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Bariatric surgery, lipoprotein metabolism and cardiovascular risk

Tailleux, Annea,b,c,d; Rouskas, Konstantinose; Pattou, Françoisa,b,f; Staels, Barta,b,c,d

doi: 10.1097/MOL.0000000000000197
HYPERLIPIDAEMIA AND CARDIOVASCULAR DISEASE: Edited by Paul N. Durrington
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Purpose of review To summarize recent epidemiological, preclinical and clinical studies on the effects of Roux-en-Y-gastric bypass (RYGBP) surgery on cardiovascular risk factors and the underlying mechanisms.

Recent findings Although RYGBP has mechanical effects on the gastrointestinal tract, the reduced gastric pouch and intestinal calorie absorption cannot fully explain the metabolic improvements.

Summary Obesity predisposes to cardiovascular risk factors such as dyslipidemia, type 2 diabetes, nonalcoholic fatty liver disease and hypertension. In contrast to the limited success of pharmacological and lifestyle interventions, RYGBP induces sustained weight loss, metabolic improvements and decreases morbidity/mortality. In line, RYGBP reduces cardiovascular risk factors. Although the mechanisms are not entirely understood, RYGBP induces complex changes in the gut affecting other organs through endocrine and metabolic signals from the intestine to all key metabolic organs, which can link RYGBP and decreased cardiovascular risk. Here, we discuss the roles of changes in lipid absorption and metabolism, bile acid metabolism, gut hormones and the microbiote as potential mechanisms in the decreased cardiovascular risk and metabolic improvement after RYGBP.

aEuropean Genomic Institute for Diabetes (EGID)

bINSERM UMR1011

cUniv Lille 2

dInstitut Pasteur de Lille, Lille, France

eBiomedical Sciences Research Center ‘Alexander Fleming’, Vari, Greece

fINSERM UMR1190, Lille, France

Correspondence to Bart Staels, Institut Pasteur of Lille - 1 rue du Pr Calmette. 59019 Lille cedex, France. Tel: +00 33 3 20 87 78 25; e-mail: Bart.Staels@pasteur-lille.fr

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