Endocrine Abstracts

Aim: To analyze the influence of bariatric surgery over serum lipids in patients with morbid obesity after 1 year of surgery.

Methods: Retrospective study of 88 patients before and after 1 year of bariatric surgery (65 by pass and 23 sleeve). We collected data about age, sex, other diseases, anthropometric measures and biochemical parameters: glucose, uric acid, total cholesterol (TC), HDL-C, LDL-C, triglycerides (TG), VLDL and non-HDL-C, homocistein and leptin.

Results: Mean age: 45.11±10.01 years, 78.4% women. Weight pre and postsurgery: by pass 136.2±23.5 vs 87.1±14.7 (P<0.05) and sleeve 149.2±35.5 vs 96.3±21.1 (P<0.05). Mean weight lost for by pass was: 51.8±18.1 vs 52.7±24.1 kg in sleeve (NS). One year postsurgery there was a significant decrease of glucose, HbA1c, uric acid and leptin. There was a significant improvement in HDL-C: 43.9 9.2 pre vs 52.02 12.3 mg/dl postsurgery (P<0.05) and decrease of TC: 200.8±36.6 pre vs 185±35.9 mg/dl postsurgery (P<0.05), LDL-C: 128.9±31.9 pre vs 114.1±34.8 mg/dl postsurgery, TG: 150.5±81.1 pre vs 98.8±51.3 mg/dl postsurgery (P<0.05), C no HDL: 156.2±35.1 pre vs 133.8±38.8 postsurgery (P<0.05), VLDL: 30.1±16.2 pre vs 19.7±10.3 postsurgery (P<0.05). Mean lipids levels before by pass and sleeve were (mg/dl): CT: 202±37.9 vs 199.2±28.2 (NS), HDL: 45.0±9.3 vs 43.8±10.3 (NS), TG: 150.8±82.7 vs 145.9±67.2 (NS), LDL-C: 131.2±33.5 vs 125.8±25.2 (NS), non-HDL-C: 156.9±38.1 vs 155.4±29.4 (NS), VLDL-C: 30.2±8.3 vs 29.2±10.2 (NS). Mean lipids levels 1 year after surgery were in by pass and sleeve (mg/dl): TC: 181.6±34.4 vs 194.1±44.6 (NS), HDL: 51.7±11.5 vs 53.4±14.7 (NS), LDL: 110.6±31.9 vs 131.0±41.2 (P<0.05), TG: 99.7±53.2 vs 78.7±28.6 (NS), non-HDL-C: 129, 8.9±32.1 vs 140.6±21.5 (NS), VLDL-C: 19.9±10.1 vs 15.7±9.6 (NS). Mean LDL-C decrease after by pass was 21.6±34.3 mg/dl vs an increase of 6.7±26.7 mg/dl (P>0.05) after sleeve. Mean decrease of non-HDL-C after by pass was 27.5±36.6 and after sleeve 7.2±26.5 (P<0.05). There was no correlation between weight and lipids decrease in both groups.

Before surgery 36.8% of patients were treated with lipid lowering drugs but 1 year after surgery only 6.8% were treated with these drugs.

Conclusion: Both methods of bariatric surgery improve lipid profile but patients with by pass surgery have more decrease of LDL-C and non-HDL-C than sleeve patients.