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Changes in lipid profile after biliopancreatic diversion
Juan de Dios García-Díaz1, Oscar Lozano, Juan Carlos Ramos
1Servicios de Medicina Interna, Hospital Universitario Priíncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain. jgarciad@hupa.insalud.es
Obesity Surgery
|November 25, 2003
Summary
Biliopancreatic diversion (BPD) significantly reduces weight and atherogenic lipoproteins in morbidly obese patients. This bariatric surgery is well-tolerated and effective for improving lipid profiles and promoting weight loss.
Area of Science:
- Metabolic Surgery
- Bariatric Surgery
- Obesity Management
Background:
- Bariatric operations exhibit varied efficacy and mechanisms.
- Evaluating the effectiveness of biliopancreatic diversion (BPD) for weight and lipid reduction is crucial.
Purpose of the Study:
- To assess the efficacy of biliopancreatic diversion (BPD) in reducing body weight and serum lipid levels.
- To analyze the impact of BPD on lipoproteins and apolipoproteins.
Main Methods:
- Prospective study of 58 morbidly obese patients (mean BMI 49.4 kg/m2) undergoing subtotal gastrectomy and BPD.
- Lipid levels, lipoproteins, and apolipoproteins were measured pre- and post-BPD over 12-72 months (average 39.4 months).
Main Results:
- Significant reductions observed in total cholesterol (32.8%), LDL (46.3%), and apolipoprotein B (37%) (P<0.001).
- Moderate decrease in triglycerides (21.3%, P=0.004) and total cholesterol/HDL ratio (29.7%).
- Substantial, sustained weight loss occurred, independent of lipid changes; younger patients and those with higher baseline lipids benefited most.
Conclusions:
- BPD is a well-tolerated bariatric procedure with excellent short- and mid-term results for weight reduction.
- Careful patient selection enhances BPD's effectiveness in lowering atherogenic lipoproteins.
- BPD offers significant benefits for managing morbid obesity and associated lipid abnormalities.