Weight loss surgeries shown to improve lipid profiles in obese patients

Serum lipids are significantly improved by certain types of bariatric surgeries, according to an analysis of weight-reduction surgery outcomes published in the Journal of American Medicine.

Sean P. Heffron, MD, MS, MSc, of the Division of Cadiology at NYU’s Langone Medical Center, along with his co-authors, conducted a meta-analysis of 178 studies involving more than 25,000 bariatric surgery patients. One year after their procedures, lipid profiles reported significant reductions in total cholesterol (an average of -28.5 mg/DL), low-density lipoprotein cholesterol (-22.0mg/dL), and trigylcerides (-61.6mg/dL).

“These procedures have shown significant benefits beyond weight reduction, including improvements in serum lipids," Heffron said. "However, changes in serum lipids beyond the period of early, rapid weight loss are not well characterized."

The patients in the analyzed studies were generally between 35 and 45 years of age, with a body mass index between 40 and 50.

To be included, studies had to include at least 20 patients undergoing one of four bariatric surgeries: bilio-pancreatic giversion (BPD), Roux-en-Y gastric bypass (RYGBP), adjustable gastric banding and sleeve gastrectomy. When separated by surgery type, the results were different, as some procedures led to improvement in lipid profile after one year and others didn’t.

“Differences in triglyceride reduction among procedures were most evident at more than one year after surgery, when reductions in subjects undergoing RYGBP and BPD were nearly 50 percent greater than in adjustable gastric banding and sleeve gastrectomy, despite similar baseline BMI in RYGBP and adjustable gastric banding cohorts," Heffron said. "Part of this difference may be secondary to greater weight loss and improvements in insulin sensitivity achieved following RYGBP and BPD versus restrictive procedures. However, the anatomic alterations of RYGBP and BPD may also play important roles.”

Those differences, Heffron said, may be important to consider when deciding which treatment would be the most beneficial for a patient.