title: Changes in Lipid Profile of Obese Patients Following Contemporary Bariatric Surgery: A Meta-Analysis.
abstract: BACKGROUND
  Although metabolic surgery was originally performed to treat hypercholesterolemia, the effects of contemporary bariatric surgery on serum lipids have not been systematically characterized.
  
  
  METHODS
  MEDLINE, EMBASE, and Cochrane databases were searched for studies with ≥ 20 obese adults undergoing bariatric surgery (Roux-en-Y gastric bypass [RYGBP], adjustable gastric banding, biliopancreatic diversion [BPD], or sleeve gastrectomy). The primary outcome was change in lipids from baseline to 1 year after surgery. The search yielded 178 studies with 25,189 subjects (preoperative body mass index 45.5 ± 4.8 kg/m(2)) and 47,779 patient-years of follow-up.
  
  
  RESULTS
  In patients undergoing any bariatric surgery, compared with baseline, there were significant reductions in total cholesterol (TC; -28.5mg/dL), low-density lipoprotein cholesterol (LDL-C; -22.0 mg/dL), triglycerides (-61.6 mg/dL), and a significant increase in high-density lipoprotein cholesterol (6.9 mg/dL) at 1 year (P < .00001 for all). The magnitude of this change was significantly greater than that seen in nonsurgical control patients (eg LDL-C; -22.0 mg/dL vs -4.3 mg/dL). When assessed separately, the magnitude of changes varied greatly by surgical type (Pinteraction < .00001; eg, LDL-C: BPD -42.5 mg/dL, RYGBP -24.7 mg/dL, adjustable gastric banding -8.8 mg/dL, sleeve gastrectomy -7.9 mg/dL). In the cases of adjustable gastric banding (TC and LDL-C) and sleeve gastrectomy (LDL-C), the response at 1 year following surgery was not significantly different from nonsurgical control patients.
  
  
  CONCLUSIONS
  Contemporary bariatric surgical techniques produce significant improvements in serum lipids, but changes vary widely, likely due to anatomic alterations unique to each procedure. These differences may be relevant in deciding the most appropriate technique for a given patient.
authors.affiliation: Leon H. Charney Division of Cardiology, NYU Langone Medical Center, New York, NY.
authors.forename: Sean P
authors.initials: SP
authors.lastname: Heffron
authors.affiliation: Department of Medicine, NYU Langone Medical Center, New York, NY.
authors.forename: Amar
authors.initials: A
authors.lastname: Parikh
authors.affiliation: North Shore - Long Island Jewish University Hospital, Manhasset, NY.
authors.forename: Alexandar
authors.initials: A
authors.lastname: Volodarskiy
authors.affiliation: Department of Surgery, NYU Langone Medical Center, New York, NY.
authors.forename: Christine
authors.initials: C
authors.lastname: Ren-Fielding
authors.affiliation: Leon H. Charney Division of Cardiology, NYU Langone Medical Center, New York, NY.
authors.forename: Arthur
authors.initials: A
authors.lastname: Schwartzbard
authors.affiliation: Medical Library, NYU Langone Medical Center, New York, NY.
authors.forename: Joseph
authors.initials: J
authors.lastname: Nicholson
authors.affiliation: Leon H. Charney Division of Cardiology, NYU Langone Medical Center, New York, NY. Electronic address: sripalbangalore@gmail.com.
authors.forename: Sripal
authors.initials: S
authors.lastname: Bangalore
mesh_terms: D050110:Bariatric Surgery; D002784:Cholesterol / Q000097:blood; D006801:Humans; D008055:Lipids / Q000097:blood*; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000601:surgery*; D014280:Triglycerides / Q000097:blood
chemical_list: D008055:Lipids; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D014280:Triglycerides; D002784:Cholesterol
keywords: Bariatric surgery; Cholesterol; Lipids; Meta-analysis; Obesity