Serum lipid changes after gastroplasty for morbid obesity

Forty-six patients with obesity exceeding 75% (according to Natvig's tables) were subjected to gastroplasty which after 12 months had resulted in an average weight loss of 32 kg. Preoperatively, serum levels of triglycerides, total cholesterol, and LDL cholesterol were significantly raised, while HDL cholesterol was significantly lower than in non-obese controls. One year after surgery, mean serum triglyceride levels had normalized while mean HDL cholesterol had increased steadily to levels not different from those in the non-obese controls. Regarding total cholesterol and estimated LDL cholesterol, no significant changes were recorded. It is concluded that gastroplasty affects serum lipid patterns in obese patients in a fashion quite different from that caused by jejunoileal bypass operations. As the incidence of coronary heart disease is known to be inversely related to serum HDL cholesterol, gastroplasty may offer an additional advantage over jejunoileal shunt operations in improving the long-term prognosis in morbid obesity.