Hormonal
Bariatric surgery (Roux-en-Y gastric bypass and sleeve gastrectomy) significantly increases HDL-C levels and improves HDL functionality (cholesterol efflux capacity and apoA-I exchange rate) in obese patients, particularly with sustained effects observed at 12 months post-surgery.
If you have severe obesity and are considering bariatric surgery, know that it is the most effective way to significantly boost your HDL cholesterol levels and improve how well your HDL functions (specifically its ability to remove cholesterol). Studies show that Roux-en-Y gastric bypass and sleeve gastrectomy can increase HDL-C by 30-32% over five years, far outperforming medical therapy alone. However, full functional benefits, such as improved cholesterol efflux, may take up to 12 months to manifest, so patience and adherence to post-surgical care are crucial.
Of particular interest is that the plasma levels of HDL-C after bariatric surgery were remarkably improved compared to the preoperative values... In the STAMPEDE clinical trial... Five years after surgical procedures, the levels of HDL-C were increased by 32%, 30%, and 7% in the RYGB, sleeve gastrectomy, and medical therapy alone groups, respectively... HDL in both RYGB and sleeve gastrectomy groups showed improved functionality, by increased apoA-I exchange rate after one and five years compared to baseline. Moreover, also cholesterol efflux capacity after five years was improved when compared to pre-operative samples
Why this rating
Based on the STAMPEDE clinical trial, a randomized controlled trial, which provides high-quality evidence for the efficacy of bariatric surgery on HDL metrics.
Source
Obesity-Related Changes in High-Density Lipoprotein Metabolism and Function
Julia T. Stadler et al. · International Journal of Molecular Sciences · 2020
DOI 10.3390/ijms21238985
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