Body weight- independent variations in HDL-cholesterol following gastric bypass
DOI:
https://doi.org/10.23938/S1137-6627/2016000100004Keywords:
Bypass gástrico, dislipemia, recuperación ponderal, composición corporalAbstract
Background. Bariatric surgery has multiple beneficial effects on lipid profile in patients with morbid obesity. However, these changes can be attenuated by weight regain. This retrospective study was designed to assess the effects of gastric bypass (GBP) on different lipid fractions over a 6 year follow-up.
Patients and Methods. We studied 177 patients (135 women) with morbid obesity (BMI 44.2+0.4 kg/m2) aged 42.4+0.9 years before and 3, 6, 9, 12, 24, 36, 48, 60 and 72 months after laparoscopic proximal GBP. Anthropometry, body composition measurement (Bod-Pod) and fasting blood samples were taken in all evaluations to measure total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), triglycerides (TG), glucose and insulin.
Results. GPB was followed by a significant BMI reduction (nadir BMI at 18 m 28.3+0.4 kg/m2 p<0,001) and fat mass decrease (p<0,001). Maximal percentage of excess BMI lost was 84.1% and that of body fat was 87% 18 months after GBP. These numbers decreased to 65.6% and 38.3% (p<0,005 vs nadir) respectively 72 months after the operation, indicating both weight and fat mass regain. TG and LDL-C values decreased 30% with respect to preoperative levels, while HDL-C increased 97% over initial values. This HDL-C increase was progressive even over the weight regain phase. Both TC/HDL-C and TG/HDL-C ratios normalized after GBP and values were sustained over the weight regain period until the end of the study.
Conclusions. These results confirm the beneficial effects of GBP on all lipid fractions, which are maintained over 6 years of follow-up. Globally, the rise in HDL-C seems to be independent of weight or fat mass changes, since it increases even over the weight regain phase, so contributing to a reduction in the prevalence of dyslipidaemia and to cardiovascular risk reduction.
Key words. Gastric bypass. Dyslipidaemia. Weight regain. Body composition.
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References
1. FRUHBECK G, YUMUK V. Obesity: a gateway disease with a raising prevalence. Obes Facts 2014; 7 (Supl2): 33-36.
https://doi.org/10.1159/000361004
2. BAYS HE, JONES PH, BROWN WV, JACOBSON TA. National Lipid Association. National Lipid Association Annual Summary of Clinical Lipidology 2015. J Clin Lipidol 2014; 8 (6 Suppl): S1-36.
https://doi.org/10.1016/j.jacl.2014.10.002
3. FRIED M, YUMUK V, OPPERT JM, SCOPINARO N, TORRES A, WEINER R et al. Interdisciplinary European guidelines on metabolic and bariatric surgery. Obes Surg 2014; 24: 42-55.
https://doi.org/10.1007/s11695-013-1079-8
4. SJÖSTRÖM L. Review of the key results from the Swedish Obese Subjects (SOS) trial - a prospective controlled intervention study of bariatric surgery. J Intern Med 2013; 273: 219-234.
https://doi.org/10.1111/joim.12012
5. SJÖSTRÖM L, PELTONEN M, JACOBSON P, SJÖSTRÖM CD, KARASON K, WEDEL H et al. Bariatric surgery and long-term cardiovascular events. JAMA 2012; 307: 56-65.
https://doi.org/10.1001/jama.2011.1914
6. COURCOULAS AP, CHRISTIAN NJ, BELLE SH, BERK PD, FLUM DR, GARCIA L et al. Longitudinal Assessment of Bariatric Surgery (LABS) Consortium. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA 2013; 310: 2416-2425.
https://doi.org/10.1001/jama.2013.280928
7. PUZZIFERRI N, ROSHEK TB 3rd, Mayo HG, Gallagher R, Belle SH, Livingston EH. Long-term follow-up after bariatric surgery: a systematic review. JAMA 2014; 312: 934-942.
https://doi.org/10.1001/jama.2014.10706
8. VALENTÍ V, ZUGASTI A. Programa de cirugía bariátrica laparoscópica en la Clínica Universidad de Navarra-Complejo Hospitalario de Navarra: resultados a un año. An Sist Sanit Navar 2012; 35: 433-444.
https://doi.org/10.4321/S1137-66272012000300009
9. GARCIA-MARIRRODRIGA I, AMAYA-ROMERO C, RUIZ-DIAZ GP, FÉRNANDEZ S, BALLESTA-LÓPEZ C, POU JM et al. Evolution of lipid profiles after bariatric surgery. Obes Surg 2012; 22: 609-616.
https://doi.org/10.1007/s11695-011-0534-7
10. TIES JS, ZLABEK JA, KALLIES KJ, AL-HAMADINI M, KOTHARI SN. The effect of laparoscopic gastric bypass on dyslipidemia in severely obese patients: a 5-year
follow-up analysis. Obes Surg 2014; 24: 549-553.
https://doi.org/10.1007/s11695-013-1120-y
11. CARSWELL KA, BELGAUMKAR AP, AMIEL SA, PATEL AG. A systematic review and meta-analysis of the effect of gastric bypass surgery on plasma lipid levels. Obes Surg 2015 Jul 26. [Epub ahead of print] PubMed PMID: 26210195.
https://doi.org/10.1007/s11695-015-1829-x
12. BROLIN RE, BRADLEY LJ, WILSON AC, Cody RP. Lipid risk profile and weight stability after gastric restrictive operations for morbid obesity. J Gastrointest
Surg 2000; 4: 464-469.
https://doi.org/10.1049/cp:20000553
13. DALLAL RM, HATALSKI A, TRANG A, CHERNOFF A. Longitudinal analysis of cardiovascular parameters after gastric bypass surgery. Surg Obes Relat Dis 2012; 8: 703-709.
https://doi.org/10.1016/j.soard.2011.09.020
14. SJÖSTRÖM L, LINDROOS AK, PELTONEN M, TORGERSON J, BOUCHARD C, CARLSSON B et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery; Swedish Obese Subjects Study Scientific Group. N Engl J Med 2004; 351: 2683-2693.
https://doi.org/10.1056/NEJMoa035622
15. WELLS JCK, FULLER NJ. Precision of measurement and body size in whole-body air-displacement plethysmography. Int J Obes 2001; 25: 1161-1167.
https://doi.org/10.1038/sj.ijo.0801634
16. GIANNINI C, SANTORO N, CAPRIO S, KIM G, LARTAUD D, SHAW M et al. The triglyceride to HDL-cholesterol ratio. Association with insulin resistance in obese youths of different ethnics backgrounds. Diabetes Care 2011; 34: 1869-1874.
https://doi.org/10.2337/dc10-2234
17. BALTASAR A, PEREZ N, SERRA C, BOU R, BENGOCHEA M, BORRÁS F et al. Weight loss reporting: predicted body mass index after bariatric surgery. Obes Surg 2011; 21: 367-372.
https://doi.org/10.1007/s11695-010-0243-7
18. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2014; 37(Suppl. 1): S81-90.
https://doi.org/10.2337/dc14-S081
19. HIGA K, HO T, TERCERO F, YUNUS T, BOONE KB. Laparoscopic Roux-en-Y gastric bypass: 10-year follow-up. Surg Obes Relat Dis 2011; 7: 516-525.
https://doi.org/10.1016/j.soard.2010.10.019
20. FLUM DR, BELLE SH, KING WC, WAHED AS, BERK P, CHAPMAN W et al. Longitudinal Assessment of Bariatric Surgery (LABS) Consortium. Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med 2009; 361: 445-454.
https://doi.org/10.1056/NEJMoa0901836
21. VAN GANSE E, LAFOREST L, ALEMAO E, DAVIES G, GUTKIN S, YIN D et al. Lipid-modifying therapy and attainment of cholesterol goals in Europe: the Return on Expenditure Achieved for Lipid Therapy (REALITY) study. Curr Med Res Opin 2005; 21: 1389-1399.
https://doi.org/10.1185/030079905X59139
22. REAVEN G. Insulin resistance and coronary heart disease in non diabetic individuals. Arterioscler Thromb Vasc Biol 2012; 32: 1754-1759.
https://doi.org/10.1161/ATVBAHA.111.241885
23. ILLÁN-GÓMEZ F, GONZÁLVEZ-ORTEGA M, OREA-SOLER I, ALCARAZ-TAFALLA MS, ARAGÓN-ALONSO A, PASCUAL-DÍAZ M et al. Obesity and inflammation: change in adiponectin, C-reactive protein, tumour necrosis factor-alpha and interleukin-6 after bariatric surgery. Obes Surg 2012; 22: 950-955.
https://doi.org/10.1007/s11695-012-0643-y
24. FRÜHBECK G, DIEZ CABALLERO A, GIL MJ. Fundus functionality and ghrelin concentrations after bariatric surgery. N Engl J Med 2004; 350: 308-309.
https://doi.org/10.1056/NEJM200401153500323
25. DE HOLLANDA A, JIMÉNEZ A, CORCELLES R, LACY AM, PATRASCIOIU I, VIDAL J et al. Gastrointestinal hormones and weight loss response after Roux-en-Y gastric bypass. Surg Obes Relat Dis 2014; 10: 814-819.
https://doi.org/10.1016/j.soard.2014.01.022
26. OSTO E, DOYTCHEVA P, CORTEVILLE C, BUETER M, DÖRIG C, STIVALA S et al. Rapid and body weight-independent improvement of endothelial and high-density lipoprotein function after Roux-en-Y gastric bypass: role of glucagon-like peptide-1. Circulation 2015; 131: 871-881.
https://doi.org/10.1161/CIRCULATIONAHA.114.011791
27. BENETTI A, DEL PUPPO M, CROSIGNANI A, VERONELLI A, MASCI E, FRIGÈ F et al. Cholesterol metabolism after bariatric surgery in grade 3 obesity: differences between malabsorptive and restrictive procedures. Diabetes Care 2013; 36: 1443-1447.
https://doi.org/10.2337/dc12-1737
28. GRIFFO E, NOSSO G, LUPOLI R, COTUGNO M, SALDALAMACCHIA G, VITOLO G et al. Early improvement of postprandial lipemia after bariatric surgery in obese type 2 diabetic patients. Obes Surg 2014; 24: 765-770.
https://doi.org/10.1007/s11695-013-1148-z
29. MATUCHANSKY C. Fecal microbiota after gastric bypass in human obesity. Am J Clin Nutr 2014; 99: 649-650.
https://doi.org/10.3945/ajcn.113.078139
30. FEIG JE, HEWING B, SMITH JD, HAZEN SL, FISHER EA. High-density lipoprotein and atherosclerosis regression: evidence from preclinical and clinical studies. Circ Res 2014; 114: 205-213.
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