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Atherogenic Dyslipidemia Remission 1 Year After Bariatric Surgery

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Abstract

Purpose

Given the lack of evidence of the effect of bariatric surgery (BS) on atherogenic dyslipidemia (AD), which is a characteristic of obese subjects, this study aimed to describe the remission rate of AD 1 year after BS in severely obese patients.

Materials and Methods

A non-randomised, prospective cohort study was conducted in patients undergoing laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy with a 1-year follow-up. AD was defined as triglycerides ≥1.71 mmol/l or treatment with fibrates and low high-density lipoprotein (HDL) cholesterol (<1.03 mmol/l in men or <1.3 mmol/l in women).

Results

AD was present in 81 (22.8%) of the 356 patients; these were more frequently men and presented higher total cholesterol and non-HDL cholesterol concentrations. AD remission rate was 74.1% at 3 months, 90.1% at 6 months and 96.3% at 12 months, respectively, after BS. In this group of patients, HDL cholesterol levels rose progressively (1.0 ± 0.2 to 1.5 ± 0.3 mmol/l, p < 0.001) and triglycerides decreased (2.5 ± 0.9 to 1.2 ± 0.5 mmol/l, p < 0.001) during follow-up. Regarding previous lipid-lowering therapy, fibrates and ezetimibe were withdrawn in all patients and statins in 69.4% 1 year after surgery.

Conclusion

BS has beneficial effects on lipid profile, achieving complete remission of AD at 1 year of follow-up in almost all patients.

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References

  1. Austin MA, King MC, Vranizan KM, et al. Atherogenic lipoprotein phenotype. A proposed genetic marker for coronary heart disease risk. Circulation. 1990;82:495–506.

    Article  CAS  PubMed  Google Scholar 

  2. Grundy S, Small LDL. Atherogenic dyslipidemia, and the metabolic syndrome. Circulation. 1997;95:1–4.

    Article  CAS  PubMed  Google Scholar 

  3. Piepoli MF, Hoes AW, Agewall S, et al., 2016 European guidelines on cardiovascular disease prevention in clinical practice: the sixth joint task force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of 10 societies and by invited experts): developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016;37:2315–81.

  4. Stone NJ, Robinson J, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH 2013 ACC/AHA guidelines on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63:2889–934.

  5. Millán Núñez-Cortés J, Pedro-Botet J, Brea-Hernando Á, et al. Use of expert consensus to improve atherogenic dyslipidemia management. Rev Esp Cardiol. 2014;67:36–44.

    Article  PubMed  Google Scholar 

  6. Pedro-Botet J, Mantilla-Morató T, Díaz-Rodríguez Á, et al. The role of atherogenic dyslipidaemia in clinical practice guidelines. Clin Investig Arterioscler. 2016;28:65–70.

    Article  PubMed  Google Scholar 

  7. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.

    Article  CAS  PubMed  Google Scholar 

  8. Sjöström L, Lindroos A-K, Peltonen M, et al. Swedish Obese Subjects study scientific group. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–93.

    Article  PubMed  Google Scholar 

  9. Benaiges D, Sagué M, Flores-Le Roux JA, et al. Predictors of hypertension remission and recurrence after bariatric surgery. Am J Hypertens. 2016;29:653–9.

    Article  PubMed  Google Scholar 

  10. Vidal J, Ibarzabal A, Romero F, et al. Type 2 diabetes mellitus and the metabolic syndrome following sleeve gastrectomy in severely obese subjects. Obes Surg. 2008;18:1077–82.

    Article  CAS  PubMed  Google Scholar 

  11. Carswell KA, Belgaumkar AP, Amiel SA, et al. Systematic review and meta-analysis of the effect of gastric bypass surgery on plasma lipid levels. Obes Surg. 2016;26:834–55.

    Article  Google Scholar 

  12. National Institutes of Health. Consensus development conference draft statement on gastrointestinal surgery for severe obesity. Obes Surg. 1991;1:257–65.

    Article  Google Scholar 

  13. Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.

    Article  CAS  PubMed  Google Scholar 

  14. Chobanian AV, Bakris GL, Black HR, et al. National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, National High Blood Pressure Education Program Coordinating Committee. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560–72.

    Article  CAS  PubMed  Google Scholar 

  15. Genuth S, Alberti KGMM, Bennett P, et al. Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care. 2003;26:3160–7.

    Article  PubMed  Google Scholar 

  16. Brethauer SA, Kim J, Chaar M El, Papasavas P, Eisenberg D, Rogers A, et al. ASMBS Clinical Issues Committee. Standardized outcomes reporting in metabolic and bariatric surgery. Obes Surg 2015;25:587–606.

  17. Grundy SM, Brewer HB, Cleeman JI, et al. American Heart Association, National Heart, Lung, and Blood Institute. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004;109:433–8.

    Article  PubMed  Google Scholar 

  18. González-Juanatey JR, Millán J, Alegría E, et al. Prevalence and characteristics of lipid abnormalities in patients treated with statins in primary and secondary prevention in Spain. DYSIS-Spain Study. Rev Esp Cardiol. 2011;64:286–94.

  19. Pedro-Botet J, Flores-Le Roux JA, Mostaza JM, et al. Atherogenic dyslipidemia: prevalence and management in lipid clinics. Rev Clin Esp. 2014;214:491–8.

    Article  CAS  PubMed  Google Scholar 

  20. Benaiges D, Flores-Le-Roux JA, Pedro-Botet J, 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.

    Article  CAS  PubMed  Google Scholar 

  21. Courcoulas AP, Christian NJ, Belle SH, et al. Longitudinal assessment of bariatric surgery (LABS) consortium. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310:2416–25.

    CAS  PubMed  PubMed Central  Google Scholar 

  22. Asztalos BF, Swarbrick MM, Schaefer EJ, et al. Effects of weight loss, induced by gastric bypass surgery, on HDL remodeling in obese women. J Lipid Res. 2010;51:2405–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Habib P, Scrocco JD, Terek M, et al. Effects of bariatric surgery on inflammatory, functional and structural markers of coronary atherosclerosis. Am J Cardiol. 2009;104:1251–5.

    Article  CAS  PubMed  Google Scholar 

  24. Lee WJ, Chong K, Ser KH, et al. Gastric bypass vs sleeve gastrectomy for type 2 diabetes mellitus: a randomized controlled trial. Arch Surg. 2011;146:143–8.

    Article  PubMed  Google Scholar 

  25. Woelnerhanssen B, Peterli R, Steinert RE, et al. Effects of postbariatric surgery weight loss on adipokines and metabolic parameters: comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy—a prospective randomized trial. Surg Obes Relat Dis. 2007;7:561–8.

    Article  Google Scholar 

  26. Mclaughlin T, Abbasi F, Cheal K, et al. Use of metabolic markers to identify overweight individuals who are insulin resistant. Ann Intern. Medicine. 2003;139:802–9.

    Google Scholar 

  27. Millán J, Pintó X, Muñoz A, et al. Lipoprotein ratios: physiological significance and clinical usefulness in cardiovascular prevention. Vasc Health Risk Manag. 2009;5:757–65.

    PubMed  PubMed Central  Google Scholar 

  28. Garcia-Marirrodriga I, Amaya-Romero C, Ruiz-Diaz GP, et al. Evolution of lipid profiles after bariatric surgery. Obes Surg. 2012;22:609–16.

    Article  PubMed  Google Scholar 

  29. Leyba JL, Aulestia SN, Llopis SN. Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for the treatment of morbid obesity. A prospective study of 117 patients. Obes Surg. 2011;21:212–6.

    Article  PubMed  Google Scholar 

  30. Pihlajamäki J, Grönlund S, Simonen M, et al. Cholesterol absorption decreases after Roux-en-Y gastric bypass but not after gastric banding. Metabolism. 2010;59:866–72.

    Article  PubMed  Google Scholar 

  31. Sjöström L, Peltonen M, Jacobson P, et al. Bariatric surgery and long-term cardiovascular events. JAMA. 2012;307:56–65.

    Article  PubMed  Google Scholar 

  32. Berrington de Gonzalez A, Hartge P, Cerhan JR, et al. Body-mass index and mortality among 1.46 million white adults. N Engl J Med. 2010;363:2211–9.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Endocrinology and Nutrition, Hospital del Mar, Paseo Marítimo, 25-29, E-08003, Barcelona, Spain

    Elisenda Climent, David Benaiges, Juan Pedro-Botet, Juana A. Flores-Le Roux, Montserrat Villatoro, Laia Fontané, Juan J. Chillarón & Albert Goday

  2. Department of Medicine, Universitat Autònoma de Barcelona, Campus Universitari Mar. Dr. Aiguader, 80, E-08003, Barcelona, Spain

    Elisenda Climent, David Benaiges, Juan Pedro-Botet, Juana A. Flores-Le Roux, Juan J. Chillarón & Albert Goday

  3. Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Dr. Aiguader, 80, E-08003, Barcelona, Spain

    David Benaiges, Juan Pedro-Botet, Juana A. Flores-Le Roux, Jose M. Ramón, Juan J. Chillarón & Albert Goday

  4. Department of General Surgery, Hospital del Mar, Paseo Marítimo, 25-29, E-08003, Barcelona, Spain

    Jose M. Ramón

  5. CiberOBN. Instituto de Salud Carlos III, Avenida Monforte de Lemos, 3-5. Pabellón 11. Planta 0, E-28029, Madrid, Spain

    Albert Goday

Authors
  1. Elisenda Climent
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  2. David Benaiges
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  3. Juan Pedro-Botet
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  4. Juana A. Flores-Le Roux
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  6. Montserrat Villatoro
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Correspondence to Elisenda Climent.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Climent, E., Benaiges, D., Pedro-Botet, J. et al. Atherogenic Dyslipidemia Remission 1 Year After Bariatric Surgery. OBES SURG 27, 1548–1553 (2017). https://doi.org/10.1007/s11695-016-2504-6

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  • DOI: https://doi.org/10.1007/s11695-016-2504-6

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