Effects of gastric bypass surgery on postprandial gut and systemic lipid handling. (February 2020)

• Record Type: Journal Article
• Authors: Jegatheesan, Prasanthi; Seyssel, Kévin; Stefanoni, Nathalie; Rey, Valentine; Schneiter, Philippe; Giusti, Vittorio; Lecoultre, Virgile; Tappy, Luc
• Is Part Of: Clinical nutrition ESPEN. Volume 35(2020)
• Page Start: 95
• Page End: 102
• Publication Date: 2020-02
• Subjects: Intestinal fat absorption -- Chylomicron-TG secretion -- 13C-labeled exogenous palmitate -- Postprandial plasma TG concentration -- Overweight -- Gastric bypass; apoB48 apolipoprotein B 48 -- fDNL fractional de novo lipogenesis -- GB gastric bypass -- iAUC incremental area under the curve -- TG triglycerides -- LM-chyloTG last meal chylomicrons triglycerides -- PS-chyloTG pre-stored chylomicron triglycerides -- TRL triglyceride-rich lipoprotein -- VLDL very low density lipoprotein; Nutritionally induced diseases -- Periodicals; Metabolism -- Disorders -- Periodicals; 616.39005
• DOI: 10.1016/j.clnesp.2019.11.002
• Languages: English
• ISSNs: 2405-4577

Abstract

Summary: Background & objectives: Obesity is often associated with increased postprandial triglyceride (TG) concentrations, mainly from chylomicrons- and VLDL-TG. These alterations are usually reverted to normal after gastric bypass surgery (GB), through mechanisms which remain unknown. The objective of this study was therefore to assess the contribution of exogenous labelled fatty acids ingested with a meal to postprandial blood chylomicrons and VLDL-TG concentrations after GB. Subjects/Methods: 7 GB patients 3–5 years after surgery (GB: 2M/5F, mean BMI 30 ± 2 kg/m 2, mean age 40 ± 3 years), 6 overweight non operated subjects (OW: 1M/5F, mean BMI 31 ± 3 kg/m 2, mean age 38 ± 2 years) and 8 normal weight healthy subjects (NW: 4M/4F, mean BMI 22 ± 1 kg/m 2, mean age 26 ± 4 years) were studied over 7 h following ingestion of a liquid meal containing 18 g fat labelled with 250 mg 13 C16 palmitate, 22 g protein, 36 g fructose and 36 g glucose. TG, 13 C palmitate ( 13 C-palm) and apoB48 concentrations were measured hourly in whole plasma and/or in chylomicrons and VLDL lipoprotein sub-fractions. Results: OW subjects had higher chylomicron-than NW (chylo-TG 96.5 (23.1) vs 28.8 (11.8) mmol/l*420min (p = 0.02)), but similar total, chylo- 13 C-palm and apoB48 iAUCs. In GB, chylo- 13 C-palm and apoB48 increased earlier after meal ingestion, but then remained lower than in NW and OW throughout the postprandial period. GB also had lower chylo-TG iAUCs than OW (8.9 (11.5) vs 96.5 (23.2) mmol/l*420min, p = 0.003). Their apoB48 iAUCs were not different from NW and OW (509.2 (90.5) vs 710.2 (80.5) and 870.1 (297.6) pg/ml*420min, all p > 0.05). Conclusions: An accelerated postprandial apoB48 rise, together with unchanged postprandial apoB48 iUAC, suggests that intestinal fat absorption and chylomicron secretion was quantitatively unaltered, but accelerated after gastric bypass. In contrast, the decreased postprandial chylo-TG and 13 C-palm iAUCs suggest that plasma chylomicron clearance was enhanced after gastric bypass.