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Obesity is a global epidemic associated with chronic inflammation, oxidative stress, and metabolic disorders. Bariatric surgery is a highly effective intervention for sustained weight loss and the improvement of obesity-related comorbidities. However, post-surgery nutritional deficiencies, including vitamin E, remain a concern. This study investigates the role of single-nucleotide polymorphisms (SNPs) in genes related to vitamin E transport and bioavailability in determining vitamin E levels post bariatric surgery. A cohort of 140 patients with obesity undergoing bariatric surgery was analyzed. Serum vitamin E levels were measured before and one year after surgery, and SNPs in genes associated with vitamin E transport and metabolism were genotyped using PCR, DHPLC, and sequencing methods. Associations between SNPs, haplotypes, and vitamin E levels were statistically evaluated. Significant associations were observed between the APOE rs7412 SNP and serum vitamin E levels. The rare T allele was linked to lower vitamin E levels post surgery, with an increased frequency in patients with severe deficiency (<11.6 μmol/L). Haplotype analysis of APOE revealed that the ε2 haplotype (T-T) was strongly associated with vitamin E deficiency. Other SNPs, including CD36 rs1761667, SCARB1 rs4238001, and ABCA1 rs4149314, were also linked to changes in vitamin E levels, suggesting that an impaired bioavailability and transport can be the reason for low vitamin E levels post surgery. Genetic polymorphisms in APOE, CD36, SCARB1, and ABCA1 significantly influence vitamin E status after bariatric surgery. These findings highlight the importance of personalized supplementation strategies considering patients' genetic profiles to mitigate the risk of vitamin E deficiency and related complications.

Background: Platelet CD36 (glycoprotein [GP] IV) deficiency occurs in 3 to 5 percent of persons of Asian or African ancestry. A subset of these individuals is at risk for immunization against CD36, but the magnitude of this problem and its significance in transfusion medicine have not yet been clarified., Study Design and Methods: Clinical and laboratory aspects of neonatal thrombocytopenia involving five infants born to four CD36- mothers were characterized. The CD36 gene was sequenced in three mothers. The literature concerning isoimmunization against CD36 was reviewed and summarized., Results: Isoantibodies reactive with CD36 on normal platelets and platelets from the fathers were identified in each of the four mothers. Two African-American mothers were homozygous for a 1264TG mutation in the CD36 gene. A mother of Italian ancestry was homozygous for a previously unidentified deletion of exons 1 through 3. Previously reported cases of isoimmunization against CD36 were reviewed and summarized., Conclusion: Isoimmunization against CD36 can cause neonatal isoimmune thrombocytopenia (NITP), refractoriness to platelet transfusions, and post-transfusion purpura. Immunization against this glycoprotein (GP) should be considered in patients with apparent alloimmune platelet disorders not explained by immunization against recognized platelet-specific alloantigens, especially in persons of African, Asian, and, possibly, Mediterranean ancestry.