Clinical Research

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. BenaigesAffiliated withDepartment of Endocrinology and Nutrition, Hospital del MarUniversitat Autònoma de Barcelona Email author 
  • , J. A. Flores-Le-RouxAffiliated withDepartment of Endocrinology and Nutrition, Hospital del MarUniversitat Autònoma de Barcelona
  • , J. Pedro-BotetAffiliated withDepartment of Endocrinology and Nutrition, Hospital del MarUniversitat Autònoma de Barcelona
  • , J. M. RamonAffiliated withUniversitat Autònoma de BarcelonaSection of Gastrointestinal Surgery, Hospital del Mar
  • , A. ParriAffiliated withDepartment of Endocrinology and Nutrition, Hospital del Mar
  • , M. VillatoroAffiliated withDepartment of Endocrinology and Nutrition, Hospital del Mar
  • , M. J. CarreraAffiliated withDepartment of Endocrinology and Nutrition, Hospital del Mar
  • , M. PeraAffiliated withUniversitat Autònoma de BarcelonaSection of Gastrointestinal Surgery, Hospital del Mar
  • , E. SagarraAffiliated withDepartment of Endocrinology and Nutrition, Hospital del Mar
    • , L. GrandeAffiliated withUniversitat Autònoma de BarcelonaSection of Gastrointestinal Surgery, Hospital del Mar
    • , A. GodayAffiliated withDepartment of Endocrinology and Nutrition, Hospital del MarUniversitat Autònoma de Barcelona
    • , On behalf the Obemar Group

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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 gastrectomy Laparoscopic Roux-en-Y gastric bypass Lipid profile Cholesterol Triglyceride