Long-term changes in lipid indices following Roux-en-Y gastric bypass: a meta-analysis

Introduction: Bariatric surgery yields clinically significant long-term weight loss accompanied by marked improvements in numerous weight-related comorbidities including type 2 diabetes, hypertension, dyslipidemia, obstructive sleep apnea, and fatty liver disease. Objective: This systematic review and meta-analysis aimed to evaluate the effect of (RYGB) surgery on lipid profile. Data source: We searched PubMed, Scopus, Web of Science and Scholar from inception to May 20th, 2024. Studies selection: Clinical studies that reported lipid profile data with a follow-up of at least 5 years after RYGB were eligible. Data extraction: Two independent reviewers extracted data and assessed the risk of bias. Results: Of the 4922 articles identified from our database search, 38 studies that measured lipid profile following RYGB were identified and selected for the analysis. Compared to pre-surgery, at post-surgery follow-up of ≥ 5 years, RYGB was associated with significant reductions in mean total cholesterol (TC) (WMD: − 17.95 mg/dl, 95% CI: − 22.68, − 13.22, 95% PI: − 46.18, 10.27 p < 0.001; I²:92.3), LDL-cholesterol (WMD: − 18.55 mg/dl, 95% CI: -21.85, -15.25, 95% PI: − 39.01, 1.92 p < 0.001; I²:91.8), and triglycerides (WMD: − 60.76 mg/dl, 95% CI: − 66.29, − 55.22, 95% PI: − 91.24, − 30.27 p < 0.001; I²:83.7), and increase in HDL-cholesterol (WMD: 13.75 mg/dl, 95% CI: 12.38, 15.13, 95% PI: 5.32, 22.19 p < 0.001; I²:91.4). Conclusion: RYBG is associated with clinically significant large improvements in serum lipids at a post-operative follow-up of 5 years or more.