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Effects of Bariatric Surgery on HDL Cholesterol
Idoia Genua1, Analia Ramos1, Francisca Caimari1
1Endocrinology and Nutrition Service, Hospital de la Santa Creu i Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain.
Insights
Bariatric surgery significantly improves high-density lipoprotein cholesterol (HDLc) levels, peaking two years post-operation. Pre-surgery HDLc and surgical method predict the extent of this beneficial increase.
Area of Science:
- Cardiology
- Metabolic Surgery
- Lipid Metabolism
Background:
- Low high-density lipoprotein cholesterol (HDLc) is a risk factor for coronary heart disease.
- Bariatric surgery is known to increase HDLc, but the timeline and predictors are not fully understood.
Purpose of the Study:
- To analyze the temporal changes in HDLc concentrations following bariatric surgery.
- To identify predictors of HDLc level increases after bariatric procedures.
Main Methods:
- Retrospective observational study of 185 patients undergoing bariatric surgery.
- Exclusion of patients with revisional surgery or those on fibrates.
- Analysis of medical records from January 2007 to March 2015.
Main Results:
- HDLc levels initially decreased at 3 months post-surgery but began to rise thereafter.
- Maximum HDLc increase (26.2%) was observed 2 years after surgery.
- Preoperative HDLc levels and surgical type (sleeve gastrectomy vs. gastric bypass) predicted the magnitude of HDLc increase.
Conclusions:
- Bariatric surgery positively impacts HDLc levels.
- The peak increase in postoperative HDLc occurs 2 years after the procedure.
- Preoperative HDLc and surgical approach are key predictors of HDLc improvement post-bariatric surgery.
Background:
Low levels of high-density lipoprotein cholesterol (HDLc) are independent predictive factors of coronary heart disease. Bariatric surgery increases HDLc concentration, but the chronology and predictors of this improvement in HDLc levels are not well-established. The aim of the present study was to analyse the changes over time in HDLc concentrations after bariatric surgery and to determine the predictors of their increase.
Subjects And Methods:
This was a retrospective, observational study. The medical records of patients who had undergone bariatric surgery at a tertiary care hospital between January 2007 and March 2015 were reviewed. Patients who underwent revisional surgery or were treated with fibrates were excluded from the analysis.
Results:
A total of 185 patients were included in the study. Follow-up rates were as follows: 87% (year 2) and 28% (year 5). At postoperative month 3, HDLc levels decreased significantly versus baseline (- 11.1%; p = 0.000), at which point they began to rise, reaching their maximum level 2 years after bariatric surgery (26.2% increase from baseline; p = 0.000). The increase in HDLc concentration 2 years after surgery correlated with the preoperative HDLc level (r = - 0.292, p = 0.001), and it was greater in patients who underwent sleeve gastrectomy versus gastric bypass (0.36 ± 0.4 vs. 0.18 ± 0.4 mmol/L, respectively; p = 0.018).
Conclusion:
Bariatric surgery has a beneficial effect on HDLc levels. The maximum increase in postoperative HDLc concentrations is observed 2 years after surgery. Preoperative HDLc and the type of surgery are both significant predictors of the maximum increase in HDLc levels.
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