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One Year Improvements in Cardiovascular Risk Factors: a Comparative Trial of Laparoscopic Roux-en-Y Gastric Bypass vs. Adjustable Gastric Banding

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Abstract

Background

Coronary artery disease (CAD) is the leading cause of death in the industrialized world with obesity as a leading preventable risk factor. Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric banding (LAGB) have been shown to improve certain biochemical cardiovascular risk factors (BCRFs) at 1 year post-op, however no study has directly compared the 12-month BCRF improvements of RYGB vs. LAGB.

Methods

At a single academic institution (2004–2009), we measured BCRF in 838 consecutive bariatric patients (765 RYGB, 73 LAGB) pre-operatively and at 12 months post-operatively. BCRF included total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides (Trig), Trig/HDL ratio, lipoprotein(a) (Lp(a)), homocysteine (HmC), high sensitivity C-reactive protein (hs-CRP), fasting insulin (FI), and hemoglobin A1C (Hgb A1C). Pre-op and 12-month post-op values were compared by a paired t test of equal variance.

Results

At 12 months post-op, RYGB patients had lost 77% of their excess weight and had significant improvements in TC, LDL, HDL, Trig, Trig/HDL, HmC, hs-CRP, FI, and Hgb A1C. LAGB patients lost 47.6% of their excess weight and had significant improvements in Trig, Trig/HDL, HmC, hs-CRP, and Hgb A1C. Having RYGB instead of LAGB was predictive of significantly greater improvements in TC at 12 months post-operatively.

Conclusions

In this study, both RYGB and LAGB demonstrated significant weight loss and improvements in BCRF at 12 months post-op. RYGB produced significant improvements in a greater number of BCRFs and in some instances the 12-month post-op BCRF values were significantly lower risk in RYGB vs. LAGB patients.

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Disclosures

This study was supported by research grants from Stanford School of Medicine. None of the authors have any related commercial interest to disclose.

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Authors and Affiliations

  1. Department of General Surgery, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA

    Gavitt A. Woodard, Joseph Peraza, Stephanie Bravo, Loren Toplosky, Tina Hernandez-Boussard & John M. Morton

  2. 300 Pasteur Drive, H3680, Stanford, CA, 94305, USA

    John M. Morton

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  1. Gavitt A. Woodard
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  2. Joseph Peraza
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  3. Stephanie Bravo
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  4. Loren Toplosky
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  5. Tina Hernandez-Boussard
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Correspondence to John M. Morton.

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Woodard, G.A., Peraza, J., Bravo, S. et al. One Year Improvements in Cardiovascular Risk Factors: a Comparative Trial of Laparoscopic Roux-en-Y Gastric Bypass vs. Adjustable Gastric Banding. OBES SURG 20, 578–582 (2010). https://doi.org/10.1007/s11695-010-0088-0

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  • DOI: https://doi.org/10.1007/s11695-010-0088-0

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