Bariatric surgery significantly reduced triglyceride-rich lipoprotein levels from 28 mg/dL to 18 mg/dL (p<0.001), with reductions correlating with improved HbA1c rather than weight loss.
Observational (n=1,637)
Does bariatric surgery reduce triglyceride-rich lipoproteins in individuals with morbid obesity?
Bariatric surgery significantly reduces atherogenic triglyceride-rich lipoproteins in parallel with improved glycemic control, independent of weight loss, particularly in patients with diabetes.
Absolute Event Rate: 18% vs 28%
p-value: p=<0.001
Introduction and Objective: Bariatric surgery (BS) can substantially reduce the increased cardiovascular (CV) risk of people with morbid obesity. Atherogenic lipoproteins, particularly triglyceride-rich lipoproteins (TRL), contribute to CV risk and are closely associated with obesity. The aim of this study was to characterize changes in lipids, with a specific focus on TRLs, and to assess their relationship with glycaemic status in a large cohort before and after BS. Methods: We conducted a retrospective, cross-sectional analysis of 1.637 individuals with MO (76% female, BMI 45±7kg/m2, age 39±12 years) and a longitudinal analysis in 442 individuals before and after BS. Patients were stratified according to their preop glycaemic status into following groups: normoglycaemia (NG), HbA1c 5.7%; prediabetes (pD), HbA1c 5.7-6.4%; and diabetes mellitus (DM), HbA1c 6.4%. Statistical analyses were performed using SPSS. Results: In the cross-sectional analysis, there was a significant increase in TRL concentrations according to glycemic status (NG 25±12mg/dl vs. pD 29±15mg/dl vs. DM 35±19mg/dl; between-group differences p0.001). Postoperatively, there was a favorable change in the overall lipid profile with a significant reduction in TRL (28±15mg/dL vs 18±18mg/dL, p0.001), LDL-C, nonHDL-C and TG (each p0.001).A correlation analysis revealed a significant association between Δ(pre vs post-op)HbA1c and ΔTRL (p0.001), but no correlation between ΔTRL and ΔBMI (p=0.62). Following stratification by glycaemic status, a highly significant association with ΔTRL was observed in the DM group (p0.001), whereas no such associations were found in the NG or pD groups. Conclusion: BSinduced weight loss significantly reduces TRL levels. The absence of a correlation between ΔTRL and ΔBMI, together with a significant association with ΔHbA1c, indicates that the CV benefits of metabolic surgery—particularly in individuals with DM—extend beyond weight loss alone. Disclosure F. Höllerl: None. B. Ludvik: Advisory Panel; Current; Novo Nordisk. Research Support; Current; Novo Nordisk. Speaker's Bureau; Current; Novo Nordisk. Advisory Panel; Current; Boehringer Ingelheim International GmbH. Research Support; Current; Boehringer Ingelheim International GmbH. Speaker's Bureau; Current; Boehringer Ingelheim International GmbH. Advisory Panel; Current; Eli Lilly and Company. Research Support; Current; Eli Lilly and Company. Speaker's Bureau; Current; Eli Lilly and Company. Research Support; Current; Amgen Inc. J.M. Brix: Advisory Panel; Current; Abbott Diabetes, Boehringer Ingelheim International GmbH. Speaker's Bureau; Current; AstraZeneca. Speaker's Bureau; Ended; Dexcom, Inc. Speaker's Bureau; Current; Bayer AG. Advisory Panel; Current; Eli Lilly and Company, Merck Sharp Ended; Medtronic. Advisory Panel; Current; Novo Nordisk.
Höllerl et al. (Fri,) conducted a observational in Morbid obesity (n=1,637). Bariatric surgery vs. Pre-operative state was evaluated on Triglyceride-rich lipoproteins (TRL) concentration (p=<0.001). Bariatric surgery significantly reduced triglyceride-rich lipoprotein levels from 28 mg/dL to 18 mg/dL (p<0.001), with reductions correlating with improved HbA1c rather than weight loss.
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