Effects of statin therapy on weight loss and diabetes in bariatric patients.
BACKGROUND
Bariatric surgeries are considered effective treatments for weight loss and improved diabetes control. Statins increase diabetes onset in prospective clinical trials and many bariatric patients with metabolic disease are concurrently on statins.


OBJECTIVE
We retrospectively examined the relationship of statin therapy to weight loss, diabetes mellitus onset and remission, and metabolic outcomes after bariatric surgery.


METHODS
Hospital.


METHODS
A total of 1575 patients (1231 women) underwent laparoscopic adjustable gastric banding (n = 1035), Roux-en-Y gastric bypass (n = 468), or sleeve gastrectomy (n = 72) and were categorized as to statin use (n = 671 statin users) and diabetes status (n = 557 patients with diabetes) preoperatively and at one year follow-up.


RESULTS
New onset cases of diabetes did not differ between patients on and not on preoperative statins (3 versus 4 new diabetes cases, respectively), but diabetes resolved after surgery in 159 (23.7%) patients on preoperative statins and in only 124 (13.7%) patients not on preoperative statins (χ2= 26.1; P<.01). Patients ceasing statin therapy experienced more diabetes remission (n = 85 or 35.7%) than patients consistently using statin therapy at both time points (n = 57 or 17.0%; χ2= 27.3; P< .01).


CONCLUSIONS
In contrast to expectations, our results suggest that diabetes resolves with bariatric surgery more often in patients maintained on statin therapy than in those never on statin therapy whereas cessation of statin therapy is associated with the greatest reductions in diabetes prevalence. These results indicate an impact of statin use on metabolic outcomes following bariatric surgery; a randomized control trial is needed to examine carefully this relationship.
Division of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, Connecticut; Department of Kinesiology, University of Connecticut, Storrs, Connecticut. Electronic address: beth.taylor@hhchealth.org.
Beth A
BA
Taylor
Centers for Surgical Weight Loss, Hartford Hospital, Hartford, Connecticut.
Janet
J
Ng
Division of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, Connecticut.
Andrea
A
Stone
Division of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, Connecticut.
Paul D
PD
Thompson
Centers for Surgical Weight Loss, Hartford Hospital, Hartford, Connecticut.
Pavlos K
PK
Papasavas
Centers for Surgical Weight Loss, Hartford Hospital, Hartford, Connecticut.
Darren S
DS
Tishler
D050110:Bariatric Surgery / Q000379:methods; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000517:prevention & control; D050171:Dyslipidemias / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood*; D009767:Obesity, Morbid / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids
Laparoscopic adjustable gastric band; Roux-en-Y gastric bypass; statins