Changes in the lipid profile 5 years after bariatric surgery: laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy

Citació

  • Climent E, Benaiges D, Flores-Le Roux JA, Ramón JM, Pedro-Botet J, Goday A. Changes in the lipid profile 5 years after bariatric surgery: laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2018 Aug;14(8):1099-1105. DOI: 10.1016/j.soard.2018.05.006

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  • Resum

    BACKGROUND: Few studies have compared mid-term results of laparoscopic Roux-en-Y gastric bypass (LRYGB) versus laparoscopic sleeve gastrectomy (LSG), and none have focused on lipid profile. OBJECTIVES: To compare LRYGB versus LSG with respect to lipid disturbance evolution and remission at mid-term after bariatric surgery (BS) and to assess associated factors with the remission of lipid disturbances at 5 years. SETTING: Hospital del Mar, Barcelona, from January 2005 to January 2012. METHODS: A retrospective analysis of a nonrandomized, prospective cohort was conducted on patients undergoing BS at Hospital del Mar, Barcelona, from January 2005 to January 2012 with ≥5 years' follow-up. RESULTS: Of 259 patients, 151 (58.3%) completed the 5-year follow-up. The proportion of patients who achieved normal low-density lipoprotein cholesterol levels at 5 years post-LRYGB was greater than after LSG (30/49 [61.2%] versus 6/23 [26.1%]; P = .005), being male sex, absence of statins treatment, and type of BS technique (LRYGB) the associated factors with remission. Hypertriglyceridemia remission was also higher after LRYGB (23/25 [92.0%] versus 10/15 [66.7%]; P = .041), although type of surgery was not an associated factor. No differences were found in remission rates of low high-density lipoprotein cholesterol between groups. Absence of fibrates treatment and 5-year percentage of excess weight loss were independently associated with hypertriglyceridemia remission, and only the latter was independently associated with low high-density lipoprotein cholesterol remission 5 years after surgery. CONCLUSIONS: Five-year outcome data showed that, among patients with severe obesity undergoing BS, LRYGB was associated with a higher total and low-density lipoprotein cholesterol reduction and remission in comparison to LSG, with no differences in hypertriglyceridemia and high-density lipoprotein cholesterol normalization.
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