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Dyslipidemia in patients undergoing gastric bypass and sleeve gastrectomy: a meta-analysis of observational studies
Objective: To compare the clinical outcomes associated with dyslipidemia, both pre- and postoperative, of two bariatric surgery procedures as reported in the scientific literature. Methodology: A meta-analysis of observational studies was conducted following the recommendations of the PRISMA statement and the Cochrane Handbook for Systematic Reviews of Interventions. Digital search strategies were applied to the Embase, PubMed, and Bireme databases. Maximum likelihood restriction models using Hegger's sets and subgroup meta-analyses by follow-up time were employed to synthesize levels of Cholesterol, HDL, LDL, and Triglycerides reported in studies for patients diagnosed with overweight and obesity. Results: Significant findings were identified regarding the variability in lipid profile levels, particularly in interventions such as sleeve gastrectomy. Notable decreases were observed in cholesterol, LDL, and triglycerides, while HDL levels increased. Variations were found according to follow-up time, especially at 12 months, in outcomes such as LDL and triglycerides. Conclusions: Bariatric surgery procedures, specifically Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), show significant improvements in the lipid profile of patients with obesity and associated comorbidities. Sleeve gastrectomy appears to be more effective in the long term in increasing HDL levels and reducing LDL levels. The choice of procedure should be based on the specific clinical conditions of each patient. It is crucial to standardize units of measurement and consider postoperative dietary habits to evaluate long-term effectiveness. A multidisciplinary approach and personalized educational programs are recommended to promote sustainable healthy changes.
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