Different effects of bariatric surgical procedures on dyslipidemia: a registry-based analysis

Hadar Spivak, Nasser Sakran, Dror Dicker, Moshe Rubin, Itamar Raz, Tamy Shohat, Orit Blumenfeld

Research output: Contribution to journalArticlepeer-review

Abstract

Background The scale and variables linked to bariatric surgery‘s effect on dyslipidemia have not been conclusive. Objective To compare the effect of Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and adjustable gastric banding (LAGB) on dyslipidemia Setting National bariatric surgery registry. Methods Plasma lipids and associated variables were compared at baseline and 1 year (12±4 mo) after surgery for registry patients with dyslipidemia enrolled from June 2013 to August 2014. Results The greatest mean total-cholesterol (TC) reduction was observed post-RYGB, 226.7±26.4 to 181.3±30.9 mg/dL (19.9%, n = 208), followed by post-SG, 227.9±24.4 to 206.7±34.2 mg/dL (8.9%, n = 1515; P<.001). Normal TC levels of below 200 mg/dL were achieved by 76% post-RYGB patients compared with 43.5% post-SG patients (odds ratio [OR] = 6.24, 95% confidence interval [CI]: 3.69–10.53) and 25.6% post-LABG patients (OR = 9.66, 95% CI: 4.11–22.67; P<.01). Although equivalent patterns were observed for low-density-lipoprotein cholesterol (LDL), the levels of high-density-lipoprotein cholesterol (HDL) were most improved post-SG, reaching normal levels in 58.1% of SG male patients versus 39.5% of RYGB male patients (OR = 1.56, 95% CI: 1.04–2.35), (P =.02). The lowering of triglyceride levels by approximately 75% was comparable after SG and RYGB procedures. The type of surgery was the strongest independent predictor for all lipid level improvements or remissions. Male sex was an independent predictor for LDL normalization only (OR = 1.88, 95% CI: 1.24–2.85). Excess weight loss offered no meaningful prediction for lipid improvement (OR = 1.01–1.03). Conclusion Particular types of bariatric surgeries had different effects on dyslipidemia, independent of weight loss. Overall, the RYGB achieved the biggest reduction in plasma lipids (TC and LDL), although SG did affect HDL. Our results could aid in the decision-making process regarding the most appropriate procedure for patients with dyslipidemia.

Original languageEnglish
Pages (from-to)1189-1194
Number of pages6
JournalSurgery for Obesity and Related Diseases
Volume13
Issue number7
DOIs
StatePublished - Jul 2017
Externally publishedYes

Keywords

  • Adjustable gastric banding
  • Dyslipidemia
  • High density
  • Lipids
  • Lipoprotein
  • Low density
  • Roux-en-Y gastric bypass
  • Sleeve gastrectomy
  • Total cholesterol
  • Triglycerides

Fingerprint

Dive into the research topics of 'Different effects of bariatric surgical procedures on dyslipidemia: a registry-based analysis'. Together they form a unique fingerprint.

Cite this