Skip to main content
Log in

Effect of Bariatric Surgery on High-Density Lipoprotein (HDL) Cholesterol in Non-diabetic Patients with Severe Obesity

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

This study evaluated changes in serum high-density lipoprotein cholesterol (HDL-C) induced by laparoscopic bariatric surgery (BS) in non-diabetic obese subjects with low (L-HDL-C) or normal (N-HDL-C) levels of HDL-C. We assessed whether increased HDL-C is associated with weight loss, serum non-HDL cholesterol (non-HDL-C), serum triglycerides (TG), and physical activity (PA) before and 6 and 15 months after BS.

Methods

In this prospective cohort study, 71 subjects undergoing BS (42 by Roux-en-Y gastric bypass and 29 by sleeve gastrectomy) were evaluated for the % Excess Weight Loss (%EWL), waist circumference (WC), serum levels of glucose, glycosylated hemoglobin, TG, HDL-C, non-HDL-C, and LDL-C, and the degree, time, and energy expenditure related to PA. The short version of the International Physical Activity Questionnaire was used to assess PA.

Results

Levels of HDL-C significantly increased 15 months after BS (p < 0.001) in subjects with low (p < 0.001) or normal (p = 0.017) values at baseline. A similar %EWL, decrease in WC, glucose, non-HDL-C, and LDL-C levels and increase in energy expenditure related to PA, was observed in both groups (L-HDL-C and N-HDL-C) at 15 months after BS. However, the L-HDL-C group presented greater decrease in TG levels compared with N-HDL-C group (p = 0.004). In subjects with increased HDL-C 15 months after BS, there was an association between this increase and the %EWL (p = 0.030), but there was no association with the change in PA.

Conclusions

Irrespective of PA after BS, subjects with low and normal HDL-C levels at baseline showed an increase in HDL-C after BS, and this increase was associated with %EWL induced by BS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Gordon T, Castelli WP, Hjortland MC, et al. High density lipoprotein as a protective factor against coronary heart disease. The Framingham. Study Am J Med. 1977;62(5):707–14.

    Article  CAS  Google Scholar 

  2. Gordon DJ, Probstfield JL, Garrison RJ, et al. High-density lipoprotein cholesterol and cardiovascular disease. Four prospective American studies. Circulation. 1989;79(1):8–15.

    Article  CAS  Google Scholar 

  3. Chapman MJ, Assmann G, Fruchart JC, et al. Raising high-density lipoprotein cholesterol with reduction of cardiovascular risk: the role of nicotinic acid--a position paper developed by the European consensus panel on HDL-C. Curr Med Res Opin. 2004;20(8):1253–68.

    Article  CAS  Google Scholar 

  4. Jung UJ, Choi MS. Obesity and its metabolic complications: the role of adipokines and the relationship between obesity, inflammation, insulin resistance, dyslipidemia and nonalcoholic fatty liver disease. Int J Mol Sci. 2014;15(4):6184–223.

    Article  Google Scholar 

  5. Weissglas-Volkov D, Pajukanta P. Genetic causes of high and low serum HDL-cholesterol. J Lipid Res. 2010;51(8):2032–57.

    Article  CAS  Google Scholar 

  6. Cong L, Zhan JQ, Yang L, et al. Overweight and obesity among low-income Muslim Uyghur women in far western China: correlations of body mass index with blood lipids and implications in preventive public health. PLoS One. 2014;9(2):e90262.

    Article  Google Scholar 

  7. Yang Z, Ding X, Liu J, et al. Associations between anthropometric parameters and lipid profiles in Chinese individuals with age ≥ 40 years and BMI <28kg/m2. PLoS One. 2017;12(6):e0178343.

    Article  Google Scholar 

  8. Rye KA, Bursill CA, Lambert G, et al. The metabolism and anti-atherogenic properties of HDL. J Lipid Res. 2009;50:S195–200.

    Article  Google Scholar 

  9. Hegele RA. Plasma lipoproteins: genetic influences and clinical implications. Nat Rev Genet. 2009;10(2):109–21.

    Article  CAS  Google Scholar 

  10. Larach DB, Cuchel M, Rader DJ. Monogenic causes of elevated HDL cholesterol and implications for development of new therapeutics. Clin Lipidol. 2013;8(6):635–48.

    Article  CAS  Google Scholar 

  11. Adams TD, Mehta TS, Davidson LE, et al. All-cause and cause-specific mortality associated with bariatric surgery: a review. Curr Atheroscler Rep. 2015;17(12):74.

    Article  Google Scholar 

  12. Conselho Federal de Medicina. Resolução CFM n° 2.131/2015. Diário Oficial da União. 2016;8(1):66.

    Google Scholar 

  13. Kjellmo CA, Karlsson H, Nestvold TK, et al. Bariatric surgery improves lipoprotein profile in morbidly obese patients by reducing LDL cholesterol, apoB, and SAA/PON1 ratio, increasing HDL cholesterol, but has no effect on cholesterol efflux capacity. J Clin Lipidol. 2018;12(1):193–202.

    Article  Google Scholar 

  14. Cunha FM, Oliveira J, Preto J, et al. The effect of bariatric surgery type on lipid profile: an age, sex, body mass index and excess weight loss matched study. Obes Surg. 2016;26(5):1041–7.

    Article  Google Scholar 

  15. Parhofer KG. Increasing HDL-cholesterol and prevention of atherosclerosis: a critical perspective. Atheroscler Suppl. 2015;18:109–11.

    Article  Google Scholar 

  16. Williams PT, Stefanick ML, Vranizan KM, et al. The effects of weight loss by exercise or by dieting on plasma high-density lipoprotein (HDL) levels in men with low, intermediate, and normal-to-high HDL at baseline. Metabolism. 1994;43(7):917–24.

    Article  CAS  Google Scholar 

  17. van de Laar AW, Dollé MH, de Brauw LM, et al. Validating the alterable weight loss (AWL) metric with 2-year weight loss outcome of 500 patients after gastric bypass. Obes Surg. 2014;24(7):1085–9.

    Article  Google Scholar 

  18. Pardini R, Matsudo S, Araújo T, et al. Validação do questionário internacional de nível de atividade física (IPAQ - versão 6): estudo piloto em adultos jovens brasileiros. Rev Bras Ciên e Mov. 2001;9(3):45–51.

    Google Scholar 

  19. Ainsworth BE, Haskell WL, Whitt MC, et al. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sport Exerc. 2000;32(9):S498–516.

    Article  CAS  Google Scholar 

  20. Praveen Raj P, Bhattacharya S, Saravana Kumar S, et al. Comparison of effects of sleeve gastrectomy and gastric bypass on lipid profile parameters in Indian obese: a case matched analysis. Obes Surg. 2017;27(10):2606–12.

    Article  CAS  Google Scholar 

  21. Sealed Envelope Ltd. 2012. Power calculator for continuous outcome superiority trial. [Online] Available from: https://www.sealedenvelope.com/power/continuous-superiority/ [Accessed Jan 18 2019].

  22. Rondanelli M, Giacosa A, Morazzoni P, et al. MediterrAsian diet products that could raise HDL-cholesterol: a systematic review. Biomed Res Int. 2016;2016:1–15.

    Article  Google Scholar 

  23. März W, Kleber ME, Scharnagl H, et al. HDL cholesterol: reappraisal of its clinical relevance. Clin Res Cardiol. 2017;106(9):663–75.

    Article  Google Scholar 

  24. Klop B, Elte JWF, Cabezas MC. Dyslipidemia in obesity: mechanisms and potential targets. Nutrients. 2013;5(4):1218–40.

    Article  CAS  Google Scholar 

  25. D'Agostino Sr RB, Vasan RS, Pencina MJ, et al. General cardiovascular risk profile for use in primary care: the Framingham heart study. Circulation. 2008;117(6):743–53.

    Article  Google Scholar 

Download references

Acknowledgments

The authors would like to thank the team of the Centro de Tratamento da Obesidade of the Hospital Santa Rita from Complexo Hospitalar Irmandade Santa Casa de Misericórdia de Porto Alegre for providing conditions to execute the study and the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) for providing the PhD fellowships.

Author information

Authors and Affiliations

Authors

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

The study was approved by the Ethical Committee of the Hospital (Approval number 51843515.1.0000.5335).

Informed Consent

Written informed consent was obtained for each participant in the study.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nienov, O.H., Machado, F.D., Dias, L.S. et al. Effect of Bariatric Surgery on High-Density Lipoprotein (HDL) Cholesterol in Non-diabetic Patients with Severe Obesity. OBES SURG 30, 154–160 (2020). https://doi.org/10.1007/s11695-019-04126-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-019-04126-6

Keywords

Navigation