Bariatric Surgery Leads to a Reduction in Antibodies to Apolipoprotein A-1: a Prospective Cohort Study

Safwaan Adam, Jan H. Ho, Yifen Liu, Tarza Siahmansur, Zohaib Iqbal, Sabrina Pagano, Shazli Azmi, Shaishav S. Dhage, Rachelle Donn, Basil J. Ammori, Akheel A. Syed, Paul N. Durrington, Rayaz A. Malik, Nicolas Vuilleumier, Handrean Soran

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Purpose: Autoantibodies against apolipoprotein A-1 have been associated with cardiovascular disease, poorer CV outcomes and all-cause mortality in obese individuals. The impact of bariatric surgery (BS) on the presence of circulating anti-apoA-1 IgG antibodies is unknown. This study aimed to determine the effect of bariatric surgery on auto-antibodies titres against Apolipoprotein A-1 (anti-apoA-1 IgG), looking for changes associated with lipid parameters, insulin resistance, inflammatory profile and percentage of excess body mass index loss (%EBMIL). Materials and Methods: We assessed 55 patients (40 women) before, 6 and 12 months post-operatively. Baseline and post-operative clinical history and measurements of body mass index (BMI), serum cholesterol, triglycerides, high- and low-density lipoprotein cholesterol (HDL-C and LDL-C), apoA-1, highly sensitive C-reactive protein (hsCRP), fasting glucose (FG), glycated haemoglobin (HbA1c) and HOMA-IR were taken at each point. Human anti-apoA-1 IgG were measured by ELISA. Results: The mean age of participants was 50 years. BS significantly improved BMI, %EBMIL triglycerides, HDL-C, apoA-1, hsCRP, HBA1c, FG and HOMA-IR. Baseline anti-apoA-1 IgG seropositivity was 25% and was associated with lower apoA-1 and higher hsCRP levels. One year after BS, anti-apoA-1 IgG seropositivity decreased to 15% (p = 0.007) and median anti-apoA-1 IgG values decreased from 0.70 (0.56–0.84) to 0.47 (0.37–0.61) AU (p < 0.001). Post-operative anti-apoA-1 IgG levels were significantly associated with a decreased post-surgical %EBMIL at 1 year. Conclusion: Bariatric surgery results in significant reduction in anti-apoA-1 IgG levels, which may adversely influence weight loss. The exact mechanisms underpinning these results are elusive and require further study before defining any clinical recommendations. Graphical abstract: [Figure not available: see fulltext.]

Original languageEnglish
Pages (from-to)355-364
Number of pages10
JournalObesity Surgery
Issue number2
Early online date9 Dec 2021
Publication statusPublished - Feb 2022


  • Anti-apolipoprotein A-1 autoantibodies
  • Bariatric surgery
  • Cardiovascular disease
  • High-density lipoprotein
  • Obesity
  • Weight loss


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