Abstract
Individuals with severe obesity (SO) are at a high risk of developing cardiovascular disease, but traditional lipid parameters are insufficient for accurately assessing the risk. This study aims to investigate the advanced characteristics of lipoproteins that may contribute to subclinical atherosclerosis in SO and the impact of bariatric surgery (BS). The study included 37 patients with SO with a one-year follow-up post-BS, and 40 control subjects. Advanced lipoprotein profiles were assessed using nuclear magnetic resonance. BS normalized proatherogenic lipoprotein alterations in SO. Small LDL and medium HDL particle numbers differed between plaque and non-plaque groups. A ratio of these particles showed an AUC of 83%, suggesting it could effectively predict subclinical atherosclerosis. Advanced NMR analysis offers more specific information on lipid profiles in SO. The small LDL-P to medium HDL-P ratio could be a valuable tool for detecting and managing subclinical atherosclerosis in this population.