Gastric Bypass Surgery for Patients with Hyperlipidemia

Extremely obese patients who undergo gastric bypass surgery experience a significant reduction in their cholesterol levels within 6 months of surgery, and overall lipid profiles continue to improve for as long as 6 years after the procedure, according to recent research from the University of Iowa led by Isaac Samuel, MD.

Samuel, a bariatric surgeon with the University’s Hospitals and Clinics, and his team performed a retrospective analysis of 248 patients undergoing Roux-en-Y gastric bypass surgery between 2000 and 2005; 94 were identified as having hyperlipidemia at baseline, and 23 were on lipid-lowering medications before the surgery. For the purposes of the study, hyperlipidemia was defined “as a total cholesterol level of 200 mg/dL or greater and elevated triglyceride levels of 150 mg/dL or greater.” The researchers also evaluated changes in the lipid profile of patients with subnormal levels of HDL (≤ 40mg/dL) and high LDL levels (> 130mg/dL).

On average, total cholesterol levels declined 20% within 6 months of surgery, from 220mg/dL to 179mg/dL. Additionally, “triglyceride levels dropped more than 40%, from 212 mg/dL at baseline to 128 mg/dL at follow-up, and LDL cholesterol levels dropped more than 20%, from 135 mg/dL at baseline to 106 mg/dL at 6-month follow-up.”

Even at the 6-year point after surgery, lipid levels remained unchanged, but the researchers observed an additional benefit: a greater than 10% increase in HDL levels (51-57mg/dL). The ratio of total to HDL cholesterol also dropped from 4.3 to 2.8.

According to Samuels, the significant improvement in lipid profiles and the longevity of the improvement raises the issue “of whether the surgery itself could become a primary tool for treating hyperlipidemia.”

"It could even be worthwhile to consider whether there could be a place for the Roux-en-Y gastric bypass surgery in the management of hyperlipidemia in patients with a BMI of less than 35 kg/m2,” Samuels continued.