%0 Journal Article
%T Bariatric surgery as a model to explore the basis and consequences of the Reaven hypothesis: Small, dense low
%A Akheel A Syed
%A Basil J Ammori
%A Handrean Soran
%A Jan H Ho
%A John P New
%A Paul N Durrington
%A Rachelle Donn
%A Rahul Yadav
%A Rayaz A Malik
%A Safwaan Adam
%A Shaishav S Dhage
%A Tarza Siahmansur
%A Yifen Liu
%J Diabetes and Vascular Disease Research
%@ 1752-8984
%D 2019
%R 10.1177/1479164119826479
%X Reaven originally described the clustering of insulin resistance/hyperinsulinaemia, obesity (particularly visceral), altered cytokine levels, glucose intolerance, hypertriglyceridaemia and low high-density lipoprotein cholesterol. Subsequently, a potentially highly atherogenic small, dense low-density lipoprotein was also reported. We have studied the effect of bariatric surgery on this and other risk factors for atherosclerosis. Forty patients (20 with type 2 diabetes mellitus) undergoing bariatric surgery were studied before and 1£¿year after bariatric surgery. Twelve£¿months after bariatric surgery, median body mass index had decreased from 49.5 to 36.5£¿kg/m2, fasting insulin from 21.3 to 7.8£¿mU/L and insulin resistance (homeostatic model assessment of insulin resistance) from 5.9 to 1.8 (all p£¿<£¿0.001). Thirteen out of 20 patients had remission from type 2 diabetes mellitus. Highly sensitive C-reactive protein, interleukin-6, fasting triglycerides (p£¿<£¿0.001) and small, dense low-density lipoprotein (p£¿<£¿0.001) decreased, while high-density lipoprotein cholesterol increased (p£¿<£¿0.001) significantly, irrespective of having type 2 diabetes mellitus and/or being treated with statin therapy before surgery. The association between marked weight loss and change in insulin resistance and hyperinsulinaemia with the change in small, dense low-density lipoprotein and interleukin-6 warrants further investigation. Bariatric surgery provides a model for investigating the mechanisms linking insulin resistance/hyperinsulinaemia to atherosclerosis
%K Insulin resistance
%K Reaven¡¯s hypothesis
%K bariatric surgery
%K obesity
%K metabolic syndrome
%K triglycerides
%U https://journals.sagepub.com/doi/full/10.1177/1479164119826479