Evolution of lipid profiles after bariatric surgery.
BACKGROUND
The most commonly encountered dyslipidemia in obese individuals is characterized by a cluster of interrelated plasma lipid and lipoprotein abnormalities including hypertriglyceridemia, low HDL cholesterol values, and increased small, dense LDL cholesterol particles. The aim of this study was to assess the changes in lipid profiles at baseline (pre-operatively) and at follow-up (6, 12, and 18 months) after a laparoscopic Roux-en-Y gastric bypass (LRYGBP). A retrospective observational study was performed involving all patients who consecutively underwent a LRYGBP between January 1, 2007 and December 31, 2009. Fasting lipids sub-fractions (total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides) were measured and HOMA-IR calculated pre-operatively and at follow-up post-LRYGBP. Pearson's correlation coefficients were used to assess the relationship between excess weight loss (EWL) and lipid sub-fractions. ANOVA was used to assess the differences between each lipid sub-fraction at various time-points.


METHODS
One hundred twenty eight (N = 128) medical charts were reviewed, and those containing data on lipid fractions at the three follow-up time-points were analyzed. One hundred fourteen patients (N = 114), 84 of whom were women (73.7%), were finally included in the study.


RESULTS
Total cholesterol, LDL cholesterol, triglycerides, and HOMA-IR were significantly reduced after LRYGBP (P < 0.0005 for all). Inversely, HDL cholesterol disclosed a significant rise (P < 0.0005). Noteworthy significant associations between lipid subfractions and EWL were detected overall (P < 0.0005 for all). A gender effect was found since female patients displayed a milder association than male patients (P < 0.0005).


CONCLUSIONS
LRYGBP-induced weight loss improves the lipid profile while reducing insulin resistance, with male patients showing a better profile than female patients.
Centro Laparoscópico Dr. Ballesta (CLB), Centro Médico Teknon, 08022, Barcelona, Spain.
Ignacio
I
Garcia-Marirrodriga
Cesar
C
Amaya-Romero
Gabriel Patiño
GP
Ruiz-Diaz
Sandra
S
Férnandez
Carlos
C
Ballesta-López
Jose M
JM
Pou
June H
JH
Romeo
Gemma
G
Vilahur
Gemma
G
Vilhur
Lina
L
Badimon
Juan
J
Ybarra
D000328:Adult; D000704:Analysis of Variance; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood* / Q000453:epidemiology; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000453:epidemiology; D010865:Pilot Projects; D011184:Postoperative Period; D057234:Preoperative Period; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D015431:Weight Loss; D055815:Young Adult
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D008055:Lipids; D014280:Triglycerides