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Roux-en-Y gastric bypass, but not sleeve gastrectomy, decreases plasma PCSK9 levels in morbidly obese patients
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Edité par CCSD ; OMICS International -
International audience. Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a master regulator of low-density lipoprotein cholesterol (LDL-C) metabolism, acting as an endogenous inhibitor of the LDL receptor. While it has been shown that bariatric surgeries differentially affect plasma LDL-C levels, little is known about their effects on plasma PCSK9 concentrations. Here, we aim: i) to investigate the effect of sleeve gastrectomy (SG) and Roux en Y Gastric Bypass (RYGB) on plasma PCSK9 concentrations; ii) to correlate baseline or post-operative plasma PCSK9 concentrations variation with anthropometric and metabolic parameters. Methods Fasting plasma PCSK9 levels were measured by ELISA in morbidly obese patients before and 6 months after bariatric surgery. Patients were recruited from three prospective cohorts (Nantes and Colombes, France; Antwerp, Belgium). Results One hundred fifty-six patients were included: 34 SG and 122 RYGB. Plasma PCSK9, LDL-C and non-high-density lipoprotein-C (non-HDL-C) levels were significantly reduced after RYGB (-19.6%;-16.6%;-19.5%, respectively; p<0.0001) but not after SG. In the whole population, post-operative PCSK9 change was positively correlated with fasting plasma glucose (r=0.22, p=0.007), HOMA-IR (r=0.24, p=0.005), total cholesterol (r=0.17, p=0.037) and non-HDL-C (r=0.17, p=0.038) variations, but not correlated with LDL-C. In contrast to what observed for glucose parameters (FPG and HOMA-IR), the correlation between PCSK9 and non-HDL-C changes after RYGB was independent of total weight loss.
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