Effects of bariatric surgery on apolipoprotein A1, apolipoprotein B, and apolipoprotein B/ apolipoprotein A1 ratio: Findings from a prospective cohort.

Abstract

Bariatric surgery is associated with significant improvements in cardiometabolic health. The apolipoprotein B (ApoB)/apolipoprotein A1 (ApoA1) ratio has been demonstrated to be a strong predictor of cardiovascular disease risk. However, the long-term impact of sleeve gastrectomy (SG) on the ApoB/ApoA1 ratio remains unexplored. Observational study including data from a prospective cohort of patients undergoing SG with ApoA1, ApoB, and ApoB/ApoA1 ratio data at baseline, 1 year, and in the long term (3- to 10 years). A total of 376 participants with baseline and 1-year ApoA1, ApoB, and ApoB/ApoA1 were included. For the long-term cohort (3- to 10-year follow-up; mean follow-up, 5.7 ± 2.5 years), 131 participants were included. The ApoB/ApoA1 ratio significantly decreased from baseline to 1 year, 3 to 5 years and >5 years [from 0.68 (95% CI 0.66 - 0.70) to 0.61 (95% CI 0.59 - 0.63), 0.55 (95% CI 0.52 - 0.59), and 0.54 (95% CI 0.51 - 0.58), respectively, adjusted means (95% CI)]. ApoA1 levels significantly increased over time [from 152.47 (95% CI 149.04 - 155.90) to 168.69 (95% CI 164.88 - 172.49), 177.99 (95% CI 171.40 - 184.57), and 184.24 (95% CI 177.46 - 191.02) mg/dL, respectively]. Significant decreases in ApoB levels were observed from baseline to 3-to-5 years [from 100.44 (95% CI 98.92 - 101.97) to 93.53 (95% CI 90.26 - 96.80) mg/dL], but did not persist in the longer term, i.e., > 5 years [97.86 (95% CI 94.53 - 101.19) mg/dL]. In a large cohort of participants with obesity, we show that SG leads to significant reductions in the ApoB/ApoA1 ratio in the long term. These findings may provide further insight into changes in the cardiometabolic profile following BS, although further research is needed.