Changes In Lipid Profile after Biliopancreatic Diversion |
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Authors: | Juan de Dios García-Díaz MD PhD Oscar Lozano MD Juan Carlos Ramos MD Mª Jesús Gaspar MD PhD Jerry Keller MD Antonio Martín Duce MD PhD |
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Institution: | (1) Servicios de Medicina Interna, Hospital Universitario Priíncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain;(2) Servicios de Cirugía, Hospital Universitario Priíncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain;(3) Servicios de Medicina Interna, Hospital Universitario Priíncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain;(4) Servicios de Bioauímica, Hospital Universitario Priíncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain;(5) Servicios de Cirugía, Hospital Universitario Priíncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain;(6) Servicios de Cirugía, Hospital Universitario Priíncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain |
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Abstract: | Background: Bariatric operations have varying degrees of effectiveness and different mechanisms of action. Our objective was
to evaluate the efficacy of the biliopancreatic diversion (BPD) in reduction of weight and serum lipids. Methods: A prospective
study was conducted with follow-up from 12 to 72 months (average 39.4 months) of 58 patients with morbid obesity (10 men,
48 women, mean BMI 49.4 kg/m2). Their lipid levels were generally normal or slightly high. All the patients were subjected to subtotal gastrectomy and
BPD with jejunoileostomy 50 cm proximal to the ileocecal valve, and they were instructed to maintain the same hypocaloric
diet as before BPD. Serum lipoproteins and apolipoproteins B and A1 were measured before BPD and every 6 months during follow-up.
Results: Early and very significant reduction (P<0.001) of total cholesterol (32.8%), LDL (46.3%), total cholesterol / HDL ratio (29.7%) and apolipoprotein B (37%), with
more moderate decrease of triglycerides (21.3%, P=0.004), were observed. This lipid decrease was maximum at 1 year after BPD. Important and persistent weight reduction that
did not correlate with changes in lipids was observed. The youngest patients and those with high basal lipid levels proved
to benefit most from BPD. There were no important side-effects. Conclusion: BPD, with careful selection of patients, is a
well tolerated procedure that offers excellent results in the short- and mid-term in reduction in weight and blood levels
of most atherogenic lipoproteins. |
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Keywords: | MORBID OBESITY BARIATRIC SURGERY MALABSORPTIVE SURGERY BILIOPANCREATIC DIVERSION LIPOPROTEINS CARDIOVASCULAR RISK |
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