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Clinical Studies and Practice

Lipid changes 8 years post gastric bypass in adolescents with severe obesity (FABS-5+ study)

International Journal of Obesity volume 41, pages 1579–1584 (2017)Cite this article

Subjects

Abstract

Objective:

Severe obesity in adolescents is increasing and few effective treatments exist. Bariatric surgery is one option, but the extent to which surgery influences cardiovascular risk factors over time in youth is not clear. We hypothesized that Roux-en Y gastric bypass (RYGB) would be associated with sustained improvements in lipids over time (>5 years).

Participants/Methods:

Youth who underwent RYGB from 2001 to 2007 were recruited for the Follow-up of Adolescent Bariatric Surgery-5+ (FABS-5+) in 2011–2014. Baseline body mass index (BMI) and lipids were abstracted from medical records. Follow-up data were obtained at a research visit. Analyses included paired t-tests to assess changes in BMI and lipids over time. General linear models were used to evaluate predictors of high-density lipoprotein (HDL) and non-HDL-cholesterol at follow-up. A non-operative group was recruited for comparison.

Results:

Surgical participants (n=58) were a mean±s.d. age of 17±2 years at baseline and 25±2 years at long-term follow-up. Eighty-six percent were Caucasian and 64% were female. At long-term follow-up BMI decreased by 29% and all lipids (except total cholesterol) significantly improved (P<0.01). Female sex was a significant predictor of non-HDL-cholesterol level at 1 year, while change in BMI from 1 year to long-term follow-up was a significant predictor of non-HDL-cholesterol and HDL-cholesterol during the same interval (P<0.05). In the non-operative group, BMI increased by 8% and lipid parameters were unchanged.

Conclusions:

This is the longest and most complete follow-up of youth following RYGB. Weight loss maintenance over time was significantly associated with improvements in lipid profile over 5 years.

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Acknowledgements

We thank Aaron Kelly, PhD, for critical review of this manuscript. This research was supported by investigator-initiated grants from Ethicon Endosurgery (Grant nos 15161 and 15151.3); the project was also supported by the National Center for Advancing Translational Sciences of the US National Institutes of Health (award number UL1TR000077). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of Ethicon Endosurgery or the National Institutes of Health.

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Authors and Affiliations

  1. Division of Endocrinology, Cincinnati Children’s Hospital and University of Cincinnati, Cincinnati, OH, USA

    A S Shah

  2. Division of Pediatric Surgery, Cincinnati Children’s Hospital and University of Cincinnati, Cincinnati, OH, USA

    T Jenkins

  3. The Heart Institute, Cincinnati Children’s Hospital and University of Cincinnati, Cincinnati, OH, USA

    Z Gao, E M Urbina, S Kirk & R Siegel

  4. University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA

    S R Daniels

  5. Department of Surgery, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA

    T H Inge

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Correspondence to A S Shah.

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Shah, A., Jenkins, T., Gao, Z. et al. Lipid changes 8 years post gastric bypass in adolescents with severe obesity (FABS-5+ study). Int J Obes 41, 1579–1584 (2017). https://doi.org/10.1038/ijo.2017.141

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