Acute and Chronic Impact of Biliopancreatic Diversion with Duodenal Switch Surgery on Plasma Lipoprotein(a) Levels in Pa
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Acute and Chronic Impact of Biliopancreatic Diversion with Duodenal Switch Surgery on Plasma Lipoprotein(a) Levels in Patients with Severe Obesity Audrey-Anne Després 1,2 & Marie-Eve Piché 1,2 & Audrey Auclair 1 & Laurent Biertho 1 & Simon Marceau 1 & Frédéric-Simon Hould 1 & Simon Biron 1 & Stéfane Lebel 1 & Odette Lescelleur 1 & François Julien 1 & Julie Martin 1 & André Tchernof 1,3 & Patrick Mathieu 1,4 & Paul Poirier 1,5 & Benoit J. Arsenault 1,2 Received: 3 September 2019 / Revised: 26 January 2020 / Accepted: 3 February 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Elevated lipoprotein(a) (Lp(a)) level is an independent risk factor for cardiovascular diseases. Lifestyle intervention studies targeting weight loss revealed little to no significant changes in Lp(a) levels. The impact of interventions that induce substantial weight loss, such as bariatric surgery, on Lp(a) levels is currently unclear. Objective To determine the acute and long-term impact of bariatric surgery on Lp(a) levels in patients with severe obesity. Methods Sixty-nine patients with severe obesity underwent biliopancreatic diversion with duodenal switch (BPD-DS) surgery. The lipid profile was evaluated and Lp(a) levels were measured before surgery and at 6 and 12 months after BPD-DS surgery. Results Median Lp(a) levels at baseline were 11.1 (4.1–41.6) nmol/L. Six months and 12 months after the BDP-DS surgery, we observed an improvement of lipid profile. At 6 months, we observed a 13% decrease in Lp(a) levels (9.7 (2.9–25.6) nmol/L, p < 0.0001) but this decrease was not sustained at 12 months (11.1 (3.9–32.8) nmol/L, p = 0.8). When the patients were separated into tertiles according to Lp(a) levels at baseline, we observed that the Lp(a) reduction at 12 months after BPD-DS surgery remained significant but modest in patients of the top Lp(a) tertile. Conclusion Our results suggest that BPD-DS surgery modestly reduces Lp(a) levels in the short term (6 months) in patients with severe obesity but this improvement is sustained over time only in patients with higher Lp(a) levels. Keywords Lipoprotein(a) . Severe obesity . Bariatric surgery . Low-density lipoprotein cholesterol . Statins
Introduction Lipoprotein(a) (Lp(a)) level is an important risk factor for a broad range of cardiovascular diseases (CVD) such as coronary artery disease, stroke, and calcific aortic valve stenosis (CAVS) [1, 2]. * Benoit J. Arsenault [email protected] 1
Centre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de Québec, Y-3601, Pavillon Marguerite D’Youville, 2725 chemin Ste-Foy, Québec, QC G1V 4G5, Canada
2
Department of Medicine, Faculty of Medicine, Université Laval, Québec, Canada
3
School of Nutrition, Université Laval, Québec, Canada
4
Department of Surgery, Faculty of Medicine, Université Laval, Québec, Canada
5
Faculty of Pharmacy, Université Laval, Québec, Canada
Lp(a) is a circulating cholesterol-rich lipoprotein particle similar t
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