Advertisement

Effects of Bariatric Surgery on HDL Cholesterol

  • Idoia Genua
  • Analia Ramos
  • Francisca Caimari
  • Carmen Balagué
  • Jose Luis Sánchez-Quesada
  • Antonio Pérez
  • Inka MiñambresEmail author
Original Contributions
  • 8 Downloads

Abstract

Background

Low levels of high-density lipoprotein cholesterol (HDLc) are independent predictive factors of coronary heart disease. Bariatric surgery increases HDLc concentration, but the chronology and predictors of this improvement in HDLc levels are not well-established. The aim of the present study was to analyse the changes over time in HDLc concentrations after bariatric surgery and to determine the predictors of their increase.

Subjects and Methods

This was a retrospective, observational study. The medical records of patients who had undergone bariatric surgery at a tertiary care hospital between January 2007 and March 2015 were reviewed. Patients who underwent revisional surgery or were treated with fibrates were excluded from the analysis.

Results

A total of 185 patients were included in the study. Follow-up rates were as follows: 87% (year 2) and 28% (year 5). At postoperative month 3, HDLc levels decreased significantly versus baseline (− 11.1%; p = 0.000), at which point they began to rise, reaching their maximum level 2 years after bariatric surgery (26.2% increase from baseline; p = 0.000). The increase in HDLc concentration 2 years after surgery correlated with the preoperative HDLc level (r = − 0.292, p = 0.001), and it was greater in patients who underwent sleeve gastrectomy versus gastric bypass (0.36 ± 0.4 vs. 0.18 ± 0.4 mmol/L, respectively; p = 0.018).

Conclusion

Bariatric surgery has a beneficial effect on HDLc levels. The maximum increase in postoperative HDLc concentrations is observed 2 years after surgery. Preoperative HDLc and the type of surgery are both significant predictors of the maximum increase in HDLc levels.

Keywords

Bariatric surgery Lipid profile HDL cholesterol 

Notes

Acknowledgements

We thank Bradley J. Londres for his support in linguistics.

Compliance with Ethical Standards

Competing Interests

The authors declare that they have no conflict of interest.

Ethics Statement and Informed Consent

For this type of study, formal consent is not required.

References

  1. 1.
    Adams KF, Schatzkin A, Harris TB, et al. Overweight, obesity, and mortality in a large prospective cohort of persons 50–71 years old. N Engl J Med. 2006;355:763–78.CrossRefGoogle Scholar
  2. 2.
    Adams TD, Gress RE, Smith SC, et al. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007;357:753–61.CrossRefGoogle Scholar
  3. 3.
    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;240:416–23.CrossRefGoogle Scholar
  4. 4.
    Flum DR, Dellinger EP. Impact of gastric bypass operation on survival: a population-based analysis. J Am Coll Surg. 2004;199:543–51.CrossRefGoogle Scholar
  5. 5.
    MacDonald Jr KG, Long SD, Swanson MS, et al. The gastric bypass operation reduces the progression and mortality of non-insulin-dependent diabetes mellitus. J Gastrointest Surg. 1997;1:213–20.CrossRefGoogle Scholar
  6. 6.
    Sjöström L. Review of the key results from the Swedish Obese Subjects (SOS) trial – a prospective controlled intervention study of bariatric surgery (review). J Intern Med. 2013;273:219–34.CrossRefGoogle Scholar
  7. 7.
    Boido A, Ceriani V, Cetta F, et al. Bariatric surgery and prevention of cardiovascular events and mortality in morbid obesity: mechanisms of action and choice of surgery. Nutr Metab Cardiovasc Dis. 25(5):437–43.CrossRefGoogle Scholar
  8. 8.
    Franssen R, Monajemi H, Stroes ES, et al. Obesity and dyslipidemia. Med Clin North Am. 2011;95:893–902.CrossRefGoogle Scholar
  9. 9.
    Castelli WP. Cholesterol and lipids in the risk of coronary artery disease - the Framingham Heart Study. Can J Cardiol. 1988;4(Suppl):5A–10A.PubMedGoogle Scholar
  10. 10.
    Bays H, Kothari SN, Azagury DE, et al. Lipids and bariatric procedures part 2 of 2: scientific statement from the American Society for Metabolic and Bariatric Surgery (ASMBS), the National Lipid Association (NLA), and Obesity Medicine Association (OMA). Surg Obes Relat Dis. 2016;12:468–95.CrossRefGoogle Scholar
  11. 11.
    Dhabuwala A, Cannan RJ, Stubbs RS. Improvement in comorbidities following weight loss from gastric bypass surgery. Obes Surg. 2000;10:428–35.CrossRefGoogle Scholar
  12. 12.
    Sjöström L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–93.CrossRefGoogle Scholar
  13. 13.
    Nguyen NT, Varela E, Sabio A, et al. Resolution of hyperlipidemia after laparoscopic Roux-en-Y gastric bypass. J Am Coll Surg. 2006;203:24–9.CrossRefGoogle Scholar
  14. 14.
    Benaiges D, Flores-Le-Roux JA, Pedro-Botet J, et al. Impact of restrictive (sleeve gastrectomy) vs hybrid bariatric surgery (Roux-en-Y gastric bypass) on lipid profile. Obes Surg. 2012;22:1268–75.CrossRefGoogle Scholar
  15. 15.
    NIH conference. Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel. Ann Intern Med. 1991;115:956–61.CrossRefGoogle Scholar
  16. 16.
    Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34(28):2159–219.CrossRefGoogle Scholar
  17. 17.
    American Diabetes Association. Classification and diagnosis of diabetes. Diabetes Care. 2016;39(Suppl.1):S13–22.Google Scholar
  18. 18.
    Guyton JR, Blazing MA, Hagar J, et al. Extended-release niacin vs gemfibrozil for the treatment of low levels of high-density lipoprotein cholesterol. Arch Intern Med. 2000;160:1177–84.CrossRefGoogle Scholar
  19. 19.
    Birjmohun RS, Hutten BA, Kastelein JJ, et al. Efficacy and safety of high-density lipoprotein cholesterol-increasing compounds: a meta-analysis of randomized controlled trials. J Am Coll Cardiol. 2005;45:185–97.CrossRefGoogle Scholar
  20. 20.
    ACCORD Study Group, Ginsberg HN, Elam MB, et al. Effects of combination lipid therapy in type 2 diabetes mellitus. N Engl J Med. 2010;362:1563–74.CrossRefGoogle Scholar
  21. 21.
    LaRosa 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
  22. 22.
    Karatasakis A, Danek BA, Karacsonyi J, et al. Effect of PCSK9 inhibitors on clinical outcomes in patients with hypercholesterolemia: a meta-analysis of 35 randomized controlled trials. J Am Heart Assoc. 2017;6(12):e006910.Google Scholar
  23. 23.
    Salas-Salvadó J, Díaz-López A, Ruiz CM, et al. Effect of a lifestyle intervention program with energy-restricted Mediterranean diet and exercise on weight loss and cardiovascular risk factors: one-year results of the PREDIMED-Plus Trial. Diabetes Care. 2018;42:777.  https://doi.org/10.2337/dc18-0836.CrossRefPubMedGoogle Scholar
  24. 24.
    Kraus WE, Houmard JA, Duscha BD, et al. Effects of the amount and intensity of exercise on plasma lipoproteins. N Engl J Med. 2002;347:1483–92.CrossRefGoogle Scholar
  25. 25.
    Investigators AIM-HIGH, 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
  26. 26.
    Barter PJ, Caulfield M, Eriksson M, et al. Effects of torcetrapib in patients at high risk for coronary events. N Engl J Med. 2007;357:2109–22.CrossRefGoogle Scholar
  27. 27.
    Schwartz GG, Olsson AG, Abt M, et al. Effects of dalcetrapib in patients with a recent acute coronary syndrome. N Engl J Med. 2012;367:2089–99.CrossRefGoogle Scholar
  28. 28.
    Lincoff AM, Nicholls SJ, Riesmeyer JS, et al. Evacetrapib and cardiovascular outcomes in high-risk vascular disease. N Engl J Med. 2017;376:1933–42.CrossRefGoogle Scholar
  29. 29.
    Vigilante A, Signorini F, Marani M, et al. Impact on dyslipidemia after laparoscopic sleeve gastrectomy. Obes Surg. 2018:3111–5.CrossRefGoogle Scholar
  30. 30.
    Bays HE, Toth PP, Kris-Etherton PM, et al. Obesity, adiposity, and dyslipidemia: a consensus statement from the National Lipid Association. J Clin Lipidol. 2013;7:304–83.CrossRefGoogle Scholar
  31. 31.
    Capoccia D, Coccia F, Guarisco G, et al. Long-term metabolic effects of laparoscopic sleeve gastrectomy. Obes Surg. 2018;28:2289–96.CrossRefGoogle Scholar
  32. 32.
    Ooi GJ, Earnest A, Doyle L, et al. Detailed description of change in serum cholesterol profile with incremental weight loss after restrictive bariatric surgery. Obes Surg. 2018:1351–62.CrossRefGoogle Scholar
  33. 33.
    Milone M, Lupoli R, Maietta P, et al. Lipid profile changes in patients undergoing bariatric surgery: a comparative study between sleeve gastrectomy and mini-gastric bypass. Int J Surg. 2015;14:28–32.CrossRefGoogle Scholar
  34. 34.
    Spivak H, Sakran N, Dicker D, et al. Different effects of bariatric surgical procedures on dyslipidemia: a registry-based analysis. Surg Obes Relat Dis. 2017;13:1189–94.CrossRefGoogle Scholar
  35. 35.
    Heffron SP, Lin BX, Parikh M, et al. Changes in high-density lipoprotein cholesterol efflux capacity after bariatric surgery are procedure dependent. Arterioscler Thromb Vasc Biol. 2018;38:245–54.CrossRefGoogle Scholar
  36. 36.
    Climent E, Benaiges D, Flores-Le Roux JA, et al. Changes in the lipid profile 5 years after bariatric surgery: laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2018;14:1099–105.CrossRefGoogle Scholar
  37. 37.
    Peterli R, Wölnerhanssen BK, Peters T, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss in patients with morbid obesity: the SM-BOSS Randomized Clinical Trial. JAMA. 2018;319:255–65.CrossRefGoogle Scholar
  38. 38.
    Salminen P, Helmiö M, Ovaska J, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss at 5 years among patients with morbid obesity: the SLEEVEPASS Randomized Clinical Trial. JAMA. 2018;319:241–54.CrossRefGoogle Scholar
  39. 39.
    Verdoia M, Schaffer A, Suryapranata H, et al. Effects of HDL-modifiers on cardiovascular outcomes: a meta-analysis of randomized trials. Nutr Metab Cardiovasc Dis. 2015;25:9–23.CrossRefGoogle Scholar
  40. 40.
    Woudberg NJ, Pedretti S, Lecour S, et al. Pharmacological intervention to modulate HDL: what do we target? Front Pharmacol. 2018;8:989.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  1. 1.Endocrinology and Nutrition ServiceHospital de la Santa Creu i Sant PauBarcelonaSpain
  2. 2.General Surgery ServiceHospital de la Santa Creu i Sant PauBarcelonaSpain
  3. 3.Biomedical Research Institute IIB Sant PauBarcelonaSpain
  4. 4.Universitat Autònoma de BarcelonaBarcelonaSpain
  5. 5.Diabetes and Metabolic Diseases CIBER (CIBERDEM)BarcelonaSpain

Personalised recommendations