Elevated plasma homocysteine concentrations six months after gastroplasty in morbidly obese subjects

Objective To investigate whether the increased homocysteine levels occur in the first 6 months postoperatively, when nutritional intake is the most in adequate and weight reduction is the most drastic. Patients and Methods Fasting glucose, insulin, lipoprotein, homocysteine, f olic acid and vitamin B12 levels and oral glucose tolerance test (OGTT) wer e determined in 12 morbidly obese subjects (3 men and 9 women with a mean a ge of 31 +/-3 years, mean SEM) before, 6 and 12 months after banded gastrop lasty. Results Gastroplasty resulted in significant weight loss, from 120 +/-6 to 92 +/-6 and 88 +/-7 kgs, 6 and 12 months postoperatively (all p <0.001). Fa sting plasma insulin and triglyceride concentrations, the ratio of total ch olesterol to HDL cholesterol, glucose and insulin responses to OGTT, and th e degree of insulin resistance as expressed by the Homeostasis model index decreased significantly (p <0.05-0.001) following gastroplasty. Fasting pla sma homocysteine concentrations increased from 10.2 +/-0.8 to 12.1 +/-0.6 a t 6 months (P=0.036) and 12.0 +/-1.2 mu mol/l at 12 months (p=0.040), respe ctively. Pooled plasma homocysteine levels were negatively correlated with serum folate concentrations (r=-0.42, p=0.013). However, serum folate and v itamin B12 levels did not change after gastroplasty, nor did the relation b etween the loss of body weight and increase in homocysteine levels. Conclusion We observed that elevated circulating homocysteine levels occurr ed as early as 6 months after gastroplasty despite improvement in carbohydr ate and lipoprotein metabolism in morbidly obese Chinese subjects.