The Effect of Bariatric Surgery Type on Lipid Profile: An Age, Sex, Body Mass Index and Excess Weight Loss Matched Study

• Published in: Obesity surgery 2016-05, Vol.26 (5), p.1041-1047
• Main Authors: Cunha, Filipe M., Oliveira, Joana, Preto, John, Saavedra, Ana, Costa, Maria M., Magalhães, Daniela, Lau, Eva, Bettencourt-Silva, Rita, Freitas, Paula, Varela, Ana, Carvalho, Davide
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Bariatric Surgery - methods; Body Mass Index; Case-Control Studies; Cholesterol, HDL - blood; Female; Gastrointestinal surgery; Humans; Lipid Metabolism - physiology; Lipids; Lipids - blood; Male; Medicine; Medicine & Public Health; Middle Aged; Obesity; Obesity, Morbid - metabolism; Obesity, Morbid - surgery; Original Contributions; Retrospective Studies; Surgery; Surgical outcomes; Surgical techniques; Weight control; Weight Loss - physiology
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-015-1825-1

Background Bariatric surgery improves lipid profile. A still unanswered question is whether this improvement is merely weight-dependent or also results from factors inherent to specificities of the bariatric procedure. We aimed to study lipid profile 1 year after bariatric surgery and compare its changes between the different procedures in patients matched for initial weight and weight loss. Methods We retrospectively analysed patients submitted to Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (AGB) or sleeve gastrectomy (SG) between 2010 and 2013. Patients were matched for age (±5 years), sex, pre-surgery body mass index (BMI) (±2 Kg/m 2 ) and excess weight loss (EWL) (±5 %). Baseline and 1-year lipid profile, its variation and percentage of variation was compared between surgeries. Results We analysed 229 patients: 72 pairs RYGB-AGB, 47 pairs RYGB-SG and 33 pairs AGB-SG. The median age was 41 (35–52) years and 11.8 % were male. Pre-operative BMI was 44.0 ± 4.6 and 32.1 ± 4.4 Kg/m 2 at 1 year. EWL at 1 year was 64.2 ± 18.9 %. There were no differences in baseline lipid profile between patients submitted to different types of bariatric surgery. At 1 year, high-density lipoprotein cholesterol (HDL) and triglycerides (TG) improved similarly with all surgeries. Total cholesterol (TC) and low-density lipoprotein cholesterol (LDL) at 1 year decreased significantly more in patients submitted to RYGB than in weight-matched patients undergoing AGB or SG. Conclusions RYGB is the only bariatric surgery that reduces TC and LDL in age-, sex-, BMI- and EWL-matched patients. All three procedures improved TG and HDL similarly when the confounding effect of weight loss is eliminated.