Comparison of Changes in Body Weight and Serum Lipid Profile after Roux-en-Y Gastric Bypass between Non-obese Patients and Obese Patients

Jung Hwan Park; Sang Mo Hong; Chang Bum Lee; You Hern Ahn; Dong Sun Kim

Article

Korean J Obes 2014; 23(3): 164-169

Published online September 30, 2014

Comparison of Changes in Body Weight and Serum Lipid Profile after Roux-en-Y Gastric Bypass between Non-obese Patients and Obese Patients

Jung Hwan Park, Sang Mo Hong, Chang Bum Lee, You Hern Ahn, Dong Sun Kim^*

Author Affiliations

Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Korea

Received: April 28, 2014; Reviewed : May 18, 2014; Accepted: May 25, 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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Background: This study was aimed to investigate the effects of bariatric surgery in non-obese patients through the comparison of the changes in body weight (BW) and serum lipid profile between non-obese and obese patients after Roux-en-Y gastric bypass.
Methods: In this study, 116 patients who received laparoscopic Roux-en-Y gastric bypass due to early gastric cancer were included. Patients were divided into two groups, non-obese group (N=76), defined as body mass index <25 kg/m², and obese group (N=40), body mass index ≥25 kg/m². BW and serum lipid profile before surgery and at 3, 6, 9, and 12 months after surgery were examined.
Results: In all groups, BW and triglyceride (TG) showed significant (P<0.05) decrease after surgery, while high-density lipoprotein cholesterol (HDL-C) showed a significant increase during the first 3 months after surgery, in obese group. Total cholesterol and low-density lipoprotein cholesterol (LDL-C) decreased. However, the effect was significant for only a limited time period after surgery. Mean percentages of BW loss and TG decrease were greater in the obese group after surgery, however, the change was significant for only a limited time period after surgery. Mean percentage of HDL-C increase in non-obese group was greater but was not statistically significant. There were no differences in mean percentages of total cholesterol and LDL-C decrease between the two groups.
Conclusion: At 12 months after surgery, all groups showed significant improvement in BW and serum lipid profile. However, mean percentages in BW loss, TG decrease, and HDL-C increase between the two groups were different.

Keywords: Bariatric surgery, Roux-en-Y gastric bypass, Lipids

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Fig. 1. Mean values of body weight and serum lipid profile before surgery and at 3, 6, 9, and 12 months after surgery in non-obese group (A) and obese group (B). HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol.

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Baseline characteristics

Body weight and lipid profile before and after gastric bypass surgery in non-obese group

Body weight and lipid profile before and after gastric bypass surgery in obese group

Comparison of changes from baseline body weight and lipid profile after gastric bypass surgery between non-obese group and obese group

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Buchwald H, Estok R, Fahrbach K, Banel D, Jensen MD, Pories WJ, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med 2009;122:248-56.
Schauer PR, Burguera B, Ikramuddin S, Cottam D, Gourash W, Hamad G, et al. Effect of laparoscopic Roux-en-Y gastric bypass on type 2 diabetes mellitus. Ann Surg 2003;238:467-84.
Scopinaro N, Marinari GM, Camerini GB, Papadia FS, Adami GF. Specific effects of biliopancreatic diversion on the major components of metabolic syndrome: a long-term follow-up study. Diabetes Care 2005;28:2406-11.
Sj?str?m L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, et al. Lifestyle, diabetes, cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004;351:2683-93.
Pories WJ, Swanson MS, MacDonald KG, Long SB, Morris PG, Brown BM, et al. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg 1995;222:339-50.
Clinical guidelines on the identification, evaluation, treatment of overweight and obesity in adults: the evidence report. National Institutes of Health. Obes Res 1998;6 Suppl 2:51-209.
Thaler JP, Cummings DE. Minireview: hormonal and metabolic mechanisms of diabetes remission after gastrointestinal surgery. Endocrinology 2009;150:2518-25.
Cummings DE. Endocrine mechanisms mediating remission of diabetes after gastric bypass surgery. Int J Obes (Lond) 2009;33 Suppl 1:33-40.
Cohen RV, Pinheiro JC, Schiavon CA, Salles JE, Wajchenberg BL, Cummings DE. Effects of gastric bypass surgery in patients with type 2 diabetes and only mild obesity. Diabetes Care 2012;35:1420-8.
Schauer PR, Kashyap SR, Wolski K, Brethauer SA, Kirwan JP, Pothier CE, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med 2012;366:1567-76.
Rubino F, Schauer PR, Kaplan LM, Cummings DE. Metabolic surgery to treat type 2 diabetes: clinical outcomes and mechanisms of action. Annu Rev Med 2010;61:393-411.
Ryan DH. BMI guidelines for bariatric surgery in diabetes: how low can we go? Diabetes Care 2012;35:1399-400.
Weisell RC. Body mass index as an indicator of obesity. Asia Pac J Clin Nutr 2002;11 Suppl 8:681-4.
Lorenzo C, Okoloise M, Williams K, Stern MP, Haffner SM; San Antonio Heart Study. The metabolic syndrome as predictor of type 2 diabetes: the San Antonio heart study. Diabetes Care 2003;26:3153-9.
Sattar N, Gaw A, Scherbakova O, Ford I, O’Reilly DS, Haffner SM, et al. Metabolic syndrome with and without C-reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study. Circulation 2003;108:414-9.
Expert Panel on Detection, Evaluation, Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001;285:2486-97.
Grundy SM, Brewer HB Jr, Cleeman JI, Smith SC Jr, Lenfant C;American Heart Association, et al. Definition of metabolic syndrome:Report of the National Heart, Lung, Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation 2004;109:433-8.
Jones PH. Low-density lipoprotein cholesterol reduction and cardiovascular disease prevention: the search for superior treatment. Am J Med 2004;116(Suppl 6):17-25.
Howard BV, Robbins DC, Sievers ML, Lee ET, Rhoades D, Devereux RB, et al. LDL cholesterol as a strong predictor of coronary heart disease in diabetic individuals with insulin resistance and low LDL: the Strong Heart Study. Arterioscler Thromb Vasc Biol 2000;20:830-5.
Hulley SB, Rosenman RH, Bawol RD, Brand RJ. Epidemiology as a guide to clinical decisions. The association between triglyceride and coronary heart disease. N Engl J Med 1980;302:1383-9.
Miller M, Stone NJ, Ballantyne C, Bittner V, Criqui MH, Ginsberg HN, et al. Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association. Circulation 2011;123:2292-333.
Manninen V, Tenkanen L, Koskinen P, Huttunen JK, M?ntt?ri M, Heinonen OP, et al. Joint effects of serum triglyceride and LDL cholesterol and HDL cholesterol concentrations on coronary heart disease risk in the Helsinki Heart Study. Implications for treatment. Circulation 1992;85:37-45.
Miller M, Cannon CP, Murphy SA, Qin J, Ray KK, Braunwald E, et al. Impact of triglyceride levels beyond low-density lipoprotein cholesterol after acute coronary syndrome in the PROVE IT-TIMI 22 trial. J Am Coll Cardiol 2008;51:724-30.