Detailed Description of Change in Serum Cholesterol Profile with Incremental Weight Loss After Restrictive Bariatric Surgery

Geraldine J. Ooi, Arul Earnest, Lisa Doyle, John M. Wentworth, Ken Sikaris, Carel W. le Roux, Paul R. Burton, Paul E. O'Brien, Wendy A. Brown

Research output: Contribution to journalArticleResearchpeer-review

3 Citations (Scopus)

Abstract

Introduction: Dyslipidemia affects up to 75% of morbidly obese individuals and is a key driver of cardiovascular disease. Weight loss is an established strategy to improve metabolic risk, including dyslipidemia. We aimed to determine weight loss goals for resolution of serum lipid abnormalities, by measuring improvements during progressive weight loss in obese individuals. Methods: We performed a prospective cohort study of obese individuals with the metabolic syndrome undergoing adjustable gastric banding. Lipid levels were monitored monthly for 9 months, then three monthly until 24 months. Results: There were 101 participants included, age 47.4 ± 10.9 years with body mass index 42.6 ± 5.9 kg/m2. At 24 months, total body weight loss (TBWL) was 18.3 ± 7.9%. This was associated with significant improvements in high-density lipoprotein (HDL) (1.18 vs 1.47, p < 0.001), triglyceride (2.0 vs 1.4, p < 0.001), and total cholesterol to HDL ratio (TC:HDL) (4.6 vs 3.6, p < 0.001). Over this time, progressive and linear improvements in HDL, triglycerides, and TC:HDL were seen with incremental weight loss (observed at 2.5% TBWL intervals). Significant improvements occurred after a threshold weight loss of 7.5–12.5% TBWL was achieved, with odds ratio (OR) 1.48–2.50 for normalization. These odds improved significantly with increasing weight loss (OR 18.2–30.4 with > 25% TBWL). Despite significant weight loss, there was no significant change in low-density lipoprotein (LDL). Conclusion: Significant improvements in triglycerides, HDL, and TC:HDL occur after 7.5–12.5% TBWL, with ongoing benefit after greater weight loss. LDL needs to be addressed independently, as this was not observed to respond to weight loss alone. Trial registration number: Australian Clinical Trials Registry (ACTRN12610000049077).

Original languageEnglish
Pages (from-to)1351-1362
Number of pages12
JournalObesity Surgery
Volume28
Issue number5
DOIs
Publication statusPublished - 1 May 2018

Keywords

  • Bariatric surgery
  • Cholesterol
  • Dyslipidemia
  • Insulin resistance
  • Lipoproteins
  • Triglycerides
  • Weight loss

Cite this

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title = "Detailed Description of Change in Serum Cholesterol Profile with Incremental Weight Loss After Restrictive Bariatric Surgery",
abstract = "Introduction: Dyslipidemia affects up to 75{\%} of morbidly obese individuals and is a key driver of cardiovascular disease. Weight loss is an established strategy to improve metabolic risk, including dyslipidemia. We aimed to determine weight loss goals for resolution of serum lipid abnormalities, by measuring improvements during progressive weight loss in obese individuals. Methods: We performed a prospective cohort study of obese individuals with the metabolic syndrome undergoing adjustable gastric banding. Lipid levels were monitored monthly for 9 months, then three monthly until 24 months. Results: There were 101 participants included, age 47.4 ± 10.9 years with body mass index 42.6 ± 5.9 kg/m2. At 24 months, total body weight loss (TBWL) was 18.3 ± 7.9{\%}. This was associated with significant improvements in high-density lipoprotein (HDL) (1.18 vs 1.47, p < 0.001), triglyceride (2.0 vs 1.4, p < 0.001), and total cholesterol to HDL ratio (TC:HDL) (4.6 vs 3.6, p < 0.001). Over this time, progressive and linear improvements in HDL, triglycerides, and TC:HDL were seen with incremental weight loss (observed at 2.5{\%} TBWL intervals). Significant improvements occurred after a threshold weight loss of 7.5–12.5{\%} TBWL was achieved, with odds ratio (OR) 1.48–2.50 for normalization. These odds improved significantly with increasing weight loss (OR 18.2–30.4 with > 25{\%} TBWL). Despite significant weight loss, there was no significant change in low-density lipoprotein (LDL). Conclusion: Significant improvements in triglycerides, HDL, and TC:HDL occur after 7.5–12.5{\%} TBWL, with ongoing benefit after greater weight loss. LDL needs to be addressed independently, as this was not observed to respond to weight loss alone. Trial registration number: Australian Clinical Trials Registry (ACTRN12610000049077).",
keywords = "Bariatric surgery, Cholesterol, Dyslipidemia, Insulin resistance, Lipoproteins, Triglycerides, Weight loss",
author = "Ooi, {Geraldine J.} and Arul Earnest and Lisa Doyle and Wentworth, {John M.} and Ken Sikaris and {le Roux}, {Carel W.} and Burton, {Paul R.} and O'Brien, {Paul E.} and Brown, {Wendy A.}",
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Detailed Description of Change in Serum Cholesterol Profile with Incremental Weight Loss After Restrictive Bariatric Surgery. / Ooi, Geraldine J.; Earnest, Arul; Doyle, Lisa; Wentworth, John M.; Sikaris, Ken; le Roux, Carel W.; Burton, Paul R.; O'Brien, Paul E.; Brown, Wendy A.

In: Obesity Surgery, Vol. 28, No. 5, 01.05.2018, p. 1351-1362.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Detailed Description of Change in Serum Cholesterol Profile with Incremental Weight Loss After Restrictive Bariatric Surgery

AU - Ooi, Geraldine J.

AU - Earnest, Arul

AU - Doyle, Lisa

AU - Wentworth, John M.

AU - Sikaris, Ken

AU - le Roux, Carel W.

AU - Burton, Paul R.

AU - O'Brien, Paul E.

AU - Brown, Wendy A.

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N2 - Introduction: Dyslipidemia affects up to 75% of morbidly obese individuals and is a key driver of cardiovascular disease. Weight loss is an established strategy to improve metabolic risk, including dyslipidemia. We aimed to determine weight loss goals for resolution of serum lipid abnormalities, by measuring improvements during progressive weight loss in obese individuals. Methods: We performed a prospective cohort study of obese individuals with the metabolic syndrome undergoing adjustable gastric banding. Lipid levels were monitored monthly for 9 months, then three monthly until 24 months. Results: There were 101 participants included, age 47.4 ± 10.9 years with body mass index 42.6 ± 5.9 kg/m2. At 24 months, total body weight loss (TBWL) was 18.3 ± 7.9%. This was associated with significant improvements in high-density lipoprotein (HDL) (1.18 vs 1.47, p < 0.001), triglyceride (2.0 vs 1.4, p < 0.001), and total cholesterol to HDL ratio (TC:HDL) (4.6 vs 3.6, p < 0.001). Over this time, progressive and linear improvements in HDL, triglycerides, and TC:HDL were seen with incremental weight loss (observed at 2.5% TBWL intervals). Significant improvements occurred after a threshold weight loss of 7.5–12.5% TBWL was achieved, with odds ratio (OR) 1.48–2.50 for normalization. These odds improved significantly with increasing weight loss (OR 18.2–30.4 with > 25% TBWL). Despite significant weight loss, there was no significant change in low-density lipoprotein (LDL). Conclusion: Significant improvements in triglycerides, HDL, and TC:HDL occur after 7.5–12.5% TBWL, with ongoing benefit after greater weight loss. LDL needs to be addressed independently, as this was not observed to respond to weight loss alone. Trial registration number: Australian Clinical Trials Registry (ACTRN12610000049077).

AB - Introduction: Dyslipidemia affects up to 75% of morbidly obese individuals and is a key driver of cardiovascular disease. Weight loss is an established strategy to improve metabolic risk, including dyslipidemia. We aimed to determine weight loss goals for resolution of serum lipid abnormalities, by measuring improvements during progressive weight loss in obese individuals. Methods: We performed a prospective cohort study of obese individuals with the metabolic syndrome undergoing adjustable gastric banding. Lipid levels were monitored monthly for 9 months, then three monthly until 24 months. Results: There were 101 participants included, age 47.4 ± 10.9 years with body mass index 42.6 ± 5.9 kg/m2. At 24 months, total body weight loss (TBWL) was 18.3 ± 7.9%. This was associated with significant improvements in high-density lipoprotein (HDL) (1.18 vs 1.47, p < 0.001), triglyceride (2.0 vs 1.4, p < 0.001), and total cholesterol to HDL ratio (TC:HDL) (4.6 vs 3.6, p < 0.001). Over this time, progressive and linear improvements in HDL, triglycerides, and TC:HDL were seen with incremental weight loss (observed at 2.5% TBWL intervals). Significant improvements occurred after a threshold weight loss of 7.5–12.5% TBWL was achieved, with odds ratio (OR) 1.48–2.50 for normalization. These odds improved significantly with increasing weight loss (OR 18.2–30.4 with > 25% TBWL). Despite significant weight loss, there was no significant change in low-density lipoprotein (LDL). Conclusion: Significant improvements in triglycerides, HDL, and TC:HDL occur after 7.5–12.5% TBWL, with ongoing benefit after greater weight loss. LDL needs to be addressed independently, as this was not observed to respond to weight loss alone. Trial registration number: Australian Clinical Trials Registry (ACTRN12610000049077).

KW - Bariatric surgery

KW - Cholesterol

KW - Dyslipidemia

KW - Insulin resistance

KW - Lipoproteins

KW - Triglycerides

KW - Weight loss

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