Conclusions RYGB surgery reverses the dyslipidaemia of obesity .
These findings support the use of RYGB in the management of high cardiovascular risk lipid profiles in morbid obesity
Background Obesity-related dyslipidaemia comprises hypercholesterolaemia , hypertriglyceridaemia , low HDL-cholesterol and normal to raised LDL-cholesterol levels .
40 % of morbidly obese surgical patients have dyslipidaemia .
Roux-en-Y gastric bypass ( RYGB ) surgery has many beneficial metabolic effects , but the full impact on plasma lipids has not been clearly defined .
Fasting compared with nonfasting triglycerides and risk of cardiovascular events in women.
CONTEXT The association of triglycerides with incident cardiovascular disease  remains controversial . Although triglyceride levels are typically obtained in the fasting state , postpr and ial hypertriglyceridemia may play an important role in atherosclerosis . OBJECTIVE To determine the association of  triglyceride levels ( fasting vs nonfasting ) and risk of future cardiovascular events . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve study of 26,509 initially healthy US women ( 20,118 fasting and 6391 nonfasting ) participating in the Women 's Health Study , enrolled between November 1992 and July 1995 and undergoing follow-up for a median of 11.4 years .  Triglyceride levels  were measured in blood sample s obtained at time of enrollment . MAIN OUTCOME MEASURE Hazard ratios for incident cardiovascular events ( nonfatal myocardial infa rct ion , nonfatal ischemic stroke , coronary revascularization , or cardiovascular death ) . RESULTS At baseline , triglyceride levels in fasting as well as nonfasting women correlated with traditional cardiac risk factors and markers of insulin resistance . During a median follow-up of 11.4 years , 1001 participants experienced an incident cardiovascular event ( including 276 nonfatal myocardial infa rct ions , 265 ischemic strokes , 628 coronary revascularizations , and 163 cardiovascular deaths ) , for an overall rate of 3.46 cardiovascular events per 1000 person-years of follow-up . After adjusting for age , blood pressure , smoking , and use of hormone therapy , both fasting and nonfasting triglyceride levels predicted cardiovascular events . Among fasting participants , further adjustment for levels of total and high-density lipoprotein cholesterol and measures of insulin resistance weakened this association ( fully adjusted hazard ratio [ 95 % confidence interval ] for increasing tertiles of triglyceride levels : 1 [ reference ] , 1.21 [ 0.96 - 1.52 ] , and 1.09 [ 0.85 - 1.41 ] [ P = .90 for trend ] ) . In contrast , nonfasting triglyceride levels maintained a strong independent relationship with cardiovascular events in fully adjusted models ( hazard ratio [ 95 % confidence interval ] for increasing tertiles of levels : 1 [ reference ] , 1.44 [ 0.90 - 2.29 ] , and 1.98 [ 1.21 - 3.25 ] [ P = .006 for trend ] ) . In secondary analyses stratified by time since participants ' last meal , triglyceride levels measured 2 to 4 hours postpr and ially had the strongest association with cardiovascular events ( fully adjusted hazard ratio [ 95 % confidence interval ] for highest vs lowest tertiles of levels , 4.48 [ 1.98 - 10.15 ] [ P<.001 for trend ] ) , and this association progressively decreased with longer periods of fasting . CONCLUSIONS In this cohort of initially healthy women , nonfasting triglyceride levels were associated with incident cardiovascular events , independent of traditional cardiac risk factors , levels of other lipids , and markers of insulin resistance ; by contrast , fasting triglyceride levels showed little independent relationship
Conclusions RYGB surgery reverses the dyslipidaemia of obesity .
These findings support the use of RYGB in the management of high cardiovascular risk lipid profiles in morbid obesity
Background Obesity-related dyslipidaemia comprises hypercholesterolaemia , hypertriglyceridaemia , low HDL-cholesterol and normal to raised LDL-cholesterol levels .
40 % of morbidly obese surgical patients have dyslipidaemia .
Roux-en-Y gastric bypass ( RYGB ) surgery has many beneficial metabolic effects , but the full impact on plasma lipids has not been clearly defined .