Bariatric surgery (BS) is known to favorably impact fasting lipid profile. Fasting and postprandial lipids were evaluated before and 2 years after BS in obese type 2 diabetic (T2DM) patients. Methods A prospective study was conducted in 19 obese T2DM patients: ten undergoing sleeve gastrectomy (SG) and nine undergoing Roux-en-Y gastric bypass (RYGB). Before and 2 years after BS, clinical parameters and the response of lipid and incretin hormones to a mixed meal (MM) were assessed. Results The two groups had similar characteristics at baseline.After BS, weight loss was similar in the two groups (p≤0.01). Fasting glucose, insulin, and triglycerides decreased while HDL cholesterol increased in a similar way (p<0.05); in contrast, fasting LDL cholesterol decreased only after RYGB (p<0.05). Post-meal glucose concentrations decreased while early insulin response significantly improved after both procedures (p<0.001 for both). Postprandial triglycerides decreased after both procedures (p<0.05) while postprandial LDL cholesterol decreased only after RYGB (p<0.05). Meal-GLP-1 increased postoperatively in both groups although to a greater extent after RYGB (p<0.001 vs. SG). GIP decreased after both procedures, especially after RYGB (p=0.003). At multivariate analysis, GLP-1 peak was the best predictor of LDL reduction (β=−0.552, p=0.039) while the improvement of HOMA-IR (β=0.574, p=0.014) and weight loss (β=0.418, p=0.036) predicted triglycerides reduction. Conclusions Both surgical procedures markedly reduce fasting and postprandial triglycerides and increase HDL cholesterol levels. LDL cholesterol decreases only after RYGB through a mechanism likely mediated by the restoration of GLP-1.

Effects of Sleeve Gastrectomy and Gastric Bypass on Postprandial Lipid Profile in Obese Type 2 Diabetic Patients: a 2-Year Follow-up / Griffo, Ettore; Cotugno, Mariella; Nosso, Gabriella; Saldalamacchia, Gennaro; Mangione, A; Angrisani, Luigi; Rivellese, ANGELA ALBAROSA; Capaldo, Brunella. - In: OBESITY SURGERY. - ISSN 0960-8923. - 26:6(2016), pp. 1247-1253. [10.1007/s11695-015-1891-4]

Effects of Sleeve Gastrectomy and Gastric Bypass on Postprandial Lipid Profile in Obese Type 2 Diabetic Patients: a 2-Year Follow-up

GRIFFO, ETTORE;COTUGNO, MARIELLA;NOSSO, GABRIELLA;SALDALAMACCHIA, GENNARO;ANGRISANI, LUIGI;RIVELLESE, ANGELA ALBAROSA;CAPALDO, BRUNELLA
2016

Abstract

Bariatric surgery (BS) is known to favorably impact fasting lipid profile. Fasting and postprandial lipids were evaluated before and 2 years after BS in obese type 2 diabetic (T2DM) patients. Methods A prospective study was conducted in 19 obese T2DM patients: ten undergoing sleeve gastrectomy (SG) and nine undergoing Roux-en-Y gastric bypass (RYGB). Before and 2 years after BS, clinical parameters and the response of lipid and incretin hormones to a mixed meal (MM) were assessed. Results The two groups had similar characteristics at baseline.After BS, weight loss was similar in the two groups (p≤0.01). Fasting glucose, insulin, and triglycerides decreased while HDL cholesterol increased in a similar way (p<0.05); in contrast, fasting LDL cholesterol decreased only after RYGB (p<0.05). Post-meal glucose concentrations decreased while early insulin response significantly improved after both procedures (p<0.001 for both). Postprandial triglycerides decreased after both procedures (p<0.05) while postprandial LDL cholesterol decreased only after RYGB (p<0.05). Meal-GLP-1 increased postoperatively in both groups although to a greater extent after RYGB (p<0.001 vs. SG). GIP decreased after both procedures, especially after RYGB (p=0.003). At multivariate analysis, GLP-1 peak was the best predictor of LDL reduction (β=−0.552, p=0.039) while the improvement of HOMA-IR (β=0.574, p=0.014) and weight loss (β=0.418, p=0.036) predicted triglycerides reduction. Conclusions Both surgical procedures markedly reduce fasting and postprandial triglycerides and increase HDL cholesterol levels. LDL cholesterol decreases only after RYGB through a mechanism likely mediated by the restoration of GLP-1.
2016
Effects of Sleeve Gastrectomy and Gastric Bypass on Postprandial Lipid Profile in Obese Type 2 Diabetic Patients: a 2-Year Follow-up / Griffo, Ettore; Cotugno, Mariella; Nosso, Gabriella; Saldalamacchia, Gennaro; Mangione, A; Angrisani, Luigi; Rivellese, ANGELA ALBAROSA; Capaldo, Brunella. - In: OBESITY SURGERY. - ISSN 0960-8923. - 26:6(2016), pp. 1247-1253. [10.1007/s11695-015-1891-4]
File in questo prodotto:
File Dimensione Formato  
Griffo2016_.pdf

solo utenti autorizzati

Descrizione: lavoro originale
Tipologia: Documento in Post-print
Licenza: Dominio pubblico
Dimensione 403.09 kB
Formato Adobe PDF
403.09 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/614202
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 29
  • ???jsp.display-item.citation.isi??? 29
social impact