Abstract
Background
Coronary artery disease (CAD) is the leading cause of death in the United States,
with obesity as a leading preventable risk factor for CAD. Certain biochemical markers
have demonstrated strong prediction for cardiovascular events. We hypothesized that
in addition to weight reduction, gastric bypass will also induce a salutary effect
on the biochemical cardiac risk factors.
Methods
At a single academic institution, from 2003 to 2004, we measured the biochemical cardiac
risk factors in gastric bypass patients preoperatively and at 3, 6, and 12 months
postoperatively. These risk factors included total cholesterol, high-density lipoprotein
(HDL) cholesterol, low-density lipoprotein cholesterol, total cholesterol/HDL cholesterol
ratio, triglyceride/HDL cholesterol ratio, triglycerides, lipoprotein A, high-sensitivity
C-reactive protein, and homocysteine. The data were analyzed using the Wilcoxon signed
rank test.
Results
The mean age of the 356 patients was 43 years; 84% were women; the mean body mass
index was 47 kg/m2; 33% were diabetic; 50% were hypertensive; 23% were taking lipid-lowering medications;
and 2% had known CAD. Significant improvement occurred in the biochemical cardiac
factors from preoperatively to 12 months. The beneficial changes were as follows:
total cholesterol, 192 mg/dL preoperatively to 166 mg/dL at 12 months; HDL cholesterol,
46 mg/dL preoperatively to 54 mg/dL at 12 months; low-density lipoprotein, 125 mg/dL
preoperatively to 88 mg/dL at 12 months; total cholesterol/HDL cholesterol ratio,
4 preoperatively to 3 at 12 months; triglyceride/HDL cholesterol ratio, 3 preoperatively
to 2 at 12 months; triglycerides, 133 mg/dL preoperatively to 92 mg/dL at 12 months;
lipoprotein A, 14 mg/dL preoperatively to 13 mg/dL at 12 months; high-sensitivity
C-reactive protein, 8 mg/L preoperatively to 1 mg/L; and homocysteine, 10 μmol/L preoperatively
to 8 μmol/L at 12 months.
Conclusions
The results of our study have shown that gastric bypass significantly improves all
biochemical markers of CAD risk, particularly C-reactive protein, which had an 80%
reduction. As a result, gastric bypass decreases the cardiac risk by both weight loss
and advantageous alterations of biochemical cardiac risk factors.
Keywords
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Article info
Publication history
Published online: December 28, 2006
Accepted:
October 5,
2006
Received in revised form:
June 21,
2005
Received:
June 10,
2005
Identification
Copyright
© 2007 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
