Abstracts
1999 Digestive Disease Week

# 2184 LIPID RISK PROFILE AND WEIGHT STABILITY AFTER GASTRIC BARIATRIC OPERATIONS
Robert E Brolin, L J Bradley, A C Wilson, UMDNJ-Robert Wood Johnson Med Sch, New Brunswick, NJ

There are no longitudinal data which address weight loss stability and lipid levels in bariatric surgical patients. The goal of this study was to determine whether weight regain adversely affected reduction in lipid levels after gastric bariatric operations. Of 651 consecutive patients undergoing gastric restrictive operations for morbid obesity 228 patients (35%) had increased serum levels of total cholesterol (TC), triglycerides (TG) or both preop. HDL-C levels were subnormal (£ 35 mg/dl) in 45 (20%) of the hyperlipidemic patients. Fasting lipid profiles were determined at 6 month intervals postop. This series included three operations; gastroplasty (GP, N= 13), std RY gastric bypass (RYGB, N= 205) and distal RY gastric bypass (DRY, N= 9). By 6 months postop, patients had a ³ 15% mean reduction in TC and ³ 50% mean reduction in TG which were significant in comparison with preop levels (p £ 0.05). Mean HDL-C levels had increased significantly vs. preop levels by 12 months postop (p < 0.05) and continued to increase thru 5 yrs. By 18 months both HDL-C and TC were significantly lower after DRY than after GP or RYGB. In 91 patients who were followed ³ 2 yrs. (mean 48 ± 25 months) mean excess weight loss was 55% with mean BMI reduced from 48 to 33 Kg/m2. This group was subdivided into patients whose weight remained stable (N= 54) and patients who regained ³15% of their lost weight or lost less than 50% of excess weight (N=37). Although mean excess weight loss and BMI were significantly different between the 2 groups (p < 0.0001), there was no difference in lipid profile (TC/HDL) between the groups at any interval thru 5 yrs. These results show that abnormal lipid profiles can be permanently improved after gastric bariatric operations and are not adversely affected by mediocre weight loss or regaining ³ 15% of lost weight. DRY appears to be a superior operation for TC reduction and lipid profile improvement in comparison with GP and RYGB.

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