Does Bariatric Surgery Improve Obese Patients’ Lipid Profiles?

A new study has found that, in addition to aiding weight loss and decreasing cardiovascular-related mortality risk among obese individuals, bariatric surgery can improve lipid profiles in this patient population.

Investigators searched MEDLINE, EMBASE, and Cochrane databases in an effort to find studies including more than 20 obese adults undergoing bariatric surgery, adjustable gastric banding, biliopancreatic diversion (BPD), or sleeve gastrectomy. The search ultimately yielded 178 studies with 25,189 subjects and 47,779 patient-years of follow-up. Compared with baseline, there were significant reductions in total cholesterol among patients undergoing any bariatric surgery, as well as substantial decreases in low-density lipoprotein cholesterol and triglycerides. In addition, the authors saw a sizable increase in high-density lipoprotein cholesterol at 1 year. The magnitude of this change was “significantly greater than that seen in non-surgical control patients,” according to the researchers.
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Bariatric surgery “is the most effective weight-loss intervention that we have to treat obesity,” said lead study author Sean Heffron, MD, MS, MSc, an instructor in the Department of Medicine at the New York University School of Medicine, who noted that obese patients frequently also have dyslipidemia.

Overall, the findings “demonstrate that obese patients who undergo bariatric surgery exhibit improvements in each component of the common lipid profile, in addition to losing weight,” Heffron said, adding that these changes persist beyond the period of early, rapid weight loss associated with each surgery.  

However, he says, the degree of change in various components of the lipid profile may vary greatly, depending upon the surgical procedure that a patient undergoes.

“We feel that the expected changes in lipid profile following each of the 4 currently performed procedures may be considered in individual patients when the choice of bariatric procedure is being made,” Heffron said, “along with the patient’s other obesity-related comorbidities, the morbidity, recovery, and potential side effects of each procedure,” for example.

—Mark McGraw

Reference

Heffron S, Parikh A, Volodarskiy A, et al. Changes in lipid profile of obese patients following contemporary bariatric surgery: a meta-analysis [published online February 17, 2016]. Am J Med. doi: 10.1016/j.amjmed.2016.02.004.