Obesity Surgery

, Volume 22, Issue 8, pp 1268–1275

Impact of Restrictive (Sleeve Gastrectomy) vs Hybrid Bariatric Surgery (Roux-en-Y Gastric Bypass) on Lipid Profile

  • D. Benaiges
  • J. A. Flores-Le-Roux
  • J. Pedro-Botet
  • J. M. Ramon
  • A. Parri
  • M. Villatoro
  • M. J. Carrera
  • M. Pera
  • E. Sagarra
  • L. Grande
  • A. Goday
  • On behalf the Obemar Group
Clinical Research

DOI: 10.1007/s11695-012-0662-8

Cite this article as:
Benaiges, D., Flores-Le-Roux, J.A., Pedro-Botet, J. et al. OBES SURG (2012) 22: 1268. doi:10.1007/s11695-012-0662-8

Abstract

Background

Few studies have evaluated the impact of hybrid versus purely restrictive bariatric surgery on lipid profile, with the results being contradictory. The effect of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) on lipid profile was compared.

Methods

A nonrandomized prospective cohort study was conducted on severely obese patients undergoing bariatric surgery. Indication for the type of surgical procedure was based on clinical criteria. Patients on lipid-lowering drugs and those that could not be matched for age, sex, and body mass index were excluded. Finally, 51 patients who underwent LSG and 51 undergoing LRYGB completed this study.

Results

During the first year post-surgery, no differences in percentage of excess weight loss and triglyceride reduction were found between groups. After LRYGR, low-density lipoprotein (LDL) cholesterol concentrations fell significantly (125.9 ± 29.3 to 100.3 ± 26.4 mg/dl, p < 0.001), whereas no significant changes were observed in the LSG group (118.6 ± 30.7 to 114.6 ± 33.5 mg/dl, p = 0.220). High-density lipoprotein (HDL) cholesterol increase was significantly greater after LSG (15.4 ± 13.1 mg/dl) compared with LRYGB (9.4 ± 14.0 mg/dl, p = 0.032). Factors independently associated with LDL cholesterol reduction were higher baseline total cholesterol and undergoing LRYGB. A greater increase in HDL cholesterol was associated with LSG, older age, and baseline HDL cholesterol.

Conclusions

LRYGB produces an overall improvement in lipid profile, with a clear benefit in all lipid fractions. Although LSG does not alter LDL cholesterol levels, its effect on HDL cholesterol is comparable to or greater than that obtained with malabsorptive techniques.

Keywords

Laparoscopic sleeve gastrectomyLaparoscopic Roux-en-Y gastric bypassLipid profileCholesterolTriglyceride

Copyright information

© Springer Science + Business Media, LLC 2012

Authors and Affiliations

  • D. Benaiges
    • 1
    • 2
  • J. A. Flores-Le-Roux
    • 1
    • 2
  • J. Pedro-Botet
    • 1
    • 2
  • J. M. Ramon
    • 2
    • 3
  • A. Parri
    • 1
  • M. Villatoro
    • 1
  • M. J. Carrera
    • 1
  • M. Pera
    • 2
    • 3
  • E. Sagarra
    • 1
  • L. Grande
    • 2
    • 3
  • A. Goday
    • 1
    • 2
  • On behalf the Obemar Group
  1. 1.Department of Endocrinology and NutritionHospital del MarBarcelonaSpain
  2. 2.Universitat Autònoma de BarcelonaBarcelonaSpain
  3. 3.Section of Gastrointestinal SurgeryHospital del MarBarcelonaSpain