl ester transfer protein (CETP), lecithin-cholesterol acyltransferase (LCAT), and apolipoprotein A-1 (apoA-I) were determined by enzyme-linked immunosorbent assay. Measurement of CETP and LCAT activity was performed via fluorometric analysis. LDL subfraction profile showed no change in both LSG and control group patients. No significant difference was observed in HDL cholesterol, HDL-subfraction distribution, and apoA-I levels in the control group. LSG patients showed a significant increase in HDL-large and a significant decrease in HDL-small fractions at postoperation day 1 compared to preoperation. HDL cholesterol significantly decreased and apoA-I significantly increased in LSG patients after postoperation oral feeding compared to both preoperation and postoperation day 1. Changes in HDL subfraction profile at postoperation day 1 after LSG were accompanied by a significant decrease in CETP protein, LCAT protein, and LCAT activity as compared to preoperation levels. Early changes in HDL subfraction profile and HDL-associated enzymes following LSG suggest that the surgical procedure, irrespective of changes in body weight, affects reverse cholesterol transport.