Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona. Campus Universitari Mar, Barcelona, Spain.
Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona. Campus Universitari Mar, Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
Surg Obes Relat Dis. 2018 Aug;14(8):1099-1105. doi: 10.1016/j.soard.2018.05.006. Epub 2018 May 19.
Few studies have compared mid-term results of laparoscopic Roux-en-Y gastric bypass (LRYGB) versus laparoscopic sleeve gastrectomy (LSG), and none have focused on lipid profile.
To compare LRYGB versus LSG with respect to lipid disturbance evolution and remission at mid-term after bariatric surgery (BS) and to assess associated factors with the remission of lipid disturbances at 5 years.
Hospital del Mar, Barcelona, from January 2005 to January 2012.
A retrospective analysis of a nonrandomized, prospective cohort was conducted on patients undergoing BS at Hospital del Mar, Barcelona, from January 2005 to January 2012 with ≥5 years' follow-up.
Of 259 patients, 151 (58.3%) completed the 5-year follow-up. The proportion of patients who achieved normal low-density lipoprotein cholesterol levels at 5 years post-LRYGB was greater than after LSG (30/49 [61.2%] versus 6/23 [26.1%]; P = .005), being male sex, absence of statins treatment, and type of BS technique (LRYGB) the associated factors with remission. Hypertriglyceridemia remission was also higher after LRYGB (23/25 [92.0%] versus 10/15 [66.7%]; P = .041), although type of surgery was not an associated factor. No differences were found in remission rates of low high-density lipoprotein cholesterol between groups. Absence of fibrates treatment and 5-year percentage of excess weight loss were independently associated with hypertriglyceridemia remission, and only the latter was independently associated with low high-density lipoprotein cholesterol remission 5 years after surgery.
Five-year outcome data showed that, among patients with severe obesity undergoing BS, LRYGB was associated with a higher total and low-density lipoprotein cholesterol reduction and remission in comparison to LSG, with no differences in hypertriglyceridemia and high-density lipoprotein cholesterol normalization.
很少有研究比较腹腔镜 Roux-en-Y 胃旁路术（LRYGB）与腹腔镜袖状胃切除术（LSG）的中期结果，且没有研究专门针对血脂情况。
比较 LRYGB 与 LSG 在减重手术后（BS）中期血脂紊乱的演变和缓解情况，并评估 5 年后血脂紊乱缓解的相关因素。
巴塞罗那，Mar 医院，2005 年 1 月至 2012 年 1 月。
对 2005 年 1 月至 2012 年 1 月在巴塞罗那，Mar 医院接受 BS 治疗且随访时间超过 5 年的患者进行非随机、前瞻性队列的回顾性分析。
在 259 例患者中，有 151 例（58.3%）完成了 5 年随访。LRYGB 术后 5 年达到正常低密度脂蛋白胆固醇水平的患者比例高于 LSG（30/49 [61.2%]比 6/23 [26.1%]；P=0.005），男性、未使用他汀类药物治疗和 BS 技术类型（LRYGB）是缓解的相关因素。LRYGB 术后高甘油三酯血症缓解率也较高（23/25 [92.0%]比 10/15 [66.7%]；P=0.041），但手术类型不是相关因素。两组间低高密度脂蛋白胆固醇缓解率无差异。未使用贝特类药物治疗和 5 年体重超标百分比是高甘油三酯血症缓解的独立相关因素，只有后者是术后 5 年低高密度脂蛋白胆固醇缓解的独立相关因素。
5 年随访结果显示，在接受 BS 的严重肥胖患者中，LRYGB 与 LSG 相比，总胆固醇和低密度脂蛋白胆固醇降低及缓解率更高，而高甘油三酯血症和高密度脂蛋白胆固醇正常化无差异。
