Brolin R E, Kenler H A, Wilson A C, Kuo P T, Cody R P
Department of Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick 08903.
Int J Obes. 1990 Nov;14(11):939-50.
Thirty-eight of 151 consecutive patients (25 percent) undergoing bypass surgery for morbid obesity had increased serum levels of total cholesterol (TC), triglycerides (TG) or both preoperatively. Ten patients had isolated TC elevation, six had isolated TG elevation and 22 had both TC and TG elevation. High density lipoprotein-cholesterol (HDL-C) levels were subnormal in 28 of the 38 patients (74 percent). Fasting lipid profiles were determined in the 38 hyperlipidemic patients at 6-month intervals postoperatively. Mean follow-up period was 29 months. By 6 months postop, patients had a greater than or equal to 20 percent mean reduction in TC and greater than or equal to 50 percent mean reduction in TG which were significant in comparison with preop levels and correlated with weight loss (P less than or equal to 0.05). Mean HDL-C levels had increased significantly vs. preop levels by 12 months postop (P less than 0.05). Lipid profiles became normal in 32 of the 38 patients (84 percent). Improvements in lipid profile were sustained in all patients with satisfactory weight loss but regressed after 12 months in patients who did not lose greater than or equal to 50 percent of their excess weight. These results suggest that abnormal serum lipid profiles can be permanently improved with sustained weight loss after gastric restriction surgery for morbid obesity.
151例接受病态肥胖搭桥手术的连续患者中，38例（25%）术前血清总胆固醇（TC）、甘油三酯（TG）水平升高或两者均升高。10例患者单纯TC升高，6例单纯TG升高，22例TC和TG均升高。38例患者中有28例（74%）高密度脂蛋白胆固醇（HDL-C）水平低于正常。对38例高脂血症患者术后每隔6个月测定空腹血脂谱。平均随访期为29个月。术后6个月时，患者TC平均降低≥20%，TG平均降低≥50%，与术前水平相比有显著差异，且与体重减轻相关（P≤0.05）。术后12个月时，平均HDL-C水平与术前相比显著升高（P＜0.05）。38例患者中有32例（84%）血脂谱恢复正常。所有体重减轻满意的患者血脂谱改善得以维持，但未减轻≥超重50%的患者在12个月后血脂谱恢复至术前水平。这些结果表明，病态肥胖患者接受胃限制手术后，持续减重可使异常血脂谱得到永久性改善。
