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



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.


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.


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).


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.


Gastric bypass surgery Gastric bypass Lipidaemia Cholesterol Triglycerides NEFA 



Adipose tissue


Bile acid


Body mass index


Gastric inhibitory polypeptide


Glucagon-like peptide 1


High-density lipoprotein cholesterol


Insulin resistance


Lipoprotein lipase


Low-density lipoprotein cholesterol


Non-esterified fatty acids


Peptide tyrosine-tyrosine


Roux-en-Y gastric bypass


Standard mean difference




Type 2 diabetes mellitus


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.


  1. 1.
    Mason EE, Ito C. Gastric bypass in obesity. Surg Clin N Am. 1967;47:1345.PubMedGoogle Scholar
  2. 2.
    Griffen Jr WO, Young VL, Stevenson CC. A prospective comparison of gastric and jejuno-ileal bypass procedures for morbid obesity. Ann Surg. 1977;186:500.PubMedPubMedCentralCrossRefGoogle Scholar
  3. 3.
    Pories WJ, Swanson MS, MacDonald KG, et al. Who would have thought it? An operative proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg. 1995;22:339–52.CrossRefGoogle Scholar
  4. 4.
    Maggard MA, Sugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142:547–59.PubMedCrossRefGoogle Scholar
  5. 5.
    Sjostrom L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. NEJM. 2004;351:2683–93.PubMedCrossRefGoogle Scholar
  6. 6.
    Buchwald H, Estok R, Fahrback K, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122:248–56. e5.PubMedCrossRefGoogle Scholar
  7. 7.
    Lee WJ, Chong K, Chen CY, et al. Diabetes remission and insulin secretion after gastric bypass in patients with BMI < 35 kg/m2. Obes Surg. 2011;21:889–95.PubMedCrossRefGoogle Scholar
  8. 8.
    Meijer RI, van Wagensveld BA, Siegert CE, et al. Bariatric surgery as a novel treatment for type 2 diabetes mellitus: a systematic review. Arch Surg. 2011;146:744–50.PubMedCrossRefGoogle Scholar
  9. 9.
    Ferchak CV, Meneghini LF. Obesity, bariatric surgery and type 2 diabetes—a systematic review. Diabetes Metab Res Rev. 2004;20:438–45.PubMedCrossRefGoogle Scholar
  10. 10.
    Dixon JB, Zimmet P, Alberti KG, et al. Bariatric surgery: an IDF statement for obese type 2 diabetes. Diabet Med. 2011;28:628–42.PubMedPubMedCentralCrossRefGoogle Scholar
  11. 11.
    Howard BV. Obesity and dyslipidaemia. Endocrinol Metab Clin N Am. 2003;32:855–67.CrossRefGoogle Scholar
  12. 12.
    Keys A, Menotti A, Aravanis C, et al. The seven countries study: 2,289 deaths in 15 years. Prev Med. 1984;13:141–54.PubMedCrossRefGoogle Scholar
  13. 13.
    Williams KJ, Tabas I. The response to retention hypothesis of early atherogenesis. Arterioscler Thromb. 1995;15:551–61.CrossRefGoogle Scholar
  14. 14.
    Nishi K, Itabe H, Uno M, et al. Oxidized LDL in carotid plaques and plasma associates with plaque instability. Arterioscler Thromb Vasc Biol. 2002;22:1640–54.Google Scholar
  15. 15.
    Nissen SE, Tuzcu EM, Schoenhagen P, et al. Effect of intensive compared with moderate lipid-lowering therapy on progression of coronary atherosclerosis: a randomized controlled trial. JAMA. 2004;291:1071–80.PubMedCrossRefGoogle Scholar
  16. 16.
    Hensen LO, Thayssen P, Pedersen KE, et al. Regression of coronary atherosclerosis by simvastatin: a serial intravascular ultrasound study. Circulation. 2004;110:265–70.CrossRefGoogle Scholar
  17. 17.
    Okazaki S, Yokoyama T, Miyauchi K, et al. Early statin treatment in patients with acute coronary syndrome: demonstration of the beneficial effect on atherosclerotic lesions by serial volumetric intravascular ultrasound analysis during half a year after coronary event: the ESTABLISH Study. Circulation. 2004;110:1061–8.PubMedCrossRefGoogle Scholar
  18. 18.
    Baigent C, Keech A, Kearney PM, et al. Efficacy and safety of cholesterol-lowering treatment. Prospective meta-analysis of data from 90, 056 participants in randomized trials of statins. Lancet. 2005;366:1267–78.PubMedCrossRefGoogle Scholar
  19. 19.
    Nicholls SJ, Tuzcu EM, Sipahi I, et al. Statins, high-density lipoprotein cholesterol, and regression of coronary atherosclerosis. JAMA. 2007;297:499–508.PubMedCrossRefGoogle Scholar
  20. 20.
    Thomas CB, Cohen BH. The familial occurrence of hypertension and coronary artery disease, with observations concerning obesity and diabetes. Ann Intern Med. 1955;42:90–127.PubMedCrossRefGoogle Scholar
  21. 21.
    The Longitudinal Assessment of Bariatric Surgery (LABS) Consortium. Peri-operative safety in the longitudinal assessment of bariatric surgery. N Engl J Med. 2009;361:445–54.CrossRefGoogle Scholar
  22. 22.
    Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. BMJ. 2009;3:e123–30.Google Scholar
  23. 23.
    Buffington CK, Cowan GSM, Hughes TA, et al. Significant changes in the lipid-lipoprotein status of premenopausal morbidly obese females following gastric bypass surgery. Obes Surg. 1994;4:328–35.PubMedCrossRefGoogle Scholar
  24. 24.
    Cowan Jr GS, Buffington CK. Significant changes in blood pressure, glucose, and lipids with gastric bypass surgery. World J Surg. 1998;22:987–92.PubMedCrossRefGoogle Scholar
  25. 25.
    Buchwald H, Estok Z, Fahrback K, et al. Trends in mortality in bariatric surgery. Surgery. 2007;142:621–35.PubMedCrossRefGoogle Scholar
  26. 26.
    Langin D. Adipose tissue lipolysis as a metabolic pathway to define pharmacological strategies against obesity and the metabolic syndrome. Pharmacol Res. 2006;53:482–4919.PubMedCrossRefGoogle Scholar
  27. 27.
    Dixon JB, O’Brien P. A disparity between conventional lipid and insulin resistance markers at body mass index levels greater than 34 kg/m2. Int J Obes Metab Dis. 2001;25:793–7.CrossRefGoogle Scholar
  28. 28.
    Brolin RE, Kenler HA, Wilson AC, et al. Serum lipids after gastric bypass surgery for morbid obesity. Int J Obes. 1990;14:939–50.PubMedGoogle Scholar
  29. 29.
    Wolf AM, Beisiegel U, Kortner B, et al. Does gastric restriction surgery reduce the risks of metabolic diseases? Obes Surg. 1998;8:9–13.PubMedCrossRefGoogle Scholar
  30. 30.
    Kelly TM, Jones SB. Changes in serum lipids after gastric bypass surgery. Lack of a relationship to weight loss. Int J Obes. 1986;10:443–52.PubMedGoogle Scholar
  31. 31.
    Gleysteen JJ, Barboriak JJ. Improvement in heart disease risk factors after gastric bypass. Arch Surg. 1983;118:681–3.PubMedCrossRefGoogle Scholar
  32. 32.
    Gonen B, Halverson JD, Schonfeld G. Lipoprotein levels in morbidly obese patients with massive, surgically induced weight loss. Metabolism. 1983;32:492–6.PubMedCrossRefGoogle Scholar
  33. 33.
    Buchwald H, Varco RL, Matts JP, et al. Effect of partial ileal bypass surgery on mortality and morbidity from coronary heart disease in patients with hypercholesterolemia. Report of the Program on the Surgical Control of the Hyperlipidemias (POSCH). N Engl J Med. 1990;323:946–55.PubMedCrossRefGoogle Scholar
  34. 34.
    Christou NV, Sampalis JS, Liberman M, et al. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg. 2004;240:416–24.PubMedPubMedCentralCrossRefGoogle Scholar
  35. 35.
    Brown EK, Settle EA, Van Rij AM. Food intake patterns of gastric bypass patients. J Am Diet Assoc. 1982;80:437–43.PubMedGoogle Scholar
  36. 36.
    Kenler HA, Brolin RE, Cody RP. Changes in eating behaviour after horizontal gastroplasty and Roux-en-Y gastric bypass. Am J Clin Nutr. 1990;52:87–92.PubMedGoogle Scholar
  37. 37.
    Kruseman M, Leimgruber A, Zumbach F, et al. Dietary, weight, and psychological changes among patients with obesity, 8 years after gastric bypass. J Am Diet Assoc. 2010;110:527–34.PubMedCrossRefGoogle Scholar
  38. 38.
    le Roux CW, Welbourn R, Werling M, et al. Gut hormones as mediators of appetite and weight loss after Roux-en-Y gastric bypass. Ann Surg. 2007;246:780–5.PubMedCrossRefGoogle Scholar
  39. 39.
    Neary NM, Small CJ, Druce MR, et al. Peptide YY 3–36 and glucagon-like peptide-1 7–36 inhibit food intake additively. Endocrinology. 2005;146:5120–7.PubMedCrossRefGoogle Scholar
  40. 40.
    Borg CM, le Roux CW, Ghatei MA, et al. Progressive rise in gut hormone levels after Roux-en-Y gastric bypass suggests gut adaptation and explains altered satiety. Br J Surg. 2006;93:210–5.PubMedCrossRefGoogle Scholar
  41. 41.
    Thirlby RC, Bahiraei F, Randall J, et al. Effect of Roux-en-Y gastric bypass on satiety and food likes: the role of genetics. J Gastrointest Surg. 2006;10:270–7.PubMedCrossRefGoogle Scholar
  42. 42.
    Olbers T, Bjorkman S, Lindroos A, et al. Body composition, dietary intake, and energy expenditure after laparoscopic Roux-en-Y gastric bypass and laparoscopic vertical banded gastroplasty: a randomized clinical trial. Ann Surg. 2006;244:715–22.PubMedPubMedCentralCrossRefGoogle Scholar
  43. 43.
    Odstrcil EA, Martinez JG, Santa Ana CA, et al. The contribution of malabsorption to the reduction in net energy absorption after long-limb Roux-en-Y gastric bypass. Am J Clin Nutr. 2010;92:704–13.PubMedCrossRefGoogle Scholar
  44. 44.
    Coughlin K, Bell RM, Bivins BA, et al. Preoperative and postoperative assessment of nutrient intakes in patients who have undergone gastric bypass surgery. Arch Surg. 1983;118:813–6.PubMedCrossRefGoogle Scholar
  45. 45.
    Mathews DH, Lawrence Jr W, Poppell JW, et al. Change in effective circulating volume during experimental dumping syndrome. Surgery. 1960;48:185–94.PubMedGoogle Scholar
  46. 46.
    Dapri G, Cadiere GB, Himpens J. Laparoscopic reconversion of Roux-en-Y gastric bypass to original anatomy: technique and preliminary outcome. Obes Surg. 2011;21:1289–95.PubMedCrossRefGoogle Scholar
  47. 47.
    Dietal M. The change in the dumping syndrome concept. Obes Surg. 2008;18:1622–4.CrossRefGoogle Scholar
  48. 48.
    Brolin RL, Robertson LB, Kenler HA, et al. Weight loss and dietary intake after vertical banded gastroplasty and Roux-en-Y gastric bypass. Ann Surg. 1994;220:782–90.PubMedPubMedCentralCrossRefGoogle Scholar
  49. 49.
    Ito C, Mason EE. Gastric bypass and pancreatic secretion. Surgery. 1971;69:526–32.PubMedGoogle Scholar
  50. 50.
    Pihlajamaki J, Gronlund S, Simonen M, et al. Cholesterol absorption decreases after Roux-en-Y gastric bypass but not after gastric banding. Metabolism. 2010;59:866–72.PubMedCrossRefGoogle Scholar
  51. 51.
    Carswell KA, Vincent RP, Belgaumkar AP, et al. The effect of bariatric surgery on intestinal absorption and transit time. Obes Surg. 2014;24(5):796–805.PubMedCrossRefGoogle Scholar
  52. 52.
    Kumar R, Lieske JC, Collazo-Clavell ML, et al. Fat malabsorption and increased intestinal oxalate absorption are common after Roux-en-Y gastric bypass surgery. Surgery. 2011;149:654–61.PubMedPubMedCentralCrossRefGoogle Scholar
  53. 53.
    Gonlachanvit S, Coleski R, Owyang C, et al. Inhibitory actions of a high fibre diet on intestinal gas transit in healthy volunteers. Gut. 2004;53:1577–82.PubMedPubMedCentralCrossRefGoogle Scholar
  54. 54.
    Flint A, Raben A, Ersboll AK, et al. The effect of physiological levels of glucagon-like peptide-1 on appetite, gastric emptying, energy and substrate metabolism in obesity. Int J Obes. 2001;25:781–92.CrossRefGoogle Scholar
  55. 55.
    Werling M, Vincent RP, Cross GF, et al. Enhanced fasting and post-prandial plasma bile acid responses after Roux-en-Y gastric bypass surgery. Scand J Gastroenterol. 2013;48:1257–64.PubMedCrossRefGoogle Scholar
  56. 56.
    Ponsky TA, Brody F, Pucci E. Alterations in gastrointestinal physiology after Roux-en-Y gastric bypass. Am J Coll Surg. 2005;201:125–30.CrossRefGoogle Scholar
  57. 57.
    Kohli R, Bradley D, Setchell KD, et al. Weight loss induced by Roux-en-Y gastric bypass but not laparoscopic adjustable gastric banding increases circulating bile acids. J Clin Endocrinol Metab. 2013;98:708–12.CrossRefGoogle Scholar
  58. 58.
    Simonen M, Dali-Youcef N, Kaminska D, et al. Conjugated bile acids associate with altered rates of glucose and lipid oxidation after Roux-en-Y gastric bypass. Obes Surg. 2012;22:1473–80.PubMedPubMedCentralCrossRefGoogle Scholar
  59. 59.
    Patti ME, Houten SM, Bianco AC, et al. Serum bile acids are higher in humans with prior gastric bypass: potential contribution to improved glucose and lipid metabolism. Obesity. 2009;17:1671–7.PubMedPubMedCentralCrossRefGoogle Scholar
  60. 60.
    Nakatani H, Kasama K, Oshiro T, et al. Serum bile acid along with plasma incretins and serum high-molecular weight adiponectin levels are increased after bariatric surgery. Metabolism. 2009;58:1400–7.PubMedCrossRefGoogle Scholar
  61. 61.
    Pournaras DJ, Glicksman C, Vincent RP, et al. The role of bile after Roux-en-Y gastric bypass in promoting weight loss and improving glycaemic control. Endocrinology. 2012;153:3613–9.PubMedPubMedCentralCrossRefGoogle Scholar
  62. 62.
    Zhang H, DiBaise JK, Zuccolo A, et al. Human gut microbiota in obesity and after gastric bypass. Proc Natl Acad Sci U S A. 2009;106:2365–70.PubMedPubMedCentralCrossRefGoogle Scholar
  63. 63.
    Wang PY, Caspi L, Lam CK, et al. Upper intestinal lipids trigger a gut-brain-liver axis to regulate glucose production. Nature. 2008;452:1012–6.PubMedCrossRefGoogle Scholar
  64. 64.
    Kong LC, Tap J, Aron-Wisnewsky J, et al. Gut microbiota after gastric bypass in human obesity: increased richness and associations of bacterial genera with adipose tissue genes. Am J Clin Nutr. 2013;98:16–24.PubMedCrossRefGoogle Scholar
  65. 65.
    Knop FK. Bile-induced secretion of glucagon-like peptide-1: pathophysiological implications in type 2 diabetes? Am J Physiol Endocrinol Metab. 2010;299:10–3.CrossRefGoogle Scholar
  66. 66.
    Li JV, Ashrafian H, Bueter M, et al. Metabolic surgery profoundly influences gut microbial-host metabolic cross-talk. Gut. 2011;60:1214–23.PubMedPubMedCentralCrossRefGoogle Scholar
  67. 67.
    Cani PD, Osto M, Geurts L, et al. Involvement of gut microbiota in the development of low-grade inflammation and type 2 diabetes associated with obesity. Gut Microbes. 2012;3:279–88.PubMedPubMedCentralCrossRefGoogle Scholar
  68. 68.
    Miettinen TA, Gylling H. Cholesterol absorption efficiency and sterol metabolism in obesity. Atherosclerosis. 2000;153:241–8.PubMedCrossRefGoogle Scholar
  69. 69.
    Chapman MJ, Ginsberg HN, Amarenco P, et al. Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management. Eur Heart J. 2011;32:1345–61.PubMedPubMedCentralCrossRefGoogle Scholar
  70. 70.
    Taylor AJ, Villines TC, Stanek EJ, et al. Extended-release niacin or ezetimibe and carotid intima-media thickness. N Engl J Med. 2009;361:2113–22.PubMedCrossRefGoogle Scholar
  71. 71.
    Lee JM, Robson MD, Yu LM, et al. Effects of high-dose modified-release nicotinic acid on atherosclerosis and vascular function: a randomized, placebo-controlled, magnetic resonance imaging study. J Am Coll Cardiol. 2009;54:1787–94.PubMedCrossRefGoogle Scholar
  72. 72.
    Miettinen TA. Detection of changes in human cholesterol metabolism. Ann Clin Res. 1970;2:1–21.Google Scholar
  73. 73.
    La Rosa JC, He J, Vupputuri S. Effect of statins on risk of coronary disease: a meta-analysis of randomized controlled trials. JAMA. 1999;282:2340–6.CrossRefGoogle Scholar
  74. 74.
    Shepherd J, Blauw GJ, Murphy MB, et al. Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial. Lancet. 2002;360:1623–30.PubMedCrossRefGoogle Scholar
  75. 75.
    Heart Protection Study Collaborative Group. MRC/BHF heart protection study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet. 2002;360:7–22.CrossRefGoogle Scholar
  76. 76.
    ALLHAT Officers and Coordinators for the ALLHAT collaborative research Group. The antihypertensive and lipid-lowering treatment to prevent heart attach trial. Major outcomes in moderately hypercholesterolemic, hypertensive patients randomised to pravastatin vs usual care: the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT-LLT). JAMA. 2002;288:2998–3007.CrossRefGoogle Scholar
  77. 77.
    Baigent C, Keech A, Kearney PM, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005;366:1267–78.PubMedCrossRefGoogle Scholar
  78. 78.
    AIM-HIGH Investigators, Boden WE, Probstfield JL, et al. Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. N Engl J Med. 2011;365:2255–67.CrossRefGoogle Scholar
  79. 79.
    Giorgino F, Laviola L, Eriksson JQ. Regional differences of insulin action in adipose tissue: insights from in vivo and in vitro studies. Acta Physiol Scand. 2005;183:13–30.PubMedCrossRefGoogle Scholar
  80. 80.
    Carpentier AC, Frisch F, Brassard P, et al. Mechanism of insulin-stimulated clearance of plasma non-esterified fatty acids in humans. Am J Physiol Endocrinol Metab. 2007;292:E693–701.PubMedCrossRefGoogle Scholar
  81. 81.
    Miles JM, Wooldridge D, Greliner WJ, et al. Nocturnal and postprandial free fatty acid kinetics in normal and type 2 diabetic subjects. Diabetes. 2003;52:675–81.PubMedCrossRefGoogle Scholar
  82. 82.
    Brassard P, Frisch F, Lavoie F, et al. Impaired plasma non-esterified fatty acid tolerance is an early defect in the natural history of type 2 diabetes. J Clin Endocrinol Metab. 2008;93:837–44.PubMedPubMedCentralCrossRefGoogle Scholar
  83. 83.
    Yki-Jarvinen II. Ectopic fat accumulation: an important cause of insulin resistance in humans. J R Soc Med. 2002;95 Suppl 42:39–45.PubMedPubMedCentralGoogle Scholar
  84. 84.
    Villanueva-Penacarrillo ML, Marques L, Gonzalez N, et al. Effects of GLP-1 on lipid metabolism in human adipocytes. Horm Metab Res. 2001;33:73–7.PubMedCrossRefGoogle Scholar
  85. 85.
    Sancho V, Trigo MV, Martin-Duce A, et al. Effect of GLP-1 on D-glucose transport, lipolysis and lipogenesis in adipocytes of obese subjects. Int J Mol Med. 2006;17:1133–7.PubMedGoogle Scholar
  86. 86.
    Valet P, Berlan M, Beauville M, et al. Neuropeptide Y and peptide YY inhibit lipolysis in human and dog fat cells through a pertussis toxin-sensitive G protein. J Clin Invest. 1990;85:291–5.PubMedPubMedCentralCrossRefGoogle Scholar
  87. 87.
    Getty-Kaushik L, Song DH, Boylan MO, et al. Glucose-dependent insulinotropic polypeptide modulates adipocyte lipolysis and re-esterification. Obesity. 2006;14:1124–31.PubMedCrossRefGoogle Scholar
  88. 88.
    Lafontan M, Langin D. Lipolysis and lipid mobilisation in human adipose tissue. Prog Lipid Res. 2009;48:275–97.PubMedCrossRefGoogle Scholar
  89. 89.
    Singer P, Godicke W, Voigt S, et al. Postprandial hyperinsulinaemia in patients with mild essential hypertension. Hypertension. 1985;7:182–6.PubMedCrossRefGoogle Scholar
  90. 90.
    Reaven GM, Ilollenbeck C, Jeng C-Y, et al. Measurement of plasma glucose, free fatty acid, lactate and insulin for 24 h in patients with NIDDM. Diabetes. 1988;37:1020–4.PubMedCrossRefGoogle Scholar
  91. 91.
    Ruge T, Hodson L, Cheeseman J, et al. Fasted to fed trafficking of fatty acids in human adipose tissue reveals a novel regulatory step for enhanced fat storage. J Clin Endocrinol Metab. 2009;94:1781–8.PubMedCrossRefGoogle Scholar
  92. 92.
    Widjaja A, Morris RJ, Levy LC, et al. Within- and between-subject variation in commonly measured anthropometric and biochemical variables. Clin Chem. 1999;45:561–6.PubMedGoogle Scholar
  93. 93.
    Magkos F, Patterson BW, Mittendorfer B. Reproducibility of stable isotope-labeled tracer measures of VLDL-triglyceride and VLDL-apolipoprotein B-100 kinetics. J Lipid Res. 2007;48:1204–11.PubMedCrossRefGoogle Scholar
  94. 94.
    Sidhu D, Naugler C. Fasting time and lipid levels in a community-based population. Arch Intern Med. 2012;172:1707–10.PubMedCrossRefGoogle Scholar
  95. 95.
    Campose H, Khoo C, Sacks FM. Diurnal and acute pattern of postprandial apolipoprotein B-48 in VLDL, IDL and LDL from normolipidemic human. Atherosclerosis. 2005;181:345–51.CrossRefGoogle Scholar
  96. 96.
    National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation and treatment of high blood cholesterol in adults (adult treatment panel III) final report. Circulation. 2002;106:3143–421.Google Scholar
  97. 97.
    De Backer G, Ambrosioni E, Borch-Johnsen K, et al. European guidelines on cardiovascular disease and prevention in clinical practice. Atherosclerosis. 2004;173:381–91.PubMedCrossRefGoogle Scholar
  98. 98.
    Bansal S, Buring JE, Rifai N, et al. Fasting compared with non-fasting triglycerides and risk of cardiovascular events in women. JAMA. 2007;298:309–16.PubMedCrossRefGoogle Scholar
  99. 99.
    Nordestgaard BG, Benn M, Scnohr P, et al. Non-fasting triglycerides and risk of myocardial infarction, ischemic heart disease and death in men and women. JAMA. 2007;298:299–308.PubMedCrossRefGoogle Scholar
  100. 100.
    Durstine JL, Grandjean PW, Cox CA, et al. Lipids, lipoproteins, and exercise. J Cardpulm Rehabil. 2002;22:385–98.CrossRefGoogle Scholar
  101. 101.
    Tamboli RA, Hossain HA, Marks PA, et al. Body composition and energy metabolism following Roux-en-Y gastric bypass surgery. Obesity. 2010;18:1718–24.PubMedPubMedCentralCrossRefGoogle Scholar
  102. 102.
    Hatoum IJ, Stein HK, Merrifield BF, et al. Capacity for physical activity predicts weight loss after Roux-en-Y gastric bypass. Obesity. 2008;507:1–8.Google Scholar
  103. 103.
    Welch G, Wesolowski C, Piepul B, et al. Physical activity predicts weight loss following gastric bypass surgery: findings from a support group survey. Obes Surg. 2008;18:517–24.PubMedCrossRefGoogle Scholar
  104. 104.
    Skottheim IB, Stormark K, Christensen H, et al. Significantly altered systemic exposure to atorvastatin acid following gastric bypass surgery in morbidly obese patients. Clin Pharmacol Ther. 2009;86:311–8.PubMedCrossRefGoogle Scholar
  105. 105.
    Ward S, Lloyd Jones M, Pandor A, et al. A systematic review and economic evaluation of statins for the prevention of coronary events. Health Technol Assess. 2007;11:1–160.Google Scholar

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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