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 .
Regression of Coronary Atherosclerosis by Simvastatin: A Serial Intravascular Ultrasound Study
Background —Angiography of the coronary arteries reflects only changes in luminal dimensions . With intravascular ultrasound , cross-sectional images can be obtained and area measurements can be added to calculate volumes of the external elastic membrane ( EEM ) , plaque plus media ( P+M ) , and lumen . The aim of this study was to investigate the effect of lipid lowering by simvastatin on coronary atherosclerotic P+M as changes in volumes of EEM , P+M , and lumen . Methods and Results —In 40 male patients with hypercholesterolemia , ischemic heart disease , and a nonsignificant coronary artery lesion in a not previously revascularized coronary artery , serial intravascular ultrasound studies with an ECG-triggered pullback were performed at baseline , after 3 months on a lipid-lowering diet , and after another 12 months on simvastatin 40 mg/d . Mean length of the analyzed atherosclerotic segments was 5.9±3.3 mm . After 12 months on simvastatin , a significant reduction in P+M volume of 6.3 % ( P = 0.002 ) was observed , whereas only a nonsignificant reduction in EEM volume of 1.8 % was seen without any concomitant change in lumen volume . A significant reduction in total cholesterol of 31.0 % ( 6.1±0.8 versus 4.2±0.7 mmol/L , P < 0.001 ) and LDL cholesterol of 42.6 % ( 4.0±0.8 versus 2.2±0.6 mmol/L , P < 0.001 ) was obtained . Conclusions —Lipid-lowering therapy with simvastatin for 12 months is associated with a significant P+M regression in coronary arteries measured as reduction in P+M and EEM volumes without any concomitant change in lumen volume
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 .