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. 2020 Dec;24(12):2722-2729.
doi: 10.1007/s11605-019-04482-9. Epub 2019 Dec 16.

Cardiovascular Benefits and Lipid Profile Changes 5 Years After Bariatric Surgery: A Comparative Study Between Sleeve Gastrectomy and Roux-en-Y Gastric Bypass

Costantino Voglino  1 , Andrea Tirone  2 , Cristina Ciuoli  3 , Nicoletta Benenati  3 , Barbara Paolini  4 , Federica Croce  5 , Ilaria Gaggelli  2 , Maria Laura Vuolo  2 , Roberto Cuomo  6 , Luca Grimaldi  6 , Giuseppe Vuolo  2
Affiliations

Cardiovascular Benefits and Lipid Profile Changes 5 Years After Bariatric Surgery: A Comparative Study Between Sleeve Gastrectomy and Roux-en-Y Gastric Bypass

Costantino Voglino et al. J Gastrointest Surg. 2020 Dec.

Abstract

Introduction: Visceral adipose tissue has been linked with cardiovascular events. Visceral adiposity index (VAI) is a routinely applicable tool for evaluation of visceral adipose dysfunction and linked to 10 year-cardiovascular risk. No previous studies have evaluated the changes over time of the VAI in patients who underwent different types of bariatric surgery.

Materials and methods: We reviewed data of 42 patients who underwent laparoscopic sleeve gastrectomy (LSG) and 61 patients who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB). VAI, lipid profile, and several anthropometric variables were measured before and after 5 years following surgery.

Results: During the studied time period, the BMI was similar between LSG and LRYGB patients (34.1 vs 31.6; p = 0.191), but the percentage of total weight loss (%TWL) for LRYGB was significantly higher than LSG (31.3% vs 23.0%; p < 0.001). LRYGB patients had a significant improvement of all lipid parameters evaluated over time, while LSG patients experienced only a reduction in triglycerides (TG) levels and an increase in HDL cholesterol (HDL-C). VAI values were similar in the two groups at baseline as well at the last follow-up point (5-year VAI, LSG: 0.93, RYGB: 0.93; p = 0.951). At multivariate regression analysis, 5-year-%TWL was the only independent predictor of a greater amount of VAI reduction over time.

Conclusion: Bariatric surgery, independent of the type of surgical procedure, decreases the cardiovascular disease (CVD) risks due to weight loss and improvement of lipid parameters. VAI could be a useful tool to better identify eligible patients for bariatric surgery and to determine the success of surgery.

Keywords: Bariatric; RYGB bypass, bypass; Surgery; bariatric surgery; metabolic surgery; sleeve gastrectomy.

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