Changes in Lipid Profile and Insulin Resistance in Morbidly Obese Patients Following Laparoscopic Total Gastric Vertical Plication

Obesity has emerged as one of the most serious public health concerns in the 21st century. The consequences of this chronic disorder are serious. Bariatric surgery has been shown to eliminate comorbid conditions associated with obesity. Currently it is considered to be the only successful, long-term therapy for morbidly obese subjects. The aim of this study was to evaluate the effect of weight reduction following laparoscopic total gastric vertical plication on anthropometric indices, lipid profile and insulin resistance in morbidly obese patients.Patients and 15 severely obese patients aged 32.4 ± 10 yr were enrolled in this prospective study. Body mass index (BMI), waist circumference, high-density lipoprotein cholesterol (HDL-c), total cholesterol (TC), low density lipoprotein cholesterol (LDL-c), triglycerides (TG), fasting glucose, fasting insulin and insulin sensitivity were measured before and 6 weeks after laparoscopic total gastric vertical plication (LTGVP). Insulin-sensitivity was estimated using the homeostasis model assessment of insulin-resistance (HOMA-IR). Anthropometric indices decreased significantly during the 6 week period after LTGVP. TG, LDL-c, fasting insulin, HOMA-IR and QUIKI also decreased but the changes in HDL-c, TC and fasting glucose were not significant. At baseline, we found a direct correlation between weight and TC, weight and fasting glucose, waist to hip ratio and TG and a negative correlation between waist to hip ratios and HDL-c. LTGVP results in significant weight loss among morbidly obese subjects, and following weight reduction, lipid profile and insulin resistance improved.