Metabolic Changes Induced by Bariatric Surgery May be Mediated by PAI-1 and PCSK9 Crosstalk.

Autor: Castro-Leyva V; Unidad de Investigación Médica en Enfermedades Endocrinas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico., Manuel-Apolinar L; Unidad de Investigación Médica en Enfermedades Endocrinas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico., Basurto-Acevedo NE; Servicio de Cirugía General, Clínica de Tracto Digestivo Superior, Cirugía Bariátrica y Metabólica, Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico., Basurto L; Unidad de Investigación Médica en Enfermedades Endocrinas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico. Electronic address: lbasurtoa@yahoo.com., González-Chávez A; Clínica para la Atención Integral del Paciente con Diabetes y Obesidad, Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico., Ruiz-Gastelum E; Servicio de Cardiología, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Sonora, Mexico., Martínez-Murillo C; Departamento de Hematología. Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico.
Jazyk: angličtina
Zdroj: Archives of medical research [Arch Med Res] 2024 Jul; Vol. 55 (5), pp. 103032. Date of Electronic Publication: 2024 Jul 05.
DOI: 10.1016/j.arcmed.2024.103032
Abstrakt: Background: Adiposity favors several metabolic disorders with an exacerbated chronic pro-inflammatory status and tissue damage, with high levels of plasminogen activator inhibitor type 1 (PAI-1) and proprotein convertase subtilisin/kexin type 9 (PCSK9).
Objective: To demonstrate the influence of bariatric surgery on the crosstalk between PAI-1 and PCSK9 to regulate metabolic markers.
Methods: Observational and longitudinal study of 190 patients with obesity and obesity-related comorbidities who underwent bariatric surgery. We measured, before and after bariatric surgery, the anthropometric variables and we performed biochemical analysis by standard methods (glucose, insulin, triglycerides [TG], total cholesterol, high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C] and TG/HDL-C ratio, PAI-1 and PCSK9 were measured by ELISA).
Results: PAI-1 levels decreased significantly after bariatric surgery, and were positively correlated with lipids, glucose, and TG, with significance on PCSK9 and TG/HDL-C alleviating the insulin resistance (IR) and inducing a state reversal of type 2 diabetes (T2D) with a significant decrease in body weight and BMI (p <0.0001). Multivariate regression analysis predicted a functional model in which PAI-1 acts as a regulator of PCSK9 (p <0.002), TG (p <0.05), and BMI; at the same time, PCSK9 modulates LDL-C HDL-C and PAI-1.
Conclusions: After bariatric surgery, we found a positive association and crosstalk between PAI-1 and PCSK9, which modulates the delicate balance of cholesterol, favoring the decrease of circulating lipids, TG, and PAI-1, which influences the glucose levels with amelioration of IR and T2D, demonstrating the crosstalk between fibrinolysis and lipid metabolism, the two main factors involved in atherosclerosis and cardiovascular disease in human obesity.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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