Hepatic Vagotomy in Patients With Obesity Leads to Improvement of the Cholesterol to High-Density Lipoprotein Ratio.
Bariatric surgery
Cholesterol
HDL
Hepatic vagotomy
Hypertension
Laparoscopic sleeve gastrectomy
Lipid profile
Obesity
PPAR
Peroxisome proliferator-activated receptor
Total cholesterol
Vagotomy
Journal
Obesity surgery
ISSN: 1708-0428
Titre abrégé: Obes Surg
Pays: United States
ID NLM: 9106714
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
14
03
2023
accepted:
18
08
2023
revised:
13
08
2023
medline:
30
11
2023
pubmed:
4
11
2023
entrez:
4
11
2023
Statut:
ppublish
Résumé
The obesity epidemic is rapidly growing, and visceral adiposity is associated with metabolic consequences secondary to peroxisome proliferator-activated receptor (PPAR)-induced inter-organ signaling pathways. PPARs are ligand-activated transcription factors that modulate vagal pathways which can improve blood pressure, arterial remodeling, cholesterol levels, and insulin sensitivity. However, an obesity-induced inflammatory milieu can interfere with the beneficial effects of PPAR activity, suggesting that a dysregulated PPAR-vagus pathway may play a role in the pathogenesis of obesity-related hypertension. Therefore, we hypothesized that hepatic vagotomy (HV) in patients with obesity would result in a significant reduction in blood pressure and/or the number of hypertension medications compared to control. We conducted a retrospective chart review of 160 patients undergoing laparoscopic sleeve gastrectomy. Patients were divided into HV and control groups, and information was collected at each clinic visit. At six-months post-operation, the HV group was found to have significantly lower total cholesterol (TC)/high-density lipoprotein (HDL) ratios than the control group. The HV group also had a numerically better blood profile for TC, HDL, low-density lipoprotein (LDL), triglycerides, C-reactive protein, and LDL/HDL ratio. Hypertensive patients in the HV group showed numerically lower hypertension medication counts after six weeks when compared to control. We present the first study to report clinically significant changes related to HV in human subjects. Our results did not support our initial hypothesis but did demonstrate an improvement of the TC/HDL ratio with HV in patients with obesity. Future studies should confirm these findings in a randomized control trial.
Identifiants
pubmed: 37924466
doi: 10.1007/s11695-023-06800-2
pii: 10.1007/s11695-023-06800-2
doi:
Substances chimiques
Lipoproteins, HDL
0
Peroxisome Proliferator-Activated Receptors
0
Cholesterol, HDL
0
Cholesterol, LDL
0
Cholesterol
97C5T2UQ7J
Triglycerides
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3740-3745Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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