Abstract
BackgroundThe beneficial effects in lipid profiles after obesity surgery might be associated with the decrease in cardiovascular risk. However, direct comparison between different surgical techniques has not been extensively performed.MethodsIn the present study we compare 20 obese women submitted to laparoscopic Roux en Y gastric bypass (RYGB) with 20 women submitted to sleeve gastrectomy (SG). Twenty control women matched for age and baseline cardiovascular risk were also included. Both patients and controls were followed up for 1 year after surgery or conventional treatment with diet and exercise, respectively. Lipid profiles were measured at baseline, 6 and 12 months later. Carotid intima-media thickness was measured by ultrasonography at baseline and at the end of the study.ResultsWomen submitted to bariatric surgery showed a decrease in total cholesterol, triglycerides, oxidized-LDL and ApoB, and an increase in HDL and ApoA concentrations that occurred regardless of the surgical procedure. LDL concentrations, however, decreased only after RYGB whereas Lp(a) showed no changes. We did not observe any correlation between the changes in serum lipid concentrations and those in carotid intima-media thickness.ConclusionsSleeve gastrectomy and gastric bypass induce a similar beneficial effect on serum lipids in women with high cardiovascular risk 1 year after surgery.
Highlights
The beneficial effects in lipid profiles after obesity surgery might be associated with the decrease in cardiovascular risk
The number of patients on statins were higher in the group submitted to Roux en Y gastric bypass (RYGB) than in the groups treated with sleeve gastrectomy (SG) diet and life-style modification (Table 1)
The cardiovascular risk measured by the Systematic Coronary Risk Evaluation (SCORE) was high (5–9% at 10 years) in all patients except for one control, one patient submitted to SG and one patient submitted to RYGB, all of whom showed very high risk (> 10% at 10 years)
Summary
The beneficial effects in lipid profiles after obesity surgery might be associated with the decrease in cardiovascular risk. The use of obesity surgery procedures has increased steadily in the past decades because such procedures characteristically result in much larger long-term weight loss than that usually achieved following diet and life-style modification [6]. This tendency has been driven by the low complications of modern laparoscopic surgical procedures that, not free of nutritional and metabolic issues [7,8,9,10], clearly compensate for the substantial long-term morbidity and mortality of severe obesity [11]. The marked weight loss that usually follows bariatric surgery ameliorates the atherogenicity of plasma lipoproteins by reducing the ApoB-containing lipoproteins and oxidised low density-lipoproteins (oxLDL), as well as by increasing the HDL-2 subfraction [20]
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