title: Impact of restrictive (sleeve gastrectomy) vs hybrid bariatric surgery (Roux-en-Y gastric bypass) on lipid profile.
abstract: BACKGROUND
  Few studies have evaluated the impact of hybrid versus purely restrictive bariatric surgery on lipid profile, with the results being contradictory. The effect of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) on lipid profile was compared.
  
  
  METHODS
  A nonrandomized prospective cohort study was conducted on severely obese patients undergoing bariatric surgery. Indication for the type of surgical procedure was based on clinical criteria. Patients on lipid-lowering drugs and those that could not be matched for age, sex, and body mass index were excluded. Finally, 51 patients who underwent LSG and 51 undergoing LRYGB completed this study.
  
  
  RESULTS
  During the first year post-surgery, no differences in percentage of excess weight loss and triglyceride reduction were found between groups. After LRYGR, low-density lipoprotein (LDL) cholesterol concentrations fell significantly (125.9 ± 29.3 to 100.3 ± 26.4 mg/dl, p < 0.001), whereas no significant changes were observed in the LSG group (118.6 ± 30.7 to 114.6 ± 33.5 mg/dl, p = 0.220). High-density lipoprotein (HDL) cholesterol increase was significantly greater after LSG (15.4 ± 13.1 mg/dl) compared with LRYGB (9.4 ± 14.0 mg/dl, p = 0.032). Factors independently associated with LDL cholesterol reduction were higher baseline total cholesterol and undergoing LRYGB. A greater increase in HDL cholesterol was associated with LSG, older age, and baseline HDL cholesterol.
  
  
  CONCLUSIONS
  LRYGB produces an overall improvement in lipid profile, with a clear benefit in all lipid fractions. Although LSG does not alter LDL cholesterol levels, its effect on HDL cholesterol is comparable to or greater than that obtained with malabsorptive techniques.
authors.affiliation: Department of Endocrinology and Nutrition, Hospital del Mar, Passeig Marítim, 25-29, 08003 Barcelona, Spain. 96002@parcdesalutmar.cat
authors.forename: D
authors.initials: D
authors.lastname: Benaiges
authors.forename: J A
authors.initials: JA
authors.lastname: Flores-Le-Roux
authors.forename: J
authors.initials: J
authors.lastname: Pedro-Botet
authors.forename: J M
authors.initials: JM
authors.lastname: Ramon
authors.forename: A
authors.initials: A
authors.lastname: Parri
authors.forename: M
authors.initials: M
authors.lastname: Villatoro
authors.forename: M J
authors.initials: MJ
authors.lastname: Carrera
authors.forename: M
authors.initials: M
authors.lastname: Pera
authors.forename: E
authors.initials: E
authors.lastname: Sagarra
authors.forename: L
authors.initials: L
authors.lastname: Grande
authors.forename: A
authors.initials: A
authors.lastname: Goday
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D050171:Dyslipidemias / Q000097:blood* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods*; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood*; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000503:physiopathology / Q000601:surgery; D011184:Postoperative Period; D011446:Prospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL