Gastric banding led to improvements in HDL, particle size after 5 years

Issue: April 2013

SAN FRANCISCO — Bariatric surgery using gastric banding did not improve LDL cholesterol or LDL particle number or size, despite significant weight loss among patients who underwent the procedure. Results suggest, however, a beneficial HDL remodeling process based on a significant increase in HDL cholesterol and HDL particle size.

Perspective from Donna M. Polk, MD, MPH

Researchers from the New York University Langone Medical Center said the HDL remodeling process persisted up to 5 years after gastric banding.

“Knowing that some studies suggest early improvements in lipids after bariatric surgery, there is a paucity of data regarding changes in the lipoprotein abnormalities characteristic of the dyslipidemia of obesity. What we sought to do was to determine both initial and long-term effects of gastric banding surgery on lipids, with attention to LDL and HDL characteristics,” researcher Amita Singh, MD, from NYU Langone Medical Center in New York, said during a presentation here.

Patients with a BMI of 30 to 40 (n=50) underwent laparoscopic gastric banding. Physical exams and blood samples for nuclear magnetic resonance spectroscopy were performed at baseline and at annual follow-up, which lasted 5 years.

At 1 and 5 years, researchers observed significant increases in HDL cholesterol (P<.001). After 5 years, mean HDL size was increased (9.1 nm at baseline vs. 9.24 nm at 5 years; P<.06), and there was a significant increase in HDL particle number (33.49 nm/L at baseline vs. 37 nm/L; P<.02). Conversely, early reductions in LDL particle number and size were nonsignificant after 5 years.

Metabolic syndrome and percent BMI loss had no effect on changes in particle number or size for both LDL and HDL. It is important to note that 20 patients were on statins at baseline, and at 5 years 13 of those 20 had their statin discontinued by their doctor. This may have confounded results. – by Samantha Costa

For more information:

Sing A. Abstract #919-5. Presented at: American College of Cardiology Scientific Sessions; March 9-11, 2013; San Francisco.

Disclosure: Singh reports no relevant financial disclosures.

Perspective

Donna M. Polk, MD, MPH

This study was interesting in the fact that we didn’t see a lot of the changes we expected. Acute weight loss lowers your cholesterol, but losing weight doesn’t lower your cholesterol, and it’s often just dietary changes. It’s interesting to see that, but it’s also limited.

Donna M. Polk, MD, MPH

Physician at Hartford Hospital (Connecticut)

Disclosures: Polk reports no relevant financial disclosures.