Bariatric surgery as a model to explore the basis and consequences of the Reaven hypothesis: Small, dense low-density lipoprotein and interleukin-6

Safwaan Adam, Yifen Liu, Tarza Siahmansur, Jan H. Ho, Shaishav S. Dhage, Rahul Yadav, John P. New, Rachelle Donn, Basil J. Ammori, Akheel A. Syed, Rayaz Malik, Handrean Soran, Paul N. Durrington

Research output: Contribution to journalArticle

Abstract

Background: Reaven originally described the clustering of insulin resistance/hyperinsulinaemia, obesity (particularly visceral), altered cytokine levels, glucose intolerance, hypertriglyceridaemia and low high-density lipoprotein cholesterol. Subsequently, a potentially highly atherogenic small, dense low-density lipoprotein was also reported. We have studied the effect of bariatric surgery on this and other risk factors for atherosclerosis. Methods: Forty patients (20 with type 2 diabetes mellitus) undergoing bariatric surgery were studied before and 1 year after bariatric surgery. Results: Twelve months after bariatric surgery, median body mass index had decreased from 49.5 to 36.5 kg/m 2 , fasting insulin from 21.3 to 7.8 mU/L and insulin resistance (homeostatic model assessment of insulin resistance) from 5.9 to 1.8 (all p < 0.001). Thirteen out of 20 patients had remission from type 2 diabetes mellitus. Highly sensitive C-reactive protein, interleukin-6, fasting triglycerides (p < 0.001) and small, dense low-density lipoprotein (p < 0.001) decreased, while high-density lipoprotein cholesterol increased (p < 0.001) significantly, irrespective of having type 2 diabetes mellitus and/or being treated with statin therapy before surgery. Conclusion: The association between marked weight loss and change in insulin resistance and hyperinsulinaemia with the change in small, dense low-density lipoprotein and interleukin-6 warrants further investigation. Bariatric surgery provides a model for investigating the mechanisms linking insulin resistance/hyperinsulinaemia to atherosclerosis.

Original languageEnglish
Pages (from-to)144-152
Number of pages9
JournalDiabetes and Vascular Disease Research
Volume16
Issue number2
DOIs
Publication statusPublished - 1 Mar 2019

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Bariatric Surgery
LDL Lipoproteins
Insulin Resistance
Interleukin-6
Hyperinsulinism
Type 2 Diabetes Mellitus
HDL Cholesterol
Fasting
Atherosclerosis
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Glucose Intolerance
Abdominal Obesity
Hypertriglyceridemia
C-Reactive Protein
LDL Cholesterol
Cluster Analysis
Weight Loss
Triglycerides
Body Mass Index
Insulin

Keywords

  • bariatric surgery
  • Insulin resistance
  • metabolic syndrome
  • obesity
  • Reaven’s hypothesis
  • triglycerides

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine

Cite this

Bariatric surgery as a model to explore the basis and consequences of the Reaven hypothesis : Small, dense low-density lipoprotein and interleukin-6. / Adam, Safwaan; Liu, Yifen; Siahmansur, Tarza; Ho, Jan H.; Dhage, Shaishav S.; Yadav, Rahul; New, John P.; Donn, Rachelle; Ammori, Basil J.; Syed, Akheel A.; Malik, Rayaz; Soran, Handrean; Durrington, Paul N.

In: Diabetes and Vascular Disease Research, Vol. 16, No. 2, 01.03.2019, p. 144-152.

Research output: Contribution to journalArticle

Adam, S, Liu, Y, Siahmansur, T, Ho, JH, Dhage, SS, Yadav, R, New, JP, Donn, R, Ammori, BJ, Syed, AA, Malik, R, Soran, H & Durrington, PN 2019, 'Bariatric surgery as a model to explore the basis and consequences of the Reaven hypothesis: Small, dense low-density lipoprotein and interleukin-6', Diabetes and Vascular Disease Research, vol. 16, no. 2, pp. 144-152. https://doi.org/10.1177/1479164119826479
Adam, Safwaan ; Liu, Yifen ; Siahmansur, Tarza ; Ho, Jan H. ; Dhage, Shaishav S. ; Yadav, Rahul ; New, John P. ; Donn, Rachelle ; Ammori, Basil J. ; Syed, Akheel A. ; Malik, Rayaz ; Soran, Handrean ; Durrington, Paul N. / Bariatric surgery as a model to explore the basis and consequences of the Reaven hypothesis : Small, dense low-density lipoprotein and interleukin-6. In: Diabetes and Vascular Disease Research. 2019 ; Vol. 16, No. 2. pp. 144-152.
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abstract = "Background: Reaven originally described the clustering of insulin resistance/hyperinsulinaemia, obesity (particularly visceral), altered cytokine levels, glucose intolerance, hypertriglyceridaemia and low high-density lipoprotein cholesterol. Subsequently, a potentially highly atherogenic small, dense low-density lipoprotein was also reported. We have studied the effect of bariatric surgery on this and other risk factors for atherosclerosis. Methods: Forty patients (20 with type 2 diabetes mellitus) undergoing bariatric surgery were studied before and 1 year after bariatric surgery. Results: Twelve months after bariatric surgery, median body mass index had decreased from 49.5 to 36.5 kg/m 2 , fasting insulin from 21.3 to 7.8 mU/L and insulin resistance (homeostatic model assessment of insulin resistance) from 5.9 to 1.8 (all p < 0.001). Thirteen out of 20 patients had remission from type 2 diabetes mellitus. Highly sensitive C-reactive protein, interleukin-6, fasting triglycerides (p < 0.001) and small, dense low-density lipoprotein (p < 0.001) decreased, while high-density lipoprotein cholesterol increased (p < 0.001) significantly, irrespective of having type 2 diabetes mellitus and/or being treated with statin therapy before surgery. Conclusion: The association between marked weight loss and change in insulin resistance and hyperinsulinaemia with the change in small, dense low-density lipoprotein and interleukin-6 warrants further investigation. Bariatric surgery provides a model for investigating the mechanisms linking insulin resistance/hyperinsulinaemia to atherosclerosis.",
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T2 - Small, dense low-density lipoprotein and interleukin-6

AU - Adam, Safwaan

AU - Liu, Yifen

AU - Siahmansur, Tarza

AU - Ho, Jan H.

AU - Dhage, Shaishav S.

AU - Yadav, Rahul

AU - New, John P.

AU - Donn, Rachelle

AU - Ammori, Basil J.

AU - Syed, Akheel A.

AU - Malik, Rayaz

AU - Soran, Handrean

AU - Durrington, Paul N.

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Y1 - 2019/3/1

N2 - Background: Reaven originally described the clustering of insulin resistance/hyperinsulinaemia, obesity (particularly visceral), altered cytokine levels, glucose intolerance, hypertriglyceridaemia and low high-density lipoprotein cholesterol. Subsequently, a potentially highly atherogenic small, dense low-density lipoprotein was also reported. We have studied the effect of bariatric surgery on this and other risk factors for atherosclerosis. Methods: Forty patients (20 with type 2 diabetes mellitus) undergoing bariatric surgery were studied before and 1 year after bariatric surgery. Results: Twelve months after bariatric surgery, median body mass index had decreased from 49.5 to 36.5 kg/m 2 , fasting insulin from 21.3 to 7.8 mU/L and insulin resistance (homeostatic model assessment of insulin resistance) from 5.9 to 1.8 (all p < 0.001). Thirteen out of 20 patients had remission from type 2 diabetes mellitus. Highly sensitive C-reactive protein, interleukin-6, fasting triglycerides (p < 0.001) and small, dense low-density lipoprotein (p < 0.001) decreased, while high-density lipoprotein cholesterol increased (p < 0.001) significantly, irrespective of having type 2 diabetes mellitus and/or being treated with statin therapy before surgery. Conclusion: The association between marked weight loss and change in insulin resistance and hyperinsulinaemia with the change in small, dense low-density lipoprotein and interleukin-6 warrants further investigation. Bariatric surgery provides a model for investigating the mechanisms linking insulin resistance/hyperinsulinaemia to atherosclerosis.

AB - Background: Reaven originally described the clustering of insulin resistance/hyperinsulinaemia, obesity (particularly visceral), altered cytokine levels, glucose intolerance, hypertriglyceridaemia and low high-density lipoprotein cholesterol. Subsequently, a potentially highly atherogenic small, dense low-density lipoprotein was also reported. We have studied the effect of bariatric surgery on this and other risk factors for atherosclerosis. Methods: Forty patients (20 with type 2 diabetes mellitus) undergoing bariatric surgery were studied before and 1 year after bariatric surgery. Results: Twelve months after bariatric surgery, median body mass index had decreased from 49.5 to 36.5 kg/m 2 , fasting insulin from 21.3 to 7.8 mU/L and insulin resistance (homeostatic model assessment of insulin resistance) from 5.9 to 1.8 (all p < 0.001). Thirteen out of 20 patients had remission from type 2 diabetes mellitus. Highly sensitive C-reactive protein, interleukin-6, fasting triglycerides (p < 0.001) and small, dense low-density lipoprotein (p < 0.001) decreased, while high-density lipoprotein cholesterol increased (p < 0.001) significantly, irrespective of having type 2 diabetes mellitus and/or being treated with statin therapy before surgery. Conclusion: The association between marked weight loss and change in insulin resistance and hyperinsulinaemia with the change in small, dense low-density lipoprotein and interleukin-6 warrants further investigation. Bariatric surgery provides a model for investigating the mechanisms linking insulin resistance/hyperinsulinaemia to atherosclerosis.

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