Document Detail


Comparison of changes in lipid profile after bilio-intestinal bypass and gastric banding in patients with morbid obesity.
MedLine Citation:
PMID:  15826472     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The presence of hypercholesterolemia is currently not considered a selection criteria for performing gastric restrictive or diversionary bariatric surgery. METHODS: We prospectively investigated the effects of the bilio-intestinal bypass (BI-bypass) with a wide cholecysto-jejunal anastomosis and of adjustable gastric banding (AGB) on blood lipid concentrations in obese patients. To clarify the mechanism of the hypocholesterolemic effect of the BI-bypass, daily fecal sterol excretion was measured by gas-liquid chromatography (GLC). RESULTS: At 1 year after BI-bypass compared to baseline, the hypercholesterolemic (n=18) and the normocholesterolemic (n=19) patients significantly reduced total (-38% and -27%, respectively), LDL (-47% and -24%, respectively) and HDL (-11% and -13%, respectively) cholesterol and total / HDL cholesterol ratio (-25% and -13%, respectively). At 1 year after AGB, the total / HDL cholesterol ratio was significantly decreased (-11%) compared to baseline in hypercholesterolemic (n=12) but not in normocholesterolemic (n=6) patients, while total and LDL cholesterol were not affected in both groups. At 3 years after BI-bypass compared to baseline, the hypercholesterolemic (n=9) and the normocholesterolemic (n=11) patients significantly reduced total (-43% and -28%, respectively) and LDL (-53% and -29%, respectively) cholesterol and total / HDL cholesterol ratio (-38% and -21%, respectively). The BI-bypass induced a significant (P <0.005; n=7) 6-fold increase in mean fecal cholesterol output. CONCLUSIONS: The BI-bypass but not the AGB leads to a persistent and marked beneficial effect on blood LDL cholesterol associated with an increased cholesterol fecal output. BI-bypass but not AGB is indicated in morbidly obese patients with hypercholesterolemia.
Authors:
Stefano Ginanni Corradini; Annarita Eramo; Carla Lubrano; Giovanni Spera; Alessandra Cornoldi; Antonio Grossi; Francesca Liguori; Maria Siciliano; Massimo Codacci Pisanelli; Gerald Salen; Ashok Kumir Batta; Adolfo Francesco Attili; Marco Badiali
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Obesity surgery     Volume:  15     ISSN:  0960-8923     ISO Abbreviation:  Obes Surg     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-04-13     Completed Date:  2005-07-14     Revised Date:  2007-12-05    
Medline Journal Info:
Nlm Unique ID:  9106714     Medline TA:  Obes Surg     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  367-77     Citation Subset:  IM    
Affiliation:
Dipartimento di Medicina Clinica Divisione di Gastroenterologia, Italy. stefano.corradini@uniroma1.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Bile Acids and Salts / analysis
Biliopancreatic Diversion / methods*
Cholestanol / analysis
Cholesterol / analysis,  blood*
Cholesterol, HDL / blood
Cholesterol, LDL / blood
Feces / chemistry
Female
Follow-Up Studies
Gastric Bypass / methods*
Humans
Hypercholesterolemia / blood,  therapy
Jejunoileal Bypass / methods*
Male
Obesity, Morbid / blood,  surgery*
Phytosterols / analysis
Prospective Studies
Triglycerides / blood
Chemical
Reg. No./Substance:
0/Bile Acids and Salts; 0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Phytosterols; 0/Triglycerides; 57-88-5/Cholesterol; 80-97-7/Cholestanol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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