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 .
Nocturnal and postprandial free fatty acid kinetics in normal and type 2 diabetic subjects: effects of insulin sensitization therapy.
Whether free fatty acid ( FFA ) rate of appearance ( R(a ) ) is increased in type 2 diabetes is controversial . To characterize nocturnal and postpr and ial abnormalities in FFA kinetics and to determine the effects of treatment with insulin sensitizers on lipolysis , we measured palmitate R(a ) in control subjects ( n = 6 ) and individuals with poorly controlled , sulfonylurea-treated type 2 diabetes ( HbA(1c ) = 8.7 + /- 0.2 % , n = 20 ) , the latter before and at the end of 12 weeks of treatment with troglitazone ( 600 mg/day , n = 4 ) , metformin ( approximately 2,000 mg/day , n = 8) , or placebo ( n = 8) . Subjects consumed a st and ard breakfast at 0800 h. Results in control subjects and type 2 diabetic subjects were compared at baseline . Integrated nocturnal FFA R(a ) ( AUC(1:00 - 8:00 A.M. ) ) was approximately 50 % higher in type 2 diabetic subjects than in control subjects ( 29.4 + /- 3.0 vs. 19.4 + /- 3.9 mmol . m(-2 ) . 7 h(-1 ) , respectively , P < 0.05 ) , whereas postpr and ial palmitate R(a ) ( AUC(0 - 240 min ) ) was almost threefold higher in type 2 diabetic subjects than in control subjects ( 14.2 + /- 1.7 vs. 5.3 + /- 1.0 mmol . m(-2 ) . 4 h(-1 ) , respectively , P < 0.01 ) . After troglitazone treatment , nocturnal palmitate R(a ) did not change , but postpr and ial palmitate R(a ) decreased by approximately 30 % ( P < 0.05 ) . Palmitate kinetics did not change with metformin or placebo treatment . In summary , nocturnal and postpr and ial FFA R(a ) is increased in type 2 diabetes . Postpr and ial lipolysis appears to be preferentially improved by thiazolidinediones compared with nocturnal lipolysis
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 .