HDL biology
Roux-en-Y gastric bypass lowers CETP activity alongside other markers of HDL function in severe obesity (Obes Surg 2020)
Original title: Effect of Roux-en-Y Gastric Bypass on Lipoprotein Metabolism and Markers of HDL Functionality in Morbid Obese Patients
In thirty-seven patients with morbid obesity undergoing Roux-en-Y gastric bypass, researchers tracked lipoprotein-associated enzymes before surgery and at one and six months afterward. Cholesteryl ester transfer protein (CETP) activity was significantly diminished at six months (P less than 0.05), while lipoprotein-associated phospholipase A2 activity, which had risen at one month, reversed by six months, and paraoxonase and arylesterase activities fell at one month before partially recovering. HDL cholesterol and apolipoprotein A-I dipped at one month but fully recovered by six months. Alongside improvements in insulin resistance and inflammation, the results point to a broadly favourable remodelling of HDL-associated enzyme activity, including CETP, after bariatric surgery.
Original abstract
Purpose: Morbid obesity represents the most severe form of obesity and surgical intervention would be its only successful treatment. Bariatric surgery could generate modifications in carbohydrate metabolism and in lipid profile plus lipoprotein-associated proteins and enzymes, such as lipoprotein-associated phoslipase A2 (Lp-PLA2), cholesteryl ester transfer protein (CETP), and paraoxonase (PON) 1. The aim of the present study was to analyze changes in inflammation markers, carbohydrate metabolism, and lipid parameters in patients who underwent bariatric surgery.
Methods: Thirty-seven patients with morbid obesity were recruited. Evaluations were performed before (T0) and 1 (T1) and 6 (T2) months after surgery. Glucose, insulin, high-sensitivity C-reactive protein (hsCRP), triglycerides, total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, apolipoproteins (apo) A-I, and B plus Interleukin 1β and 6 levels in addition to CETP, Lp-PLA2, and PON 1 activities were determined.
Results: Body mass index decreased at T1 and T2 (p < 0.01). An improvement in all markers of insulin resistance (p < 0.05) was observed at T1. hsCRP levels diminished at T2 (p < 0.05). Triglyceride levels decreased at T1 and T2 (p < 0.05). HDL-C and apo A-I showed a decrease at T1 which was completely reversed at T2 (p < 0.05). Lp-PLA2 activity increased at T1, which was reversed at T2 (p < 0.05), and CETP activity was diminished at T2 (p < 0.05). PON and ARE activities decreased at T1 and partially recovered at T2 (p < 0.05).
Conclusions: These results would be indicative of a favorable effect of bariatric surgery on markers of carbohydrate metabolism and cardiovascular disease lipid risk factors.
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.