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Weight loss surgery in adolescents corrects high-density lipoprotein subspecies and their function

International Journal of Obesity volume 41, pages 83–89 (2017)Cite this article

Subjects

Abstract

Background/Objective:

Youth with obesity have an altered high-density lipoprotein (HDL) subspecies profile characterized by depletion of large apoE-rich HDL particles and an enrichment of small HDL particles. The goal of this study was to test the hypothesis that this atherogenic HDL profile is reversible and that HDL function would improve with metabolic surgery.

Methods:

Serum samples from adolescent males with severe obesity mean±s.d. age of 17.4±1.6 years were studied at baseline and 1 year following vertical sleeve gastrectomy (VSG). HDL subspecies and HDL function were evaluated pre and post VSG using paired t-tests. A lean group of adolescents was included as a reference group.

Results:

After VSG, body mass index decreased by 32% and insulin resistance as estimated by homeostatic model assessment of insulin resistance decreased by 75% (both P<0.01). Large apoE-rich HDL subspecies increased following VSG (P<0.01) and approached that of lean adolescents despite participants with considerable residual obesity. In addition, HDL function improved compared with baseline (cholesterol efflux capacity increased by 12%, HDL lipid peroxidation potential decreased by 30% and HDL anti-oxidative capacity improved by 25%, all P<0.01).

Conclusions:

Metabolic surgery results in a significant improvement in the quantity of large HDL subspecies and HDL function. Our data suggest metabolic surgery may improve cardiovascular risk in adolescents and young adults.

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Acknowledgements

We would like to acknowledge Aaron Kelly PhD for his helpful discussions and input during preparation of the manuscript, the Pediatric Obesity Tissue Repository co-investigators Todd Jenkins PhD and Stavra Xanthakos MD and the coordinators who helped with the study including Lindsey Shaw, Rosemary Miller and Jennifer Black. K23HL118132 (ASS), R01HL67093 (WSD), R01HL104136 (WSD) from NHLBI, The Central Society for Clinical and Translational Research (ASS) and the Cincinnati Pediatric Diabetes and Obesity Center at Cincinnati Children’s Hospital Medical Center.

Author contributions

AS designed the study, analyzed the data and wrote the manuscript, TH recruited the participants and edited the manuscript, HS and AH performed the experiments, analyzed the data and edited the manuscript, DE recruited participants from preliminary experiments, DH edited the manuscript, JM performed the experiments and edited the manuscript, WSD designed the study and wrote the manuscript.

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Authors and Affiliations

  1. Department of Pathology and Laboratory Medicine, Center for Lipid and Arteriosclerosis Science, University of Cincinnati, Cincinnati, OH, USA

    W S Davidson, D Y Hui & J T Melchior

  2. Department of Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA

    T H Inge

  3. Division of Endocrinology, Department of Pediatrics, Cincinnati Children's Hospital Research Foundation, Cincinnati, OH, USA

    H Sexmith, A Heink, D Elder & A S Shah

  4. David Geffen School of Medicine, University of California, Los Angeles, CA, USA

    T Kelesidis

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Correspondence to A S Shah.

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Davidson, W., Inge, T., Sexmith, H. et al. Weight loss surgery in adolescents corrects high-density lipoprotein subspecies and their function. Int J Obes 41, 83–89 (2017). https://doi.org/10.1038/ijo.2016.190

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