Analysis of the lipid profile of patients submitted to sleeve gastrectomy and Roux-en-Y gastric bypass.

Lira, Natália S.; Macedo, Carlos Eduardo Soares; Belo, Giselle Menezes; Santa-Cruz, Fernando; Siqueira, Luciana T.; Ferraz, Álvaro Antonio Bandeira

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Original Article • Rev. Col. Bras. Cir. 45 (6) • 2018 • https://doi.org/10.1590/0100-6991e-20181967 copy

Analysis of the lipid profile of patients submitted to sleeve gastrectomy and Roux-en-Y gastric bypass.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to compare the improvements in lipid profile in patients undergoing sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB).

Methods:

in a mixed cohort study, we evaluated 334 patients undergoing SG and 178 patients undergoing RYGB at the University Hospital of the Federal University of Pernambuco and at the Real Hospital Português de Beneficência, Recife, PE, Brazil. We measured serum levels of total cholesterol, LDL, HDL and triglycerides preoperatively and at three, six, 12 and 24 months follow-up.

Results:

the SG group consisted of 58 men and 276 women. In the group submitted to RYGB, there were 64 men and 114 women. The mean age was 37.2±20.5 years in the SG group and 41.9±11.1 years in the RYGB group. The preoperative mean BMI was 39.4±2.6kg/m² and 42.7±5.8kg/m² for the SG and RYGB groups, respectively. In the preoperative period, 80% of the patients had at least one abnormality in the lipid profile. Two years after surgery, there was improvement in total cholesterol, LDL, HDL and triglycerides in the group submitted to RYGB. In the group submitted to SG, after two years there was improvement in total cholesterol, HDL and triglyceride levels.

Conclusion:

both techniques resulted in improvements in the lipid profile, but the RYGB was more effective.

Keywords:
Obesity; Bariatric Surgery; Gastric Bypass; Dyslipidemias

Lipids	Preop	3 Months	6 Months	12 Months	24 Months
	SG	SG	SG	SG	SG
	RYGB	RYGB	RYGB	RYGB	RYGB
	p	p	p	p¹ 1 Student's t-test for paired samples (if p-value <0.05, the means of the two types of treatment differ significantly);	p
Total cholesterol (mg/dl)	204.0±39.0 205.4±40.2 0.706¹ 1 Student's t-test for paired samples (if p-value <0.05, the means of the two types of treatment differ significantly);	186.2±38.2 158.8±34.6 <0.001¹ 1 Student's t-test for paired samples (if p-value <0.05, the means of the two types of treatment differ significantly);	187.6±29.4 154.8±35.2 <0.001¹ 1 Student's t-test for paired samples (if p-value <0.05, the means of the two types of treatment differ significantly);	183.2±35.2 155.6±30.4 <0.001	190.2±39.9 155.8±32.1 <0.001¹ 1 Student's t-test for paired samples (if p-value <0.05, the means of the two types of treatment differ significantly);
LDL cholesterol (mg/dl)	124.6±34.9 121.1±31.6 0.264¹ 1 Student's t-test for paired samples (if p-value <0.05, the means of the two types of treatment differ significantly);	118.7±37.0 95.9±28.9 <0.001¹ 1 Student's t-test for paired samples (if p-value <0.05, the means of the two types of treatment differ significantly);	118.6±33.2 88.5±22.9 <0.001¹ 1 Student's t-test for paired samples (if p-value <0.05, the means of the two types of treatment differ significantly);	110.8±32.7 86.9±24.4 <0.001	113.1±37.9 84.3±25.3 <0.001¹ 1 Student's t-test for paired samples (if p-value <0.05, the means of the two types of treatment differ significantly);
HDL Cholesterol (mg/dl) Women	50.6±11.7 48.6±12.9 0.035² 2 Mann-Whitney test (if p-value <0.05, the measured distributions differ between the treatments types).	49.0±12.4 44.2±13.3 0.001² 2 Mann-Whitney test (if p-value <0.05, the measured distributions differ between the treatments types).	51.3±13.4 50.5±14.1 0.742¹ 1 Student's t-test for paired samples (if p-value <0.05, the means of the two types of treatment differ significantly);	56.4±12.1 54.4±12.5 0.281	59.3±15.2 61.2±13.9 0.561¹ 1 Student's t-test for paired samples (if p-value <0.05, the means of the two types of treatment differ significantly);
HDL Cholesterol (mg/dl) Men	41.9±10.4 42.9±9.3 0.594¹ 1 Student's t-test for paired samples (if p-value <0.05, the means of the two types of treatment differ significantly);	44.3±12.6 36.5±7.5 0.001¹ 1 Student's t-test for paired samples (if p-value <0.05, the means of the two types of treatment differ significantly);	50.4±9.2 44.3±9.3 0.052¹ 1 Student's t-test for paired samples (if p-value <0.05, the means of the two types of treatment differ significantly);	57.4±9.7 47.6±9.6 0.004	50.2±10.0 52.5±8.2 0.614¹ 1 Student's t-test for paired samples (if p-value <0.05, the means of the two types of treatment differ significantly);
Triglycerides (mg/dl)	153.1±92.6 191.3±173.6 0.001² 2 Mann-Whitney test (if p-value <0.05, the measured distributions differ between the treatments types).	96.9±35.1 115.1±52.8 <0.001² 2 Mann-Whitney test (if p-value <0.05, the measured distributions differ between the treatments types).	94.2±37.9 95.8±32.9 0.435² 2 Mann-Whitney test (if p-value <0.05, the measured distributions differ between the treatments types).	78.3±28.3 81.8±30.6 0.620	91.9±51.0 72.0±24.2 0.075² 2 Mann-Whitney test (if p-value <0.05, the measured distributions differ between the treatments types).

Lipids	Preop	3 Months	6 Months	12 Months	24 Months
	SG	SG	SG	SG	SG
	RYGB	RYGB	RYGB	RYGB	RYGB
	p¹ 1 Chi-square test for proportion comparison (if p-value <0.05, the proportions differ significantly); - the test could not be applied because some frequencies were equal to zero.	p¹ 1 Chi-square test for proportion comparison (if p-value <0.05, the proportions differ significantly); - the test could not be applied because some frequencies were equal to zero.	p¹ 1 Chi-square test for proportion comparison (if p-value <0.05, the proportions differ significantly); - the test could not be applied because some frequencies were equal to zero.	p¹ 1 Chi-square test for proportion comparison (if p-value <0.05, the proportions differ significantly); - the test could not be applied because some frequencies were equal to zero.	p¹ 1 Chi-square test for proportion comparison (if p-value <0.05, the proportions differ significantly); - the test could not be applied because some frequencies were equal to zero.
Total cholesterol	177 (53.0%) 102 (57.3%) 0.361	66 (34.4%) 14 (10.3%) <0.001	31 (32.6%) 5 (6.2%) <0.001	41 (32.5%) 11 (10.9%) <0.001	16 (36.4%) 6 (10.2%) <0.001
LDL cholesterol	136 (42.1%) 69 (40.8%) 0.785	65 (34.2%) 15 (11.3%) <0.001	33 (35.1%) 2 (2.6%) <0.001	34 (27.0%) 5 (5.0%) <0.001	12 (27.3%) 4 (7.0%) 0.006
HDL CholesterolWomen	144 (52.2%) 72 (63.7%) 0.038	99 (60.7%) 64 (73.6%) 0.043	38 (45.8%) 24 (54.5%) 0.347	38 (33.6%) 28 (38.9%) 0.466	11 (28.9%) 10 (23.8%) 0.602
HDL CholesterolMen	24 (51.1%) 23 (37.1%) 0.145	12 (44.4%) 33 (70.2%) 0.029	1 (8.3%) 11 (30.6%) 0.248	0 (0.0%) 7 (24.1%) -	0 (0.0%) 1 (6.3%) -
Triglycerides	121 (36.4%) 89 (50.0%) 0.003	16 (8.4%) 19 (14.2%) 0.097	11 (11.7%) 8 (9.9%) 0.699	1 (0.8%) 2 (2.0%) 0.845	5 (11.6%) 0 (0.0%) -

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