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Laparoscopic Roux-En-Y Gastric Bypass Improves Lipid Profile and Decreases Cardiovascular Risk: a 5-Year Longitudinal Cohort Study of 1048 Patients

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Abstract

Background

Dyslipidemia is a known risk factor for cardiovascular (CV) events. The aim of the study was to assess lipid profiles and their impact on CV risk changes in a large patient cohort 5 years after Roux-en-Y gastric bypass (RYGB).

Methods

All patients who underwent primary RYGB for severe obesity in our two hospitals between January 1999 and December 2009 were included. The Framingham risk score was used.

Results

One thousand and forty-eight patients were included, 791 women and 257 men. Five-year complete lipid profile was available for 77% of patients. At 5 years, mean body mass index (BMI) decreased from 45.7 ± 6 to 31 ± 5.8 kg/m2 (p < 0.001), excess BMI loss (EBMIL) was 72.35 ± 22%, and total body weight loss (TWL) 31.5 ± 9%. Lipid values improved significantly. Total- and LDL-cholesterol levels dropped at 1 year from 5.4 to 4.48 mmol/L and 3.2 to 2.41 mmol/L, respectively, and slightly increased thereafter. Triglyceride levels dropped from 2 to 1.17 mmol/L at 1 year and remained unchanged. HDL levels rose continuously from 1.27 to 1.77 mmol/L at 5 years. Lipid profile improved more in patients with greater weight loss (%EBMIL ≥ 50 or %TWL ≥ 25%). Assuming that all patients were non-smokers and other baseline risk factors (hypertension, diabetes) remained unchanged at 5 years, the amelioration of the lipid profile itself yielded to a 27% reduction of CV risk (p < 0.001).

Conclusions

RYGB results in sustained excess weight loss and in amelioration of the lipid profile from the first to fifth postoperative year. This improvement translates into significantly lower CV risk from the first year after surgery.

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Authors and Affiliations

  1. Department of Visceral Surgery, University Hospital (CHUV), Lausanne, Switzerland

    Daniel Gero, Pierre Allemann, Pierre Fournier, Nicolas Demartines & Michel Suter

  2. Division of Endocrinology, Diabetology and Metabolism, University Hospital (CHUV), Lausanne, Switzerland

    Lucie Favre

  3. Department of Surgery, Riviera-Chablais Hospital, Aigle-Monthey, Switzerland

    Michel Suter

  4. Hopital Riviera-Chablais, Chemin du Grand-Chêne, 1860, Aigle, Switzerland

    Michel Suter

Authors
  1. Daniel Gero
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  2. Lucie Favre
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  3. Pierre Allemann
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  4. Pierre Fournier
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  5. Nicolas Demartines
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  6. Michel Suter
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Corresponding author

Correspondence to Michel Suter.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all patients before surgery, which included consent for the procedure as well as for follow-up, inclusion in our database, and de-identified outcome data reporting.

Ethical Approval

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments. The study was approved by the institutional review board (decision 304/15).

Additional information

This study was presented as oral communication at the 7th Congress of the International Federation for the Surgery of Obesity and Metabolic Disorders European Chapter (IFSO-EC), 1–4 June 2016, Gothenburg, Sweden.

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Gero, D., Favre, L., Allemann, P. et al. Laparoscopic Roux-En-Y Gastric Bypass Improves Lipid Profile and Decreases Cardiovascular Risk: a 5-Year Longitudinal Cohort Study of 1048 Patients. OBES SURG 28, 805–811 (2018). https://doi.org/10.1007/s11695-017-2938-5

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  • DOI: https://doi.org/10.1007/s11695-017-2938-5

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