Skip to main content
Top
Published in: Obesity Surgery 10/2018

01-10-2018 | Original Contributions

Impact on Dyslipidemia After Laparoscopic Sleeve Gastrectomy

Authors: Agustina Vigilante, Franco Signorini, Marcos Marani, Virginia Paganini, Germán Viscido, Luciano Navarro, Lucio Obeide, Federico Moser

Published in: Obesity Surgery | Issue 10/2018

Login to get access

Abstract

Background

Improvement of dyslipidemia is an important benefit of bariatric surgery. The benefits of laparoscopic sleeve gastrectomy (LSG) among dyslipidemia are still a matter of debate.

Methods

We conducted a retrospective descriptive study between 2010 and 2013. Obese patients undergoing LSG, with recorded dyslipidemia at admission and a follow-up for at least 1 year, were included for analysis. Demographic characteristics, medication in use, and a complete lipid profile were collected before surgery. After surgery, weight was controlled at 1, 3, 6, and 12 months. Lipid profile was re-evaluated 1 year after surgery. Patients were divided according to weight loss into two groups: (A) adequate weight loss and (B) inadequate weight loss. Lipid profile evolution was then compared between groups.

Results

One hundred seven patients met the inclusion criteria. Pre-op mean BMI was 45.13 ± 7.5 kg/m2. One year after LSG, mean BMI was 30.6 ± 7.1 kg/m2 with a change in BMI of 11.5 ± 6.6 kg/m2, a %TWL of 26.9 ± 13.5%, and a %EWL of 60.3 ± 36.6%. Hypercholesterolemia and hypertriglyceridemia remission was achieved in 45 and 86% of the patients and improved in another 19 and 4% respectively. Seventy-four percent improved HDL levels. LDL levels improved in 39% and remitted in 37%. Medication was discontinued in 43.7%. HDL increase and LDL, TG, and non-HDL-C decrease were significantly greater in group A.

Conclusions

LSG produces an improvement in lipid profile, with a significant increase in HDL and a decrease in LDL, triglycerides, and non-HDL-C.
Literature
1.
go back to reference WHO. Obesity and overweight. Fact sheet N°311. Geneva: World Health Organization; 2015. WHO. Obesity and overweight. Fact sheet N°311. Geneva: World Health Organization; 2015.
2.
go back to reference The Global BMI Mortality Collaboration. Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet. 2016;388(10046):776–86.CrossRefPubMedPubMedCentral The Global BMI Mortality Collaboration. Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet. 2016;388(10046):776–86.CrossRefPubMedPubMedCentral
3.
go back to reference Gloy VL, Briel M, Bhatt DL, et al. Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ. 2013;347:f5934.CrossRefPubMedPubMedCentral Gloy VL, Briel M, Bhatt DL, et al. Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ. 2013;347:f5934.CrossRefPubMedPubMedCentral
4.
go back to reference Catapano A, Graham I, De Backer G, et al. 202016 ESC/EAS guidelines for the management of dyslipidaemias. Eur Heart J. 2016;37(39):2999–3058.CrossRefPubMed Catapano A, Graham I, De Backer G, et al. 202016 ESC/EAS guidelines for the management of dyslipidaemias. Eur Heart J. 2016;37(39):2999–3058.CrossRefPubMed
5.
go back to reference Bays H, Kothari SN, Azagury DE, et al. Lipids and bariatric procedures part 2 of 2: scientific statements 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(3):468–95.CrossRefPubMed Bays H, Kothari SN, Azagury DE, et al. Lipids and bariatric procedures part 2 of 2: scientific statements 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(3):468–95.CrossRefPubMed
6.
go back to reference Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.CrossRefPubMed Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.CrossRefPubMed
7.
go back to reference Santry HP, Gillen DL, Lauderdale DS. Trends in bariatric surgical procedures. JAMA. 2005;294:1909–17.CrossRefPubMed Santry HP, Gillen DL, Lauderdale DS. Trends in bariatric surgical procedures. JAMA. 2005;294:1909–17.CrossRefPubMed
8.
go back to reference Li J, Lai D, Wu D. Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy to treat morbid obesity-related comorbidities: a systematic review and meta-analysis. Obes Surg. 2016;26(2):429–42.CrossRefPubMed Li J, Lai D, Wu D. Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy to treat morbid obesity-related comorbidities: a systematic review and meta-analysis. Obes Surg. 2016;26(2):429–42.CrossRefPubMed
9.
go back to reference Regan JP, Inabnet WB, Gagner M, et al. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13:861–4.CrossRefPubMed Regan JP, Inabnet WB, Gagner M, et al. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13:861–4.CrossRefPubMed
10.
go back to reference Zacharoulis D, Sioka E, Papamargaritis D, et al. Influence of the learning curve on safety and efficiency of laparoscopic sleeve gastrectomy. Obes Surg. 2012;22(3):411–5. 20CrossRefPubMed Zacharoulis D, Sioka E, Papamargaritis D, et al. Influence of the learning curve on safety and efficiency of laparoscopic sleeve gastrectomy. Obes Surg. 2012;22(3):411–5. 20CrossRefPubMed
11.
go back to reference Breaux JA, Kennedy CI, Richardson WS. Advanced laparoscopic skills decrease the learning curve for laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2007;21:985–8.CrossRefPubMed Breaux JA, Kennedy CI, Richardson WS. Advanced laparoscopic skills decrease the learning curve for laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2007;21:985–8.CrossRefPubMed
12.
go back to reference ASMBS Clinical Issues Committee. Updated position statement on sleeve gastrectomy as a bariatric procedure. Surg Obes Relat Dis. 2012;8(3):e21–6.CrossRef ASMBS Clinical Issues Committee. Updated position statement on sleeve gastrectomy as a bariatric procedure. Surg Obes Relat Dis. 2012;8(3):e21–6.CrossRef
13.
go back to reference Peterli R, Wölnerhanssen BK, Vetter D, et al. Laparoscopic sleeve gastrectomy versus Roux-Y-gastric bypass for morbid obesity-3-year outcomes of the Prospective Randomized Swiss Multicenter Bypass Or Sleeve Study (SM-BOSS). Ann Surg. 2017;265(3):466–73.CrossRefPubMed Peterli R, Wölnerhanssen BK, Vetter D, et al. Laparoscopic sleeve gastrectomy versus Roux-Y-gastric bypass for morbid obesity-3-year outcomes of the Prospective Randomized Swiss Multicenter Bypass Or Sleeve Study (SM-BOSS). Ann Surg. 2017;265(3):466–73.CrossRefPubMed
14.
go back to reference Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes—5-year outcomes. N Engl J Med. 2017;376:641–51.CrossRefPubMedPubMedCentral Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes—5-year outcomes. N Engl J Med. 2017;376:641–51.CrossRefPubMedPubMedCentral
15.
go back to reference Brethauer SA, Kim J, el Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis. 2015;11(3):489–506.CrossRefPubMed Brethauer SA, Kim J, el Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis. 2015;11(3):489–506.CrossRefPubMed
16.
go back to reference Jacobson TA, Ito MK, Maki KC, et al. National Lipid Association recommendations for patient-centered management of dyslipidemia: part 1—executive summary. J Clin Lipidol. 2014;8(5):473–88.CrossRefPubMed Jacobson TA, Ito MK, Maki KC, et al. National Lipid Association recommendations for patient-centered management of dyslipidemia: part 1—executive summary. J Clin Lipidol. 2014;8(5):473–88.CrossRefPubMed
18.
go back to reference Chevallier JM, Paita M, Rodde-Dunet MH, et al. Predictive factors of outcome after gastric banding: a nationwide survey on the role of center activity and patients’ behavior. Ann Surg. 2007;246(6):1034–9.CrossRefPubMed Chevallier JM, Paita M, Rodde-Dunet MH, et al. Predictive factors of outcome after gastric banding: a nationwide survey on the role of center activity and patients’ behavior. Ann Surg. 2007;246(6):1034–9.CrossRefPubMed
19.
go back to reference Coleman KJ, Toussi R, Fujioka K. Do gastric bypass patient characteristics, behavior, and health differ depending upon how successful weight loss is defined? Obes Surg. 2010;20(10):1385–92.CrossRefPubMed Coleman KJ, Toussi R, Fujioka K. Do gastric bypass patient characteristics, behavior, and health differ depending upon how successful weight loss is defined? Obes Surg. 2010;20(10):1385–92.CrossRefPubMed
20.
go back to reference Coleman KJ, Huang YC, Hendee F, et al. Three-year weight outcomes from a bariatric surgery registry in a large integrated healthcare system. Surg Obes Relat Dis. 2014;10(3):396–403.CrossRefPubMed Coleman KJ, Huang YC, Hendee F, et al. Three-year weight outcomes from a bariatric surgery registry in a large integrated healthcare system. Surg Obes Relat Dis. 2014;10(3):396–403.CrossRefPubMed
21.
go back to reference Heneghan HM, Yimcharoen P, Brethauer SA, et al. Influence of pouch and stoma size on weight loss after gastric bypass. Surg Obes Relat Dis. 2012;8(4):408–15.CrossRefPubMed Heneghan HM, Yimcharoen P, Brethauer SA, et al. Influence of pouch and stoma size on weight loss after gastric bypass. Surg Obes Relat Dis. 2012;8(4):408–15.CrossRefPubMed
23.
go back to reference 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(4):304–83.CrossRefPubMed 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(4):304–83.CrossRefPubMed
24.
go back to reference Colquitt JL, Pickett K, Loveman E, et al. Surgery for weight loss in adults. Cochrane Data base Syst Rev. 2014;8:CD003641. Colquitt JL, Pickett K, Loveman E, et al. Surgery for weight loss in adults. Cochrane Data base Syst Rev. 2014;8:CD003641.
25.
go back to reference Cunha FM, Olivera J, Preto J, et al. The effect of bariatric surgery type on lipid profile: an age, sex, body mass index, and excess weight loss matched study. Obes Surg. 2016;26(5):1041–7.CrossRefPubMed Cunha FM, Olivera J, Preto J, et al. The effect of bariatric surgery type on lipid profile: an age, sex, body mass index, and excess weight loss matched study. Obes Surg. 2016;26(5):1041–7.CrossRefPubMed
26.
go back to reference Benaiges L-RF, Botet P, 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.CrossRefPubMed Benaiges L-RF, Botet P, 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.CrossRefPubMed
27.
go back to reference Strain G, Saif T, Ebel F, et al. Lipid profile changes in the severely obese after laparoscopic sleeve gastrectomy (LSG), 1, 3, and 5 years after surgery. Obes Surg. 2015;25:285–9.CrossRefPubMed Strain G, Saif T, Ebel F, et al. Lipid profile changes in the severely obese after laparoscopic sleeve gastrectomy (LSG), 1, 3, and 5 years after surgery. Obes Surg. 2015;25:285–9.CrossRefPubMed
28.
go back to reference Capoccia D, Coccia F, Silecchia G, Guarisco G, Testa M, Rendina R, Abbatini F, et al. Long-term metabolic effects of laparoscopic sleeve gastrectomy. Obes Surg 2018. Capoccia D, Coccia F, Silecchia G, Guarisco G, Testa M, Rendina R, Abbatini F, et al. Long-term metabolic effects of laparoscopic sleeve gastrectomy. Obes Surg 2018.
Metadata
Title
Impact on Dyslipidemia After Laparoscopic Sleeve Gastrectomy
Authors
Agustina Vigilante
Franco Signorini
Marcos Marani
Virginia Paganini
Germán Viscido
Luciano Navarro
Lucio Obeide
Federico Moser
Publication date
01-10-2018
Publisher
Springer US
Published in
Obesity Surgery / Issue 10/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-018-3343-4

Other articles of this Issue 10/2018

Obesity Surgery 10/2018 Go to the issue