Results of surgery: long-term effects on hyperlipidemia

To define frequency of lipid abnormalities and to monitor improvement or correction of those abnormalities postoperatively, 66 patients with chronic morbid obesity had total cholesterol, high-density-lipoprotein (HDL) cholesterol, and triglyceride determinations preoperatively and at staged intervals up to 5-7 y after Roux-Y gastric bypass. Preoperative abnormal HDL-cholesterol and triglyceride concentrations were frequent. Major improvements occurred in these lipid concentrations by 6 mo postoperatively, and some further improvements occurred with additional weight loss at 1 y. At 5-7 y, among 33 patients, raised concentrations of HDL cholesterol were upheld in women (P less than 0.01); reductions in triglycerides were maintained in men (P less than 0.025); and reduced total cholesterol:HDL-cholesterol, which was achieved by 6 mo, was sustained in both men and women (P less than 0.01). In comparing lipid profiles of gastric surgery through 5 y with recent data from the surgical arm of the Program on Surgical Control of the Hyperlipidemias (POSCH), postulates are made of anticipated reduction in morbid, and even fatal, cardiac events in the operated morbidly obese population.