Blood lipid profile in patients with obesity and type 2 diabetes mellitus and without type 2 diabetes mellitus before and after bariatric surgery
- Authors: Mozgunova V.S.1, Volkova A.R.1, Semikova G.V.1, Khalimov Y.S.1, Vasilevsky D.I.1, Balandov S.G.1, Anisimova K.A.1
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Affiliations:
- Pavlov First Saint Petersburg State Medical University
- Issue: Vol 31, No 8 (2024)
- Pages: 91-96
- Section: Original articles
- URL: https://journals.eco-vector.com/2073-4034/article/view/680239
- DOI: https://doi.org/10.18565/pharmateca.2024.8.91-96
- ID: 680239
Cite item
Abstract
Background. Lipid metabolism disorders are observed in 60–70% of patients with obesity. Type 2 diabetes mellitus (DM2) is an independent risk factor for cardiovascular disease and is associated with increased cardiovascular risk. The presence of DM2 and hyperlipidemia determines the target group of patients for taking statins. However, at present, the prescription and administration of lipid-lowering therapy (LLT) remain unsatisfactory, and adherence to statin therapy also remains quite low. Bariatric surgery is currently becoming widespread due to its effectiveness in achieving DM2 remission. However, there are currently no recommendations regarding statin therapy in patients after bariatric interventions; clinical studies on this topic are few.
Objective. Evaluation of the blood lipid profile in patients with obesity and DM2 and without DM2 before and after bariatric surgery (BS).
Methods. An observational prospective study of 211 patients with grade I–III obesity was conducted. Patients were recruited from January 2018 to April 2023. Of the 211 patients enrolled in the study, 99 had confirmed type 2 diabetes, including 63 women and 36 men. All patients underwent gastrectomy (longitudinal gastrectomy – LG - or gastric bypass – GB – using the standard technique). All patients had their lipid profile assessed before gastrectomy and in the plateau phase. Cardiovascular risk was assessed to determine the patient’s need for LLT.
Results. In the study group of patients (n = 211), LLT was indicated in 163 (77.3%) patients, but only 36 (22%) of these patients received statins. Among diabetic patients (n = 99), LLT was received by 23 (23.2%) patients. The total cholesterol (TC) level in patients not receiving statin therapy was 5.0 ± 0.9 mmol/L, low-density lipoprotein (LDL) – 2.8 ± 0.8 mmol/L. In patients receiving LLT, the TC and LDL levels were slightly lower: TC – 4.6 ± 1.0; LDL – 2.4 ± 0.8 mmol/L (P> 0.05). Among obese patients with DM2, 42 (42.4%) patients underwent LG, 57 (57.6%) patients underwent GB. Among obese patients without DM2, 98 (87.5%) patients underwent LG, 14 (12.5%) patients underwent GB. In the group of patients without DM2 who underwent LG and GB, the TC level significantly decreased after BS (P < 0.05), and the LDL levels also slightly decreased. In the group of patients with DM2, a significant decrease in the TC and LDL levels was noted in the LG and GB groups (P < 0.05), both operations were comparable in terms of the decrease in the TC and LDL levels (P> 0.05). The achievement of target LDL values after BS was also assessed: in the group of patients with obesity and DM2, target LDL values were achieved by 65 patients (85.5%), in the group of patients with obesity without DM2 – 88 (88.9%). No significant differences were obtained between LG and GB in achieving target LDL values.
Conclusion. Metabolic surgery allows achieving a significant reduction in TC levels in obese patients with and without DM2, as well as LDL levels in obese diabetic patients.
Full Text

About the authors
V. S. Mozgunova
Pavlov First Saint Petersburg State Medical University
Email: volkovaa@mail.ru
ORCID iD: 0000-0002-0841-3438
Russian Federation, Saint Petersburg
A. R. Volkova
Pavlov First Saint Petersburg State Medical University
Author for correspondence.
Email: volkovaa@mail.ru
ORCID iD: 0000-0002-5189-9365
Dr. Sci. (Med.), Professor, Head of the Endocrinology Division of the Department of Faculty Therapy with Course in Endocrinology, Cardiology and Functional Diagnostics with a Clinic
Russian Federation, Saint PetersburgG. V. Semikova
Pavlov First Saint Petersburg State Medical University
Email: volkovaa@mail.ru
ORCID iD: 0000-0003-0791-4705
Russian Federation, Saint Petersburg
Yu. Sh. Khalimov
Pavlov First Saint Petersburg State Medical University
Email: volkovaa@mail.ru
ORCID iD: 0000-0002-7755-7275
Russian Federation, Saint Petersburg
D. I. Vasilevsky
Pavlov First Saint Petersburg State Medical University
Email: volkovaa@mail.ru
ORCID iD: 0000-0001-7283-079X
Russian Federation, Saint Petersburg
S. G. Balandov
Pavlov First Saint Petersburg State Medical University
Email: volkovaa@mail.ru
ORCID iD: 0000-0001-5306-5332
Russian Federation, Saint Petersburg
K. A. Anisimova
Pavlov First Saint Petersburg State Medical University
Email: volkovaa@mail.ru
ORCID iD: 0000-0002-6042-322X
Russian Federation, Saint Petersburg
References
- Доборджгинидзе Л.М., Грацианский Н.А. Особенности диабетической дислипидемии и пути ее коррекции: эффект статинов. Проблемы эндокринологии. 2001;47(5):35–40. [Dobordzhginidze LM, Gratsiansky NA Features of diabetic dyslipidemia and ways of its correction: the effect of statins. Problems of endocrinology. 2001;47(5):35–40. (In Russ.)]. doi: 10.14341/probl11683.
- Ежов М.В., Кухарчук В.В., Сергиенко И.В. и др. Нарушения липидного обмена. Клинические рекомендации. 2023. Российский кардиологический журнал. 2023;28(5). [Ezhov M.V., Kukharchuk V.V., Sergienko I.V., et al. Lipid metabolism disorders. Clinical guidelines. 2023. Russ J Cardiol. 2023;28(5). (In Russ.)].
- Остроумова О.Д. Статины и сахарный диабет: взгляд кардиолога. Consilium Medicum. 2018;1. [Ostroumova O.D. Statins and diabetes mellitus: a cardiologist’s view. Consilium Medicum. 2018;1. (In Russ.)].
- Дедов И.И., Шестакова М.В., Викулова О.К. и др. Эпидемиологические характеристики сахарного диабета в российской федерации: клинико-статистический анализ по данным регистра сахарного диабета на 01.01.2021. Сахарный диабет. 2021;3:204–21. Dedov I.I., Shestakova M.V., Vikulova O.K., et al. Epidemiological characteristics of diabetes mellitus in the Russian Federation: clinical and statistical analysis based on diabetes mellitus registry data as of 01/01/2021. Diabetes mellitus. 2021;3:204–21. (In Russ.)].
- Клинические рекомендации. Нарушения липидного обмена. 2023-2024-2025 (15.02.2023). [Clinical guidelines. Lipid metabolism disorders. 2023-2024-2025 (15.02.2023). (In Russ.)].
- Шляхто Е.В., Недогода С.В., Конради А.О. и др. Диагностика, лечение, профилактика ожирения и ассоциированных с ним заболеваний (национальные клинические рекомендации). Санкт-Петербург, 2017. [Shlyakhto E.V., Nedogoda S.V., Konradi A.O. et al. Diagnostics, treatment, prevention of obesity and associated diseases (national clinical guidelines). St. Petersburg, 2017. (In Russ.)].
- Волкова А.Р., Семикова Г.В., Дыгун О.Д. и др. Особенности ведения больных ожирением после бариатрических операций: по материалам практических рекомендаций европейской ассоциации по изучению ожирения (2017). Consilium Medicum. 2020;4. [Volkova A.R., Semikova G.V., Dygun O.D. et al. Features of the management of obese patients after bariatric surgery: based on the practical recommendations of the European Association for the Study of Obesity (2017). Consilium Medicum. 2020;4. (In Russ.)].
- Bays H.E., Jones P.H., Jacobson T.A., et al. Lipids and bariatric procedures part 1 of 2: Scientific statement from the National Lipid Association, American Society for Metabolic and Bariatric Surgery, and Obesity Medicine Association: FULL REPORT. J Clin Lipidol. 2016;10(1):33–57. doi: 10.1016/j.jacl.2015.12.002.
- Risstad H., Svanevik M., Kristinsson J.A., et al. Standard vs Distal Roux-en-Y Gastric Bypass in Patients With Body Mass Index 50 to 60: A Double-blind, Randomized Clinical Trial. JAMA. Surg. 2016;151(12):1146–55. doi: 10.1001/jamasurg.2016.2798.
- Schauer P.R., Kashyap S.R., Wolski K., et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012;366(17):1567–76. doi: 10.1056/NEJMoa1200225.
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