title: Evolution of glycolipid profile after sleeve gastrectomy vs. Roux-en-Y gastric bypass: results of a prospective randomized clinical trial.
abstract: BACKGROUND
  This study aims to report glycolipid changes after sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) in the setting of a prospective randomized clinical trial.
  
  
  METHODS
  One hundred patients were randomly assigned to RYGB (n = 45) and SG (n = 55). Fasting glucose, insulin, glycated hemoglobin (HbA1c%), triglycerides, and serum cholesterol (total, HDL, and LDL) were evaluated at inclusion and after 1, 3, 6, and 12 months. The index for homeostasis model assessment of insulin resistance (HOMA-IR) and β cell function (HOMA-B) were assessed.
  
  
  RESULTS
  Mean postoperative 1-, 3-, 6-, and 12-month excess weight loss was 25.39, 43.47, 63.75, and 80.38 % after RYGB and 25.25, 51.32, 64.67, and 82.97 % after SG, respectively. Mean fasting glucose and fasting serum insulin were similarly and statistically significantly reduced in both RYGB and SG. Mean HOMA-IR improved in both groups, particularly in case of high preoperative values, and mean HOMA-B improved at 1 year after RYGB. HbA1c% dropped from 5.66 % (SD = 0.61) to 5.57 % (SD = 0.32) after RYGB and from 5.64 % (SD = 0.43) to 5.44 % (SD = 0.43) after SG. Total cholesterol was significantly higher at 1 month (p = 0.04), 3 months (p = 0.03), and 1 year (p = 0.005) after SG as compared to RYGB. LDL cholesterol decreased significantly after RYGB at 1 month (p = 0.03), 3 months (p = 0.0001), and 1 year (p = 0.0004) as compared to SG. HDL cholesterol was increased at 1 year in the RYGB group but not in the SG group. Triglycerides decreased similarly in both groups.
  
  
  CONCLUSIONS
  Short-term glycemic control was comparable after SG and RYGB. An improved lipid profile was noted after RYGB in patients with abnormal preoperative values.
authors.affiliation: IRCAD-IHU, University of Strasbourg, Strasbourg, France. Michel.vix@ircad.fr
authors.forename: Michel
authors.initials: M
authors.lastname: Vix
authors.forename: Michele
authors.initials: M
authors.lastname: Diana
authors.forename: Keng-Hao
authors.initials: KH
authors.lastname: Liu
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Urso
authors.forename: Didier
authors.initials: D
authors.lastname: Mutter
authors.forename: Hurng-Sheng
authors.initials: HS
authors.lastname: Wu
authors.forename: Jacques
authors.initials: J
authors.lastname: Marescaux
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D005260:Female; D015390:Gastric Bypass; D015391:Gastroplasty; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006017:Glycolipids / Q000097:blood*; D006706:Homeostasis; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000097:blood* / Q000601:surgery; D011446:Prospective Studies; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D002784:Cholesterol; D006442:Glycated Hemoglobin; D006017:Glycolipids; D014280:Triglycerides; C517652:hemoglobin A1c protein, human