Research on the Differential Effects of Gastric Bypass and Banding on the Cardiovascular Risk Profile in Morbidly Obese Subjects: The Correlation with Plasma Apolipoprotein A-IV Concentration
The goal of this work was to research the impact on the cardiovascular risk profile in morbidly obese patients of 2 commonly performed bariatric surgical procedures; laparoscopic Roux-en-Y gastric bypass (RYGBP) and laparoscopic gastric band (BAND), and its association with the plasma apolipoprotein (apo) A-IV stage. Patient and Methods: This study was performed prospectively on 34 bariatric surgery patients. Two classes were randomly allocated to them; group 1 = BAND (18 cases); group 2 = RYGBP gastric bypass (16 cases). Both groups were observed pre-operatively and 12 months after surgery, respectively. Changes in body mass index ( BMI), blood pressure, fasting blood sugar, fasting serum insulin, insulin resistance (HOMA-IR) and lipid profile were included in the data collected. Furthermore, by the Western blot process, apo A-IV was calculated. Effects: The results showed a highly significant decrease in body weight as measured by a decrease in BMI as opposed to preoperative measurements in both groups I & II. In addition, twelve months after surgery, both groups had substantially lower systolic blood pressure, fasting blood glucose ( FBG), fasting serum insulin, and HOMA-IR. BMI, systolic blood pressure, FBG and HOMA-IR improvements were substantially greater in group II than in group I. The lipid profiles were identical in Group I & II prior to surgery. In both groups I & II, 12 months after surgery, the HDL-cholesterol was significantly higher. Furthermore, in both classes, apo A-IV levels increased after surgery. Conclusion: Both gastric band and gastric bypass are associated with significant improvement of the cardiovascular risk profile, although it is more pronounced after gastric bypass. The improvement correlates well with the increase of apo A-IV in both groups. Thus Apo A-IV may play a positive role in improving the cardiovascular risk profile after bariatric surgery.
Hala Mourad Demerdash
Department of Clinical Pathology, Alexandria University Hospital, 75, Ismail Serry Street, Smouha, Alexandria, Egypt.
Department of Biochemistry, Alexandria University Hospital, Egypt.
Department of Surgery, Alexandria University Hospital, Egypt.
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