Evidence mapPaperPMID 38879559Full record

Trial reportCardiovascular diabetology2024

Short-term effects of gastric bypass versus sleeve gastrectomy on high LDL cholesterol: The BASALTO randomized clinical trial.

David Benaiges, Albert Goday, Anna Casajoana, Juana A Flores-Le Roux, Montserrat Fitó, Oscar J Pozo, Carme Serra, Manuel Pera, Gemma Llauradó, Elisenda Climent and 4 more

Registry-linked trialAbstract readRandomized Controlled TrialComparative Study
In one paragraph

Trial report in Cardiovascular diabetology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03975478 (BASALTO), which is not on this map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03975478 naunknown statusnot on this map

BASALTO (Bariatric Surgery and LDL Cholesterol) Trial

TypeinterventionalSponsorParc de Salut MarRan2019 to 2023Enrolled36ConditionsBariatric SurgeryArmsGastric bypass, Sleeve gastrectomy
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Observational
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

David BenaigesDepartment of Endocrinology and Nutrition, Hospital del Mar, Passeig Marítim, 25-29, Barcelona, 08003, Spain. dbenaiges@psmar.cat.
Albert GodayDepartment of Endocrinology and Nutrition, Hospital del Mar, Passeig Marítim, 25-29, Barcelona, 08003, Spain.
Anna CasajoanaUnit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Dr. Aiguader, 80, Barcelona, 08003, Spain.
Juana A Flores-Le RouxDepartment of Endocrinology and Nutrition, Hospital del Mar, Passeig Marítim, 25-29, Barcelona, 08003, Spain.
Montserrat FitóUnit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Dr. Aiguader, 80, Barcelona, 08003, Spain.
Oscar J PozoApplied Metabolomics Research Group, Neurosciences Research Program, IMIM (Hospital del Mar Research Institute), Dr. Aiguader 88, 08003, Barcelona, Spain.
Carme SerraDepartment of Endocrinology and Nutrition, Hospital del Mar, Passeig Marítim, 25-29, Barcelona, 08003, Spain.
Manuel PeraEsophago-Gastric and Bariatric Surgery Unit, Department of Surgery, Hospital del Mar, Passeig Marítim, 25-29, Barcelona, 08003, Spain.
Gemma LlauradóDepartment of Endocrinology and Nutrition, Hospital del Mar, Passeig Marítim, 25-29, Barcelona, 08003, Spain.
Elisenda ClimentDepartment of Endocrinology and Nutrition, Hospital del Mar, Passeig Marítim, 25-29, Barcelona, 08003, Spain.
Montserrat VillatoroDepartment of Endocrinology and Nutrition, Hospital del Mar, Passeig Marítim, 25-29, Barcelona, 08003, Spain.
Iolanda LazaroUnit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Dr. Aiguader, 80, Barcelona, 08003, Spain.
Olga CastañerUnit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Dr. Aiguader, 80, Barcelona, 08003, Spain.
Juan Pedro-BotetDepartment of Endocrinology and Nutrition, Hospital del Mar, Passeig Marítim, 25-29, Barcelona, 08003, Spain.

Funding

Instituto de Salud Carlos III (ISCIII) and co-funded by the European Union PI19/00006
6 · The paper itself

Abstract

backgroundThere has been a substantial increase in the use of laparoscopic sleeve gastrectomy (SG) to treat morbid obesity despite observational evidence demonstrating the superiority of Roux-en-Y gastric bypass (RYGB) for reducing low-density lipoprotein (LDL) cholesterol. The main aim was to ascertain whether high LDL cholesterol levels should be considered when selecting the most appropriate surgical procedure for each patient (RYGB or SG).

methodsIn this single-center, randomized clinical trial using intention-to-treat analysis, 38 patients with severe obesity and elevated levels of LDL cholesterol were randomly assigned to undergo RYGB or SG. The primary outcome was LDL cholesterol remission at 12 months, defined as LDL cholesterol < 3.36 nmol/l without lipid-lowering medications. Secondary outcomes included changes in weight, other comorbidities, qualitative lipoprotein traits, cholesterol esters, glycoproteins, cholesterol absorption and synthesis metabolites and complications.

resultsIntention-to-treat analysis revealed that LDL cholesterol remission occurred in 66.6% of RYGB patients compared to 27.8% of SG patients (p = 0.019). Among patients completing follow-up, RYGB demonstrated superior remission (80.0% vs. 29.4%, p = 0.005). Exclusive benefits of RYGB included a reduction in large, medium, and small LDL particles. Cholesterol absorption markers showed differential behavior after both techniques: campesterol (Δ -15.2 µg/mg, 95% CI -30.2 to -0.1) decreased after RYGB, and sitosterol (Δ 21.1 µg/mg, 95% CI 0.9 to 41.2), cholestanol (Δ 30.6 µg/mg, 95% CI 14.8 to 57.9) and campesterol (Δ 18.4 µg/mg, 95% CI 4.4 to 32.3) increased after SG. No differences in weight loss, cholesterol esters, glycoproteins, cholesterol synthesis metabolites or postoperative complications were observed between techniques.

conclusionIn conclusion, RYGB is superior to SG in terms of short-term of high LDL cholesterol remission. Furthermore, RYGB also led to a greater improvement in lipoprotein parameters that confer an atherogenic profile. Therefore, the presence of elevated levels of LDL cholesterol should be considered when determining the optimal bariatric surgery procedure for each patient.

trial registrationClinicaltrials.gov number, NCT03975478).

Indexed as

BiomarkersCholesterol, LDLGastrectomyGastric BypassObesity, MorbidAdultFemaleHumansHypercholesterolemiaLaparoscopyMaleMiddle AgedRemission InductionSitosterolsTime FactorsTreatment OutcomeBiomarkersCholesterol, LDLSitosterolsBariatric surgeryCholesterol estersHypercholesterolemiaLDL cholesterolLipoproteinRoux-en-Y gastric bypassSleeve gastrectomy

Identifiers

PMID38879559
PMCPMC11180388

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.