Researchers at the Boston University Chobanian & Avedisian School of Medicine have made a significant discovery in understanding the link between obesity and cardiovascular disease (CVD).
Their study, focusing on the functionality of low-density lipoprotein (LDL), often referred to as “bad cholesterol,” reveals how obesity affects LDL, increasing the risk of CVD.
Obesity, a growing public health issue, affects over 40% of adults in the U.S., with more than 9% suffering from severe obesity.
This condition is not just about weight but also involves various health complications such as hyperlipidemia, diabetes, hypertension, chronic inflammation, and oxidative stress, all of which heighten the risk of CVD.
LDL plays a crucial role in cholesterol transport in the blood. While cholesterol is vital for cellular function, excess levels lead to CVD as it can deposit in the arteries.
This study demonstrates that in obesity, it’s the quality, not just the quantity, of LDL that exacerbates “bad cholesterol” due to inflammation associated with obesity.
This results in a shift in cholesterol delivery from normal to abnormal pathways, causing cholesterol to accumulate in arterial walls and form plaques that block blood flow.
The study involved comparing blood lipoproteins from patients with severe obesity before and after bariatric surgery, as well as with a control group of lean individuals.
The researchers examined lipoprotein interactions with cell receptors essential for LDL function and also assessed LDL composition, particle charge, and aggregation.
They discovered that in patients with obesity, LDL particles were dysfunctional, poorly delivering cholesterol to normal receptors and instead favoring harmful pathways like scavenger receptors or arterial wall retention.
This dysfunction was attributed to changes in LDL’s biochemical composition induced by obesity-associated inflammation.
Interestingly, the study found that after bariatric surgery, as patients lost weight and inflammation subsided, the quality of LDL improved progressively at 6 and 12 months post-operation.
However, LDL quality still did not match that of lean controls, indicating a direct correlation between weight loss and LDL functionality.
Although patients’ BMI did not reach the levels of lean controls, the improvement in LDL quality significantly reduced their CVD risk.
Senior author Olga Gursky, PhD, emphasizes that this study is not only relevant for bariatric surgery patients but also holds promise for those attempting weight loss through various methods. As weight normalizes, LDL quality continues to improve, suggesting a continuous decline in CVD risk.
This research sheds light on the intricate relationship between obesity, LDL functionality, and cardiovascular health.
It underscores the importance of addressing obesity not just from a weight perspective but also in terms of its broader metabolic and vascular impacts.
The findings highlight the potential of weight loss as a means to improve LDL quality and reduce the risk of CVD, offering a ray of hope for those struggling with obesity and its associated health risks.
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The research findings can be found in the Journal of Lipid Research.
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