Obesity Surgery

, Volume 20, Issue 5, pp 578–582 | Cite as

One Year Improvements in Cardiovascular Risk Factors: a Comparative Trial of Laparoscopic Roux-en-Y Gastric Bypass vs. Adjustable Gastric Banding

  • Gavitt A. Woodard
  • Joseph Peraza
  • Stephanie Bravo
  • Loren Toplosky
  • Tina Hernandez-Boussard
  • John M. Morton
Clinical Research

Abstract

Background

Coronary artery disease (CAD) is the leading cause of death in the industrialized world with obesity as a leading preventable risk factor. Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric banding (LAGB) have been shown to improve certain biochemical cardiovascular risk factors (BCRFs) at 1 year post-op, however no study has directly compared the 12-month BCRF improvements of RYGB vs. LAGB.

Methods

At a single academic institution (2004–2009), we measured BCRF in 838 consecutive bariatric patients (765 RYGB, 73 LAGB) pre-operatively and at 12 months post-operatively. BCRF included total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides (Trig), Trig/HDL ratio, lipoprotein(a) (Lp(a)), homocysteine (HmC), high sensitivity C-reactive protein (hs-CRP), fasting insulin (FI), and hemoglobin A1C (Hgb A1C). Pre-op and 12-month post-op values were compared by a paired t test of equal variance.

Results

At 12 months post-op, RYGB patients had lost 77% of their excess weight and had significant improvements in TC, LDL, HDL, Trig, Trig/HDL, HmC, hs-CRP, FI, and Hgb A1C. LAGB patients lost 47.6% of their excess weight and had significant improvements in Trig, Trig/HDL, HmC, hs-CRP, and Hgb A1C. Having RYGB instead of LAGB was predictive of significantly greater improvements in TC at 12 months post-operatively.

Conclusions

In this study, both RYGB and LAGB demonstrated significant weight loss and improvements in BCRF at 12 months post-op. RYGB produced significant improvements in a greater number of BCRFs and in some instances the 12-month post-op BCRF values were significantly lower risk in RYGB vs. LAGB patients.

Keywords

Cardiovascular risk factors Bariatric surgery Comparative trial Roux-en-Y gastric bypass Laparoscopic adjustable gastric banding Cholesterol Triglycerides C-reactive protein Fasting insulin Hemoglobin A1C 

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Copyright information

© Springer Science + Business Media, LLC 2010

Authors and Affiliations

  • Gavitt A. Woodard
    • 1
  • Joseph Peraza
    • 1
  • Stephanie Bravo
    • 1
  • Loren Toplosky
    • 1
  • Tina Hernandez-Boussard
    • 1
  • John M. Morton
    • 1
    • 2
  1. 1.Department of General SurgeryStanford University School of MedicineStanfordUSA
  2. 2.StanfordUSA

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