Original article
Effects of statin therapy on weight loss and diabetes in bariatric patients

https://doi.org/10.1016/j.soard.2016.11.018Get rights and content

Abstract

Background

Bariatric surgeries are considered effective treatments for weight loss and improved diabetes control. Statins increase diabetes onset in prospective clinical trials and many bariatric patients with metabolic disease are concurrently on statins.

Objectives

We retrospectively examined the relationship of statin therapy to weight loss, diabetes mellitus onset and remission, and metabolic outcomes after bariatric surgery.

Setting

Hospital.

Methods

A total of 1575 patients (1231 women) underwent laparoscopic adjustable gastric banding (n = 1035), Roux-en-Y gastric bypass (n = 468), or sleeve gastrectomy (n = 72) and were categorized as to statin use (n = 671 statin users) and diabetes status (n = 557 patients with diabetes) preoperatively and at one year follow-up.

Results

New onset cases of diabetes did not differ between patients on and not on preoperative statins (3 versus 4 new diabetes cases, respectively), but diabetes resolved after surgery in 159 (23.7%) patients on preoperative statins and in only 124 (13.7%) patients not on preoperative statins (χ2 = 26.1; P<.01). Patients ceasing statin therapy experienced more diabetes remission (n = 85 or 35.7%) than patients consistently using statin therapy at both time points (n = 57 or 17.0%; χ2 = 27.3; P< .01).

Conclusion

In contrast to expectations, our results suggest that diabetes resolves with bariatric surgery more often in patients maintained on statin therapy than in those never on statin therapy whereas cessation of statin therapy is associated with the greatest reductions in diabetes prevalence. These results indicate an impact of statin use on metabolic outcomes following bariatric surgery; a randomized control trial is needed to examine carefully this relationship.

Section snippets

Participants

We reviewed data from our prospectively maintained database of patients who underwent bariatric surgery at our center. A total of 2878 patients underwent bariatric surgery with 1 of 2 surgeons. Procedures included laparoscopic adjustable gastric banding (LAGB; n = 1776), RYGB (n = 939), and sleeve gastrectomy (SG; n = 163). We included only patients who had statin use and diabetes status data before surgery and completed 1-year follow-up visits for a final sample size of 1575 patients (1035

Baseline characteristics

Patients using statins preoperatively were more likely to have diagnosed hypertension and hyperlipidemia; higher triglycerides, fasting glucose, insulin and HbA1C values; and lower total and LDL cholesterol (Table 1). Women comprised 481 statin users (71.7%) versus 750 nonstatin users (83.0%; χ2 = 28.7; P<.01). In addition, more patients (χ2 = 162.8; P<.01) on statins had type 2 diabetes (T2D) (Fig. 1). There were no differences in statin use among surgery types (χ2 = .17; P = .92) with 597

Discussion

This study is, to our knowledge, the first to examine the influence of statin therapy on diabetes status, weight loss, and metabolic changes after bariatric surgery. Our results suggest that preoperative statin therapy, as well as statin use in the ensuing postsurgical year, does not have a detrimental impact on bariatric weight loss, metabolic outcomes and diabetes risk. We did, however, observe that patients who ceased statin therapy from preoperative use to 1-year follow-up were more likely

Conclusion

Our results indicate that there is no detrimental effect of preoperative statin therapy on weight loss or change in BMI in bariatric surgical patients, and statin use was associated with increased weight loss in RYGB patients. In addition, preoperative statin use did not increase the number of new onset diabetes cases, and improved the likelihood of diabetes remission relative to patients not using preoperative statins. However, ceasing statin therapy after surgery was associated with greater

Disclosures

The authors have no commercial associations that might be a conflict of interest in relation to this article.

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