{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T05:07:00Z","timestamp":1788671220731,"version":"build-2803163510"},"reference-count":40,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Surg"],"published-print":{"date-parts":[[2024,9,1]]},"abstract":"Importance<\/jats:title>Roux-en-Y gastric bypass (RYGB) is associated with reduced cardiovascular (CV) risk factors, morbidity, and mortality. Whether these effects are specifically induced by the surgical procedure or the weight loss is unclear.<\/jats:p><\/jats:sec>Objective<\/jats:title>To compare 6-week changes in CV risk factors in patients with obesity undergoing matching caloric restriction and weight loss by RYGB or a very low-energy diet (VLED).<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This nonrandomized controlled study (Impact of Body Weight, Low Calorie Diet, and Gastric Bypass on Drug Bioavailability, Cardiovascular Risk Factors, and Metabolic Biomarkers [COCKTAIL]) was conducted at a tertiary care obesity center in Norway. Participants were individuals with severe obesity preparing for RYGB or a VLED. Recruitment began February 26, 2015; the first patient visit was on March 18, 2015, and the last patient visit (9-week follow-up) was on August 9, 2017. Data were analyzed from April 30, 2021, through June 29, 2023.<\/jats:p><\/jats:sec>Interventions<\/jats:title>VLED alone for 6 weeks or VLED for 6 weeks after RYGB; both interventions were preceded by 3-week LED.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Between-group comparisons of 6-week changes in CV risk factors.<\/jats:p><\/jats:sec>Results<\/jats:title>Among 78 patients included in the analyses, the mean (SD) age was 47.5 (9.7) years; 51 (65%) were women, and 27 (35%) were men. Except for a slightly higher mean (SD) body mass index of 44.5 (6.2) in the RYGB group (n\u2009=\u200941) vs 41.9 (5.4) in the VLED group (n = 37), baseline demographic and clinical characteristics were similar between groups. Major atherogenic blood lipids (low-density lipoprotein cholesterol, non\u2013high-density lipoprotein cholesterol, apolipoprotein B, lipoprotein[a]) were reduced after RYGB in comparison with VLED despite a similar fat mass loss. Mean between-group differences were \u221217.7 mg\/dL (95% CI, \u221227.9 to \u22127.5), \u221217.4 mg\/dL (95% CI, \u221229.8 to \u22125.0) mg\/dL, \u22129.94 mg\/dL (95% CI, \u221215.75 to \u22124.14), and geometric mean ratio was 0.55 U\/L (95% CI, 0.42 to 0.72), respectively. Changes in glycemic control and blood pressure were similar between groups.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>This study found that clinically meaningful reductions in major atherogenic blood lipids were demonstrated after RYGB, indicating that RYGB may reduce CV risk independent of weight loss.<\/jats:p><\/jats:sec>Trial Registration<\/jats:title>ClinicalTrials.gov Identifier: NCT02386917<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jamasurg.2024.2162","type":"journal-article","created":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T15:01:56Z","timestamp":1720018916000},"page":"971","source":"Crossref","is-referenced-by-count":10,"title":["Gastric Bypass vs Diet and Cardiovascular Risk Factors"],"prefix":"10.1001","volume":"159","author":[{"given":"Cecilia","family":"Karlsson","sequence":"first","affiliation":[{"name":"Late-Stage Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, 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