Gero D, et al. - Authors planned this study to ascertain lipid profiles and their impact on cardiovascular (CV) risk changes in a large patient cohort 5 years after Roux-en-Y gastric bypass (RYGB). As per findings, RYGB resulted in maintained excess weight loss and an improvement of the lipid profile from the first to fifth postoperative year. This improvement translated into markedly lower CV risk from the first year after surgery.

Methods

• From January 1999 to December 2009, authors included patients who underwent primary RYGB for severe obesity in their two hospitals.
• For this study, the Framingham risk score was used.

Results

• 1048 patients were included; 791 were women and 257 were men.
• 77% of patients had five-year complete lipid profile available.
• At 5 years, a decrease in mean body mass index (BMI) was observed from 45.7 ± 6 to 31 ± 5.8 kg/m² (p < 0.001); excess BMI loss (EBMIL) was 72.35 ± 22%, and total body weight loss (TWL) 31.5 ± 9%.
• A significant improvement in lipid values was observed.
• At 1 year, authors noticed drop in total- and LDL-cholesterol levels from 5.4 to 4.48 mmol/L and 3.2 to 2.41 mmol/L, respectively, and this slightly increased thereafter.
• Drop in triglyceride levels was observed from 2 to 1.17 mmol/L at 1 year and this remained unchanged.
• At 5 years, HDL levels rose continuously from 1.27 to 1.77 mmol/L.
• In patients with greater weight loss (%EBMIL ≥ 50 or %TWL ≥ 25%), lipid profile improved more.
• Assuming that all patients were non-smokers and other baseline risk factors (hypertension, diabetes) remained unchanged at 5 years, the amelioration of the lipid profile itself yielded to a 27% reduction of CV risk (p < 0.001).