Traditional lipid tests often underestimate cardiovascular risk in SO. A study published in Cardiovascular Translational Research used nuclear magnetic resonance (NMR) profiling to uncover advanced lipoprotein patterns linked to subclinical atherosclerosis and the effects of BS.

The analysis included 37 patients with SO evaluated before and one year after BS, compared with 40 healthy controls. Bariatric surgery corrected proatherogenic lipoprotein changes observed in SO. Patients with atherosclerotic plaque had higher small LDL and lower medium HDL particle numbers. The small LDL-P to medium HDL-P ratio demonstrated strong predictive accuracy (AUC 83%) for detecting subclinical atherosclerosis.

Advanced NMR-based profiling provides a more precise cardiovascular risk assessment than traditional lipid panels. The identified particle ratio may serve as a practical marker for early detection and management of atherosclerosis in patients with severe obesity.