The alteration of lipid metabolism and its correlation with glycometabolism following laparoscopic sleeve gastrectomy: A meta-analysis

The LSG has been shown to be effective in consistently reducing the body weight and improve the metabolism of patients with excessive obesity. However, its long-term effect in lipid metabolism and the correlation with glycometabolism have not been well summarized and analyzed.

The aims of this meta-analysis were to establish the panorama of lipid metabolism following LSG, study its correlation with glycometabolism, and provide evidence for therapeutic response assessment and prognosis prediction.

The meta-analysis identified all available studies reporting the lipid metabolism alterations following LSG from January, 2011, to March, 2023. Using relevant key words, articles were searched from the MEDLINE, PubMed, and EMBASE databases and screened following the PRISMA guideline. A total of 46 studies reporting the levels of several lipid markers across time points up to 24 months following LSG were included in the final analysis.

Significant level decrease was found with FBG, FBI, HbA1C, HOMA-IR, and TG, in parallel with the drop of BMI following LSG up to 24 months, and significant level increase was observed in HDL. In contrast, no significant level changes were observed with TC and LDL. FBI and HOMA-IR exhibited the earliest (3–7 days) significant alterations even before BMI changed, and they also showed the biggest percentage decrease in all markers, while HDL exhibited the biggest percentage increase. All markers except LDL showed significant linear correlation with BMI, and TC and TG showed significant correlation with individual glycometabolism markers. TC, TG, and HDL showed significant correlation with each other, while LDL showed no significant correlation with other lipid markers except TC.

Insulin-related markers, HDL and TG, could be early response markers for LSG. Good correlation was found between BMI change and glyco- or lipid markers, while only TC and TG appeared to correlate with glycomarkers.