Document Detail


Cholesterol absorption decreases after Roux-en-Y gastric bypass but not after gastric banding.
MedLine Citation:
PMID:  20015521     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The differences in cholesterol metabolism after the 2 most common forms of obesity surgery, Roux-en-Y gastric bypass (RYGB) and gastric banding (GB), have not been well characterized. In this study, effects of RYGB and GB on cholesterol absorption and synthesis were investigated. To this aim, 1-year follow-up of cholesterol metabolism in 2 nonrandomized cohorts undergoing either RYGB (n = 29; age, 45.2 +/- 7.7 years; body mass index [BMI], 46.0 +/- 6.1 kg/m(2)) or GB (n = 26; age, 45.9 +/- 8.6 years; BMI, 50.1 +/- 7.7 kg/m(2)) was performed in a university hospital center specializing in the treatment of morbid obesity. Serum markers of cholesterol synthesis (cholestenol, desmosterol, and lathosterol) and cholesterol absorption (campesterol, sitosterol, avenasterol, and cholestanol) were measured preoperatively and at follow-up and expressed as ratios to cholesterol. As expected based on observed weight loss (25% after RYGB and 17% after GB, P < .001 between groups), both operations decreased serum levels of cholesterol synthesis markers by 12% to 28% (all Ps < .001). A decrease in cholesterol absorption markers was only observed after RYGB (-26% for sitosterol) and not after GB (+16%, P = 2 x 10(-6) for difference between the groups). The difference in sitosterol ratio between the groups remained significant after adjustment for age, BMI, fasting insulin levels, and nutritional status (P = 2 x 10(-4)), indicating a specific effect related to RYGB. We conclude that decrease in cholesterol absorption is a novel beneficial effect of RYGB. Together with an improved control of blood glucose, this may contribute to a better cardiovascular risk profile after RYGB.
Authors:
Jussi Pihlajam?ki; Sari Gr?nlund; Marko Simonen; Pirjo K?kel?; Leena Moilanen; Matti P??kk?nen; Elina Pirinen; Marjukka Kolehmainen; Vesa K?rj?; Sakari Kainulainen; Matti Uusitupa; Esko Alhava; Tatu A Miettinen; Helena Gylling
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-12-16
Journal Detail:
Title:  Metabolism: clinical and experimental     Volume:  59     ISSN:  1532-8600     ISO Abbreviation:  Metab. Clin. Exp.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-24     Completed Date:  2010-06-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375267     Medline TA:  Metabolism     Country:  United States    
Other Details:
Languages:  eng     Pagination:  866-72     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Medicine, University of Kuopio and Kuopio University Hospital, 70210 Kuopio, Finland. jussi.pihlajamaki@uef.fi
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MeSH Terms
Descriptor/Qualifier:
Adult
Anastomosis, Roux-en-Y*
Bariatric Surgery*
Blood Glucose / metabolism
Body Height / physiology
Body Mass Index
Body Weight / physiology
Cholesterol / biosynthesis,  metabolism
Cholesterol, Dietary / pharmacokinetics*
Cholesterol, LDL / blood
Female
Gastric Bypass
Humans
Intestinal Absorption / physiology*
Liver / pathology
Male
Middle Aged
Obesity / metabolism,  surgery
Phytosterols / blood
Sterols / blood
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Cholesterol, Dietary; 0/Cholesterol, LDL; 0/Phytosterols; 0/Sterols; 57-88-5/Cholesterol

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