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Effects of Roux‐en‐Y gastric bypass on sugar‐induced hypertriglyceridemia
Author(s) -
Surowska A,
De Giorgi S,
Theytaz F,
Lecoultre V,
Campos V,
Giusti V,
Tappy L
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.600.3
Subject(s) - postprandial , chylomicron , medicine , hypertriglyceridemia , triglyceride , endocrinology , fructose , meal , chemistry , cholesterol , insulin , biochemistry , lipoprotein , very low density lipoprotein
Oral fructose increases postprandial blood triglyceride (TG) concentrations, possibly by stimulating intestinal de novo lipogenesis (iDNL) and decreasing extrasplanchnic TG clearance. We hypothesized that these effects of fructose may be abolished by Roux‐en‐Y‐gastric bypass (RYGB) due to bypass of the proximal small bowel. To evaluate this hypothesis, we studied 8 patients 12‐18 months after RYGB, and 8 age‐, weight‐ and gender‐matched controls (C). Each participant was studied on two occasions, over 6‐hours after ingestion of 1) a protein/ lipid meal (PL), and 2) a protein/ lipid/ glucose/ fructose meal (PLGF). Chylomicrons‐triglyceride secretion and clearance were assessed from postprandial incremental areas under the curve for TG and apoB48. Sugar‐related hyperlipemia was assessed from the difference between chylomicron‐TG iAUC after PLGF and after PL. Postprandial chylomicrons‐TG iAUCs were, in RYGB: 16.8 ± 7.0 mmol/L*360min after PL vs 6.4 ± 5.7 mmol/L*360min after PLGF (NS), and in C: 28.4 ± 12.7 mmol/L*360min after PL vs 67.9 ± 23.0 mmol/L*360min after PLGF (p = 0.025). Sugar‐related hypertriglyceridemia was 2.1 ± 10.6 mmol/L*360min in RYGB vs 46.7 ± 15.0 mmol/L*360min in C (p = 0.03). ApoB48 peaked earlier in RYGB than in C, but post‐prandial iAUCs for apoB48 were not different in the two groups. These results indicate that sugar induced hypertriglyceridemia was abolished after RYGB. A lower iDNL may possibly account for this effect of RYGB. An increased extrasplanchnic clearance of chylomicrons‐TG (as suggested by lower TG iAUCs together with unchanged apoB48 iAUCs) may also be involved. This work was supported by the Swiss National Science Foundation