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Obesity Surgery

, Volume 26, Issue 4, pp 843–855 | Cite as

A Systematic Review and Meta-analysis of the Effect of Gastric Bypass Surgery on Plasma Lipid Levels

  • Kirstin A. CarswellEmail author
  • Ajay P. Belgaumkar
  • Stephanie A. Amiel
  • Ameet G. Patel
Original Contributions

Abstract

Background

Obesity-related dyslipidaemia comprises hypercholesterolaemia, hypertriglyceridaemia, low HDL-cholesterol and normal to raised LDL-cholesterol levels. 40 % of morbidly obese surgical patients have dyslipidaemia. Roux-en-Y gastric bypass (RYGB) surgery has many beneficial metabolic effects, but the full impact on plasma lipids has not been clearly defined.

Methods

A systematic review of electronic databases (Ovid; Medline; PubMed; Embase) between 1960 and March 2012 was performed using search terms including the following: obesity surgery, bariatric surgery, gastric bypass, cholesterol, lipids, triglycerides and non-esterified fatty acids. A total of 2442 manuscripts were screened. Papers with paired plasma lipid levels around RYGB surgery were included. Exclusions included the following: editorials, dual publications, n < 10, resulting in 75 papers of relevance. A meta-analysis was performed of the effect of RYGB surgery upon plasma lipids at different time points up to 4 years following surgery, using a random effects model.

Results

Paired data were available for 7815 subjects around RYGB surgery for morbid obesity with a baseline BMI 48 kg/m2 (n = 2331). There was a reduction in plasma total cholesterol and LDL-C from 1 month up to 4 years post-RYGB (p < 0.00001, p < 0.00001). Following RYGB, HDL-C increased from 1 year onwards (p < 0.00001), and triglyceride levels were reduced postoperatively from 3 months up to 4 years (p < 0.00001). NEFA levels were increased at 1 month postoperatively (p = 0.003), but from 3 months onwards did not differ from preoperative levels (p = 0.07).

Conclusions

RYGB surgery reverses the dyslipidaemia of obesity. These findings support the use of RYGB in the management of high cardiovascular risk lipid profiles in morbid obesity.

Keywords

Gastric bypass surgery Gastric bypass Lipidaemia Cholesterol Triglycerides NEFA 

Abbreviations

AT

Adipose tissue

BA

Bile acid

BMI

Body mass index

GIP

Gastric inhibitory polypeptide

GLP-1

Glucagon-like peptide 1

HDL-C

High-density lipoprotein cholesterol

IR

Insulin resistance

LPL

Lipoprotein lipase

LDL-C

Low-density lipoprotein cholesterol

NEFA

Non-esterified fatty acids

PYY

Peptide tyrosine-tyrosine

RYGB

Roux-en-Y gastric bypass

SMD

Standard mean difference

TG

Triglycerides

T2DM

Type 2 diabetes mellitus

Notes

Conflict of Interest

The authors declare that they have no conflict of interest.

Compliance with Ethical Standards

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

This study does not apply informed consent.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Kirstin A. Carswell
    • 1
    • 2
    Email author
  • Ajay P. Belgaumkar
    • 1
  • Stephanie A. Amiel
    • 2
  • Ameet G. Patel
    • 1
  1. 1.Department of General SurgeryKing’s College HospitalLondonUK
  2. 2.Division of Diabetes and Nutritional SciencesKing’s College LondonLondonUK

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