背景:减肥手术旨在减轻体重并解决与肥胖相关的合并症。很少有研究评估袖状胃切除术与胃旁路术的中期/长期血脂变化。进行这项研究是为了评估和比较60个月后每种程序的脂质分布变化。
方法:这是一个观察性的,纳入100例患者的分析队列的回顾性研究分为两组:50例接受胃旁路术(GBP)手术和50例袖状胃切除术(SG)手术.总胆固醇(TC),低密度脂蛋白(LDL),高密度脂蛋白(HDL),在手术前和1、6、12、24、36、48和60个月测量甘油三酯(TG)水平。还评估了每种程序的体重减轻和血脂异常的消退。
结果:100例患者中有95例完成了随访。60个月时,TC和LDL水平在BPG组中显著降低(167.42±31.22mg/dl和88.06±31.37mg/dl,分别),而SG组没有差异。两种手术均增加了HDL水平(BPG:62.69±16.3mg/dlvs.SG:60.64±18.73mg/dl),程序之间没有区别。两组的TG水平均降低(BPG:86.06±56.57mg/dlvs.SG:111.09±53.08mg/dl),但BPG组的值较高(P<0.05)。BPG组中超重损失(PSP)的百分比更高:75.65±22.98mg/dl与GV组:57.83±27.95mg/dl。
结论:与袖状胃切除术相比,胃旁路术在减轻体重和消除高胆固醇血症方面取得了更好的中期/长期效果。虽然胃旁路术改善了所有的血脂参数,袖状胃切除术仅改善HDL和甘油三酯水平。
BACKGROUND: Bariatric surgery aims to reduce weight and resolve the comorbidities associated with obesity. Few studies have assessed mid/long-term changes in lipid profile with sleeve gastrectomy versus gastric bypass. This study was conducted to assess and compare changes in lipid profile with each procedure after 60 months.
METHODS: This was an observational, retrospective study of analytical cohorts enrolling 100 patients distributed into two groups: 50 had undergone gastric bypass (GBP) surgery and 50 sleeve gastrectomy (SG) surgery. Total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride (TG) levels were measured before surgery and at 1, 6, 12, 24, 36, 48, and 60 months. Weight loss and the resolution of dyslipidemia with each of the procedures were also assessed.
RESULTS: Ninety-five of the 100 patients completed follow-up. At 60 months, TC and LDL levels had significantly decreased in the BPG group (167.42 ± 31.22 mg/dl and 88.06 ± 31.37 mg/dl, respectively), while there were no differences in the SG group. Increased HDL levels were seen with both procedures (BPG: 62.69 ± 16.3 mg/dl vs. SG: 60.64 ± 18.73 mg/dl), with no difference between the procedures. TG levels decreased in both groups (BPG: 86.06 ± 56.57 mg/dl vs. SG: 111.09 ± 53.08 mg/dl), but values were higher in the BPG group (P < .05). The percentage of overweight lost (PSP) was higher in the BPG group: 75.65 ± 22.98 mg/dl vs. the GV group: 57.83 ± 27.95 mg/dl.
CONCLUSIONS: Gastric bypass achieved better mid/long-term results in terms of weight reduction and the resolution of hypercholesterolemia as compared to sleeve gastrectomy. While gastric bypass improved all lipid profile parameters, sleeve gastrectomy only improved HDL and triglyceride levels.