Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, UFRGS, Porto Alegre, Brazil.
Centro de Tratamento da Obesidade, Hospital Santa Rita do Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil.
Obes Surg. 2020 Jan;30(1):154-160. doi: 10.1007/s11695-019-04126-6.
This study evaluated changes in serum high-density lipoprotein cholesterol (HDL-C) induced by laparoscopic bariatric surgery (BS) in non-diabetic obese subjects with low (L-HDL-C) or normal (N-HDL-C) levels of HDL-C. We assessed whether increased HDL-C is associated with weight loss, serum non-HDL cholesterol (non-HDL-C), serum triglycerides (TG), and physical activity (PA) before and 6 and 15 months after BS.
In this prospective cohort study, 71 subjects undergoing BS (42 by Roux-en-Y gastric bypass and 29 by sleeve gastrectomy) were evaluated for the % Excess Weight Loss (%EWL), waist circumference (WC), serum levels of glucose, glycosylated hemoglobin, TG, HDL-C, non-HDL-C, and LDL-C, and the degree, time, and energy expenditure related to PA. The short version of the International Physical Activity Questionnaire was used to assess PA.
Levels of HDL-C significantly increased 15 months after BS (p < 0.001) in subjects with low (p < 0.001) or normal (p = 0.017) values at baseline. A similar %EWL, decrease in WC, glucose, non-HDL-C, and LDL-C levels and increase in energy expenditure related to PA, was observed in both groups (L-HDL-C and N-HDL-C) at 15 months after BS. However, the L-HDL-C group presented greater decrease in TG levels compared with N-HDL-C group (p = 0.004). In subjects with increased HDL-C 15 months after BS, there was an association between this increase and the %EWL (p = 0.030), but there was no association with the change in PA.
Irrespective of PA after BS, subjects with low and normal HDL-C levels at baseline showed an increase in HDL-C after BS, and this increase was associated with %EWL induced by BS.
本研究评估了腹腔镜减重手术（BS）对非糖尿病肥胖患者中血清高密度脂蛋白胆固醇（HDL-C）水平的影响，这些患者的 HDL-C 水平较低（L-HDL-C）或正常（N-HDL-C）。我们评估了增加的 HDL-C 是否与体重减轻、血清非高密度脂蛋白胆固醇（非-HDL-C）、血清甘油三酯（TG）和体力活动（PA）有关，这些指标是在 BS 之前和之后 6 个月和 15 个月测量的。
在这项前瞻性队列研究中，评估了 71 名接受 BS（42 例行 Roux-en-Y 胃旁路术，29 例行袖状胃切除术）的患者的体重减轻百分比（%EWL）、腰围（WC）、血糖、糖化血红蛋白、TG、HDL-C、非-HDL-C 和 LDL-C 水平，以及 PA 的程度、时间和能量消耗。使用国际体力活动问卷的短版来评估 PA。
BS 后 15 个月，低（p<0.001）和正常（p=0.017）基线 HDL-C 值的患者的 HDL-C 水平显著升高。BS 后 15 个月，两组（L-HDL-C 和 N-HDL-C）患者的 %EWL、WC、血糖、非-HDL-C 和 LDL-C 水平下降，PA 相关的能量消耗增加。然而，L-HDL-C 组的 TG 水平下降幅度大于 N-HDL-C 组（p=0.004）。在 BS 后 15 个月 HDL-C 升高的患者中，这种增加与 %EWL 之间存在相关性（p=0.030），但与 PA 的变化之间没有相关性。
无论 BS 后的 PA 如何，BS 前 HDL-C 水平较低和正常的患者在 BS 后 HDL-C 水平升高，这种升高与 BS 引起的 %EWL 增加有关。
