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01-05-2018 | Original Contributions

Detailed Description of Change in Serum Cholesterol Profile with Incremental Weight Loss After Restrictive Bariatric Surgery

Authors: Geraldine J. Ooi, Arul Earnest, Lisa Doyle, Cheryl Laurie, John M. Wentworth, Ken Sikaris, Carel W. le Roux, Paul R. Burton, Paul E. O’Brien, Wendy A. Brown

Published in: Obesity Surgery | Issue 5/2018

Abstract

Introduction

Dyslipidemia affects up to 75% of morbidly obese individuals and is a key driver of cardiovascular disease. Weight loss is an established strategy to improve metabolic risk, including dyslipidemia. We aimed to determine weight loss goals for resolution of serum lipid abnormalities, by measuring improvements during progressive weight loss in obese individuals.

Methods

We performed a prospective cohort study of obese individuals with the metabolic syndrome undergoing adjustable gastric banding. Lipid levels were monitored monthly for 9 months, then three monthly until 24 months.

Results

There were 101 participants included, age 47.4 ± 10.9 years with body mass index 42.6 ± 5.9 kg/m². At 24 months, total body weight loss (TBWL) was 18.3 ± 7.9%. This was associated with significant improvements in high-density lipoprotein (HDL) (1.18 vs 1.47, p < 0.001), triglyceride (2.0 vs 1.4, p < 0.001), and total cholesterol to HDL ratio (TC:HDL) (4.6 vs 3.6, p < 0.001). Over this time, progressive and linear improvements in HDL, triglycerides, and TC:HDL were seen with incremental weight loss (observed at 2.5% TBWL intervals). Significant improvements occurred after a threshold weight loss of 7.5–12.5% TBWL was achieved, with odds ratio (OR) 1.48–2.50 for normalization. These odds improved significantly with increasing weight loss (OR 18.2–30.4 with > 25% TBWL). Despite significant weight loss, there was no significant change in low-density lipoprotein (LDL).

Conclusion

Significant improvements in triglycerides, HDL, and TC:HDL occur after 7.5–12.5% TBWL, with ongoing benefit after greater weight loss. LDL needs to be addressed independently, as this was not observed to respond to weight loss alone.

Trial registration number

Australian Clinical Trials Registry (ACTRN12610000049077)

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Title: Detailed Description of Change in Serum Cholesterol Profile with Incremental Weight Loss After Restrictive Bariatric Surgery
Authors: Geraldine J. Ooi
Arul Earnest
Lisa Doyle
Cheryl Laurie
John M. Wentworth
Ken Sikaris
Carel W. le Roux
Paul R. Burton
Paul E. O’Brien
Wendy A. Brown
Publication date: 01-05-2018
Publisher: Springer US
Published in: Obesity Surgery / Issue 5/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-017-3015-9

At a glance: The STEP trials

Springer Medicine

Detailed Description of Change in Serum Cholesterol Profile with Incremental Weight Loss After Restrictive Bariatric Surgery

Abstract

Introduction

Methods

Results

Conclusion

Trial registration number

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Trial registration number

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