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22-04-2010 | Cardiometabolic | Article

Malabsorptive bariatric surgery has favorable impact on lipids


Free abstract

MedWire News: Malabsorptive bariatric techniques appear to be more effective than restrictive techniques for the treatment of visceral obesity and its complications, researchers believe.

Bariatric surgery is increasingly used to facilitate weight loss in obese individuals but little is known about the long-term effects of different bariatric procedures on body composition and cardiometabolic factors.

Carla Lubrano (Sapienza University, Rome, Italy) and co-workers prospectively studied 80 people with a body mass index (BMI) >40 kg/m2 or >35 kg/m2 plus comorbidities. None of the patients had a history of cardiovascular disease and all had been referred for bariatric surgery following the failure of nonsurgical measures.

Half of the participants underwent biliointestinal bypass (BIBP) while half underwent laparoscopic gastric banding (LAGB); these are purely malabsorptive and purely restrictive procedures, respectively.

By 1 year after surgery, patients in both groups showed significant reductions in BMI, fat mass, triglycerides, blood pressure, and markers of inflammation and glucose handling.

Patients in the BIBP group also exhibited significant reductions in lipid parameters, including total cholesterol, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol.

In the LAGB group, by contrast, there was a significant increase in HDL cholesterol and no reduction in total or LDL cholesterol.

The ratio of total to LDL cholesterol fell in both groups, but the reduction was significantly more marked in the BIBP group.  

Writing in the International Journal of Obesity, Lubrano et al say that their study shows that restrictive and malabsorptive bariatric techniques have a different impact on cardiometabolic risk factors.

“If bariatric surgery is aimed only at reducing BMI, then both procedures seem to be effective,” they write. “However, if the goal is also to treat visceral adiposity and comorbid conditions, then BIBP seems to be the better treatment option.”

They add: “In fact, data regarding measures of body composition clearly demonstrate the pivotal role of this malabsorptive procedure in ameliorating body fat distribution and concomitant metabolic derangements.”

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Joanna Lyford