Centro Laparoscópico Dr. Ballesta (CLB), Centro Médico Teknon, 08022, Barcelona, Spain.
Obes Surg. 2012 Apr;22(4):609-16. doi: 10.1007/s11695-011-0534-7.
The most commonly encountered dyslipidemia in obese individuals is characterized by a cluster of interrelated plasma lipid and lipoprotein abnormalities including hypertriglyceridemia, low HDL cholesterol values, and increased small, dense LDL cholesterol particles. The aim of this study was to assess the changes in lipid profiles at baseline (pre-operatively) and at follow-up (6, 12, and 18 months) after a laparoscopic Roux-en-Y gastric bypass (LRYGBP). A retrospective observational study was performed involving all patients who consecutively underwent a LRYGBP between January 1, 2007 and December 31, 2009. Fasting lipids sub-fractions (total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides) were measured and HOMA-IR calculated pre-operatively and at follow-up post-LRYGBP. Pearson's correlation coefficients were used to assess the relationship between excess weight loss (EWL) and lipid sub-fractions. ANOVA was used to assess the differences between each lipid sub-fraction at various time-points.
One hundred twenty eight (N = 128) medical charts were reviewed, and those containing data on lipid fractions at the three follow-up time-points were analyzed. One hundred fourteen patients (N = 114), 84 of whom were women (73.7%), were finally included in the study.
Total cholesterol, LDL cholesterol, triglycerides, and HOMA-IR were significantly reduced after LRYGBP (P < 0.0005 for all). Inversely, HDL cholesterol disclosed a significant rise (P < 0.0005). Noteworthy significant associations between lipid subfractions and EWL were detected overall (P < 0.0005 for all). A gender effect was found since female patients displayed a milder association than male patients (P < 0.0005).
LRYGBP-induced weight loss improves the lipid profile while reducing insulin resistance, with male patients showing a better profile than female patients.
肥胖患者最常见的血脂异常表现为一组相互关联的血浆脂质和脂蛋白异常，包括高三酰甘油血症、低高密度脂蛋白胆固醇值和小而密的低密度脂蛋白胆固醇颗粒增加。本研究旨在评估腹腔镜 Roux-en-Y 胃旁路术（LRYGBP）前后的血脂谱变化。回顾性观察研究纳入了 2007 年 1 月 1 日至 2009 年 12 月 31 日期间连续接受 LRYGBP 的所有患者。术前和 LRYGBP 后随访（6、12 和 18 个月）时测量空腹血脂亚组分（总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和三酰甘油）并计算 HOMA-IR。Pearson 相关系数用于评估超重减轻（EWL）与血脂亚组分之间的关系。方差分析用于评估各血脂亚组分在不同时间点的差异。
回顾性分析了 128 份病历，其中包含三个随访时间点的血脂亚组分数据。最终纳入 114 例患者（N=114），其中 84 例为女性（73.7%）。
LRYGBP 后总胆固醇、低密度脂蛋白胆固醇、三酰甘油和 HOMA-IR 显著降低（均 P<0.0005）。相反，高密度脂蛋白胆固醇显著升高（P<0.0005）。总体上发现血脂亚组分与 EWL 之间存在显著关联（均 P<0.0005）。发现了性别效应，因为女性患者的关联比男性患者更轻微（P<0.0005）。
LRYGBP 诱导的体重减轻可改善血脂谱，同时降低胰岛素抵抗，男性患者的血脂谱优于女性患者。
