Key result
Roux-en-Y gastric bypass and sleeve gastrectomy resulted in similar improvements in glucose levels at 12 months, though RYGB led to significantly greater reductions in total cholesterol, LDL, and triglycerides.
Why the study?
Does Roux-en-Y-bypass compared to sleeve gastrectomy improve lipid profiles and glucose levels in obese female patients?
Observational (n=40)
No
Does Roux-en-Y-bypass compared to sleeve gastrectomy improve lipid profiles and glucose levels in obese female patients?
Absolute Event Rate: 83.62% vs 88.12%
p-value: p=0.419
While RYGB provides greater reductions in total cholesterol, LDL, and triglycerides compared to SG at 12 months, both procedures similarly improve glucose levels and cause temporary liver overload, suggesting SG may be considered as a first option due to its less invasive nature.
Lipid reductions with RYGB should not yet guide bariatric choices; leaves open whether benefits exceed sleeve gastrectomy in randomized cardiovascular trials.
BACKGROUND: The aim of this study was to evaluate the effect of sleeve gastrectomy (SG) and Roux-en-Y-bypass (RYGB) on anthropometric and biochemical parameters, including changes in glucose levels, lipid profile and liver function. Drastic decrease in all lipid fractions a few weeks or months after the surgery could be regarded as favourable, but low level of HDL is an independent risk factor for heart diseases. Extreme load on the liver without preparation of the patient to the surgery can have negative consequences. METHODS: The test group comprised of 40 female patients at the age of 42.96 with average body weight of 131.56 kg and BMI 46.49. Biochemical analyses were performed using calorimetric method. RESULTS: No statistically significant differences were observed in glucose levels between the two types of procedures. The highest differences were noted for triglycerides levels, which decreased, as well as all cholesterol fractions, after RYGB, but were increasing during the first months after SG procedure. Changes in lipid profile, caused by the reduction of all lipid fractions, were more visible after RYGB. The decrease in total cholesterol directly and activity of liver enzymes after the procedure was as higher after RYGB as after SG. Increased activity of transaminases indicates significant liver overload. CONCLUSIONS: With the selection of groups of patients with similar initial parameters, it is not clear whether the differences between the two procedures when assessing the improvement of glycaemia are significant. However, due to invasive character of RYGB, liver overload lasting several months and lifelong limited absorption of nutrients, the possibility of SG procedure should be considered as a first option.
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Szczuko et al. (2016) conducted an observational in Obesity (n=40). Roux-en-Y gastric bypass (RYGB) vs. Sleeve gastrectomy (SG) was evaluated on Glucose concentration at 12 months (mg/dl) (p=0.419). Roux-en-Y gastric bypass and sleeve gastrectomy resulted in similar improvements in glucose levels at 12 months, though RYGB led to significantly greater reductions in total cholesterol, LDL, and triglycerides.
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