The effect of laparoscopic gastric bypass surgery on dyslipidemia in severely obese patients.
BACKGROUND
Dyslipidemia is common in the morbidly obese population. Lipid parameters typically improve after bariatric surgery, but the effects have been inconsistent and may depend on the surgical procedure performed. If bariatric surgery consistently improves dyslipidemia, there may be associated cost savings in lipid-modifying medications.


METHODS
Patients undergoing laparoscopic Roux-en-Y gastric bypass surgery (RYGB) for morbid obesity had lipid analyses performed preoperatively and 1 and 2 years postoperatively. The number of lipid-modifying medications taken was documented by an electronic medical record review.


RESULTS
A total of 168 patients were enrolled. Of these, 96 patients had preoperative and 1-year postoperative data and 18 had preoperative and 2-year postoperative data. In the 1-year cohort, total cholesterol (TC) decreased by 12.5%, low-density lipoprotein cholesterol (LDL) decreased by 19.4%, high-density lipoprotein cholesterol (HDL) increased by 23.2%, triglycerides (TG) decreased by 41.2%, and the percentage of dyslipidemic patients decreased from 82.3% to 28.1% (P < .001 for all). In the 2-year cohort, TC decreased by 7.2% (P = .036), LDL decreased by 21.7% (P < .001), HDL increased by 40.3% (P < .001), TG decreased by 27.3% (P = .015), and the percentage of dyslipidemic patients decreased from 94.4% to 27.8% (P < .001). In the 1-year cohort, 26.0% of patients were taking lipid-modifying medications preoperatively, compared with 14.6% postoperatively (P = .049).


CONCLUSIONS
Laparoscopic RYGB improved all lipid parameters studied and decreased the percentage of dyslipidemic patients. Furthermore, fewer patients were taking lipid-modifying medications postoperatively, suggesting a substantial medication cost savings over time.
Zlabek
Jonathan A
JA
Subsection of Vascular Medicine, Gundersen Lutheran Medical Center, La Crosse, Wisconsin, USA. jazlabek@gundluth.org
Grimm
Melissa S
MS
Larson
Christopher J
CJ
Mathiason
Michelle A
MA
Lambert
Pamela J
PJ
Kothari
Shanu N
SN
D000328:Adult; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015897:Comorbidity; D050171:Dyslipidemias / Q000097:blood / Q000453:epidemiology*; D005260:Female; D015390:Gastric Bypass / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000601:surgery; D011184:Postoperative Period
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D002784:Cholesterol