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Genua I, Miñambres I, Puig R, Sardà H, Fernández-Ananin S, Sánchez-Quesada JL, Pérez A. Weight loss benefits on HDL cholesterol persist even after weight regaining. Surg Endosc 2024; 38:3320-3328. [PMID: 38684527 DOI: 10.1007/s00464-024-10826-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/23/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Obesity-related comorbidities may relapse in patients with weight regain after bariatric surgery. However, HDL cholesterol (HDLc) levels increase after surgery and seem to remain stable despite a gradual increase in BMI. The aim of this study is to analyze the effects of weight regain after bariatric surgery on HDL cholesterol. MATERIALS AND METHODS This is a retrospective, observational, cohort study in patients who underwent bariatric surgery in the Hospital de la Santa Creu i Sant Pau (Barcelona) between 2007 and 2015. Patients without at least 5 years of follow-up after surgery, under fibrate treatment, and those who required revisional surgery were excluded from the analysis. Data were collected at baseline, 3 and 6 months after surgery, and then annually until 5 years post-surgery. RESULTS One hundred fifty patients were analyzed. 93.3% of patients reached > 20% of total weight loss after surgery. At 5th year, 37% of patients had regained > 15% of nadir weight, 60% had regained > 10%, and 22% had regained < 5% of nadir weight. No differences were found in HDLc levels between the different groups of weight regain, nor in the % of change in HDLc levels between nadir weight and 5 years, or in the proportion of patients with normal HDLc concentrations either. CONCLUSION HDLc remains stable regardless of weight regain after bariatric surgery.
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Affiliation(s)
- Idoia Genua
- Department of Endocrinology and Nutrition, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, C/Sant Quintí 89, 08025, Barcelona, Spain
- Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Inka Miñambres
- Department of Endocrinology and Nutrition, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, C/Sant Quintí 89, 08025, Barcelona, Spain.
- Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain.
- CIBER of Diabetes and Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - Rocío Puig
- Department of Endocrinology and Nutrition, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, C/Sant Quintí 89, 08025, Barcelona, Spain
| | - Helena Sardà
- Department of Endocrinology and Nutrition, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, C/Sant Quintí 89, 08025, Barcelona, Spain
- Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Sonia Fernández-Ananin
- Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
- Unit of Esophagogastric and Bariatric and Metabolic Surgery, Department of General and Digestive Surgery, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - José Luis Sánchez-Quesada
- CIBER of Diabetes and Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Cardiovascular Biochemistry Group, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Antonio Pérez
- Department of Endocrinology and Nutrition, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, C/Sant Quintí 89, 08025, Barcelona, Spain.
- Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain.
- CIBER of Diabetes and Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
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Chin WL, Tu WL, Yang TH, Chen CY, Chen JH, Hung TT. Impact of Recurrent Weight Gain Thresholds on Comorbid Conditions Progression Following Laparoscopic Sleeve Gastrectomy. Obes Surg 2024:10.1007/s11695-024-07282-6. [PMID: 38771478 DOI: 10.1007/s11695-024-07282-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/22/2024]
Abstract
INTRODUCTION Defining recurrent weight gain after metabolic bariatric surgery poses a significant challenge. Our study aimed to standardize recurrent weight gain measurements in patients undergoing laparoscopic sleeve gastrectomy (LSG) and ascertain its association with comorbidity progression. METHODS We conducted a retrospective data analysis on 122 patients who underwent LSG, tracking their progress over 2-7 years. Data on weight, blood pressure measurements, and laboratory tests were collected, focusing on the postoperative period to identify nadir weight, total weight loss, and recurrent weight gain. RESULTS Significant weight loss and comorbidity remission were noted, with diabetes, hypertension, and dyslipidemia showing substantial remission rates of 85.71%, 68.24%, and 85.37%, respectively. The median recurrent weight gain was 6.30 kg within 12 months of the nadir. Progression proportion of diabetes, hypertension, and dyslipidemia were 8.20%, 44.26%, and 40.98%, respectively. Hypertension progression was strongly associated with a recurrent weight gain ≥ 10 kg and ≥ 20% of maximum weight loss. Dyslipidemia progression was significantly correlated with recurrent weight gain ≥ 10 kg and ≥ 20% of maximum weight loss. Diabetes progression was significantly correlated with recurrent weight gain ≥ 10% of pre-surgery body weight and ≥ 25% of maximum weight loss. A ≥ 10% weight gain of maximum weight loss did not significantly impact the progression of these conditions. CONCLUSION Recurrent weight gain ≥ 20% of maximum weight loss can be treated as a specific threshold indicating comorbidity progression post-LSG. Standardizing the measurement of recurrent weight gain can help healthcare providers to implement targeted management strategies to optimize long-term health outcomes.
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Affiliation(s)
- Wei-Leng Chin
- Department of Chemical Engineering & Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, 84001, Taiwan
- Bariatric and Metabolism International Surgery Center, E-Da Hospital, Kaohsiung, Taiwan
- Department of Family Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Wan-Ling Tu
- Bariatric and Metabolism International Surgery Center, E-Da Hospital, Kaohsiung, Taiwan
- Department of Nutrition Therapy, E-Da Hospital, Kaohsiung, Taiwan
| | - Tze-Ho Yang
- Division of General Surgery, E-Da Hospital, Kaohsiung, Taiwan
- Department of General Surgery, E-Da Hospital, Kaohsiung, Taiwan
| | - Chung-Yen Chen
- Bariatric and Metabolism International Surgery Center, E-Da Hospital, Kaohsiung, Taiwan
- Division of General Surgery, E-Da Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Department of General Surgery, E-Da Hospital, Kaohsiung, Taiwan
| | - Jian-Han Chen
- Bariatric and Metabolism International Surgery Center, E-Da Hospital, Kaohsiung, Taiwan.
- Division of General Surgery, E-Da Hospital, Kaohsiung, Taiwan.
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
- Department of General Surgery, E-Da Hospital, Kaohsiung, Taiwan.
| | - Tien-Tsan Hung
- Department of Chemical Engineering & Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, 84001, Taiwan.
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Cao Y, Luo P, Tang H, Li P, Wang G, Li W, Song Z, Su Z, Sun X, Yi X, Fu Z, Cui B, Zhu S, Zhu L. Insulin resistance levels predicted metabolic improvement and weight loss after metabolic surgery in Chinese patients with type 2 diabetes. Surg Obes Relat Dis 2024; 20:80-90. [PMID: 37739868 DOI: 10.1016/j.soard.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/12/2023] [Accepted: 08/05/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND The causes for failure of metabolic improvement and inadequate weight loss after metabolic surgery (MS) in Chinese patients with type 2 diabetes (T2D) have not been fully elucidated. The effect of insulin resistance (IR) on the outcome of T2D, hypertension, hyperlipidemia, and obesity after MS in Chinese patients with T2D and a body mass index (BMI) of 25-32.5 kg/m2 warrants further study. OBJECTIVES Patients with T2D and a BMI of 25-32.5 kg/m2 who underwent MS between July 2019 and June 2021 were included. SETTING University hospital, China. METHODS IR levels were evaluated with the glucose disposal rate (GDR). Improvement of T2D, hypertension, and hyperlipidemia was assessed with the composite triple endpoint (CTEP), and weight loss was assessed with the percent of total weight loss (%TWL). Partial correlation analysis, binary logistic regression analysis, multiple linear regression analysis, receiver operating characteristic curve (ROC) analysis, and subgroup analysis were used to analyze the relationship between the CTEP, %TWL at 1 year postoperative, and GDR preoperative. RESULTS This study analyzed the data of 51 patients with T2D and a BMI of 25-32.5 kg/m2 (30 men and 21 women) with a mean preoperative GDR of 3.72 ± 1.48 mg/kg/min. Partial correlation coefficients between CTEP, %TWL, and GDR were .303 (P = .041) and .449 (P = .001), respectively. The preoperative GDR was significantly positively correlated with CTEP (OR = 1.610, P = .024) and %TWL (β = 1.38, P = .003). The preoperative GDR predicted cutoff values of 4.36 and 5.35 mg/kg/min for CTEP attainment and %TWL ≥ 20%, respectively. CONCLUSION IR levels predicted metabolic improvement and weight loss 1 year after MS in Chinese patients with T2D and a BMI of 25-32.5 kg/m2.
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Affiliation(s)
- Yaoquan Cao
- Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Ping Luo
- Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Haibo Tang
- Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Pengzhou Li
- Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Guohui Wang
- Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Weizheng Li
- Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhi Song
- Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhihong Su
- Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Xulong Sun
- Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Xianhao Yi
- Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhibing Fu
- Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Beibei Cui
- Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Shaihong Zhu
- Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Liyong Zhu
- Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, China.
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Ramos-Levi AM, Rubio-Herrera MA, Matía-Martín P, Pérez-Ferre N, Marcuello C, Sánchez-Pernaute A, Torres-García AJ, Calle-Pascual AL. Mixed Meal Tolerance Test Versus Continuous Glucose Monitoring for an Effective Diagnosis of Persistent Post-Bariatric Hypoglycemia. J Clin Med 2023; 12:4295. [PMID: 37445330 DOI: 10.3390/jcm12134295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/31/2023] [Accepted: 06/24/2023] [Indexed: 07/15/2023] Open
Abstract
Gastric bypass determines an increase in incretin secretion and glucose excursions throughout the day and may sometimes entail the development of severe post-bariatric hypoglycemia (PBH). However, there is no consensus on the gold standard method for its diagnosis. In this study, we evaluated the usefulness of a mixed meal tolerance test (MMTT) and continuous glucose monitoring (CGM) for the diagnosis of PBH, defined as glucose levels <54 mg/dL (3.0 mmol/L). We found that hypoglycemia occurred in 60% of patients after the MMTT and in 75% during CGM, and it was predominantly asymptomatic. The MMTT confirmed the diagnosis of PBH in 88.9%of patients in whom surgery had been performed more than three years ago, in comparison to 36.4% in cases with a shorter postsurgical duration. CGM diagnosed nocturnal asymptomatic hypoglycemia in 70% of patients, and daytime postprandial hypoglycemia in 25% of cases. The mean duration of asymptomatic hypoglycemia was more than 30 min a day. Patients with ≥2% of their CGM readings with hypoglycemia exhibited a higher degree of glucose variability than those with <1% of the time in hypoglycemia. Our results show that the MMTT may be a useful dynamic test to confirm the occurrence of hypoglycemia in a large number of patients with persistent and recurrent PBH during long-term follow-up after gastric bypass. CGM, on its part, helps identify hypoglycemia in the real-world setting, especially nocturnal asymptomatic hypoglycemia, bringing to light that PBH is not always postprandial.
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Affiliation(s)
- Ana M Ramos-Levi
- Departament of Endocrinology and Nutrition, Hospital La Princesa, Instituto de Investigación Princesa, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Miguel A Rubio-Herrera
- Departament of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain
- Faculty of Medicine, Department of Medicine, Universidad Complutense, 28040 Madrid, Spain
| | - Pilar Matía-Martín
- Departament of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain
- Faculty of Medicine, Department of Medicine, Universidad Complutense, 28040 Madrid, Spain
| | - Natalia Pérez-Ferre
- Departament of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain
- Faculty of Medicine, Department of Medicine, Universidad Complutense, 28040 Madrid, Spain
| | - Clara Marcuello
- Departament of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain
| | - Andrés Sánchez-Pernaute
- Department of Surgery, Hospital Clínico San Carlos, IdISSC, Faculty of Medicine, Universidad Complutense, 28040 Madrid, Spain
| | - Antonio J Torres-García
- Department of Surgery, Hospital Clínico San Carlos, IdISSC, Faculty of Medicine, Universidad Complutense, 28040 Madrid, Spain
| | - Alfonso L Calle-Pascual
- Departament of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain
- Faculty of Medicine, Department of Medicine, Universidad Complutense, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28040 Madrid, Spain
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Torrego-Ellacuría M, Barabash A, Matía-Martín P, Sánchez-Pernaute A, Torres AJ, Calle-Pascual AL, Rubio-Herrera MA. Combined Effect of Genetic Variants on Long-Term Weight Response after Bariatric Surgery. J Clin Med 2023; 12:4288. [PMID: 37445323 DOI: 10.3390/jcm12134288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
The pathophysiology of body weight control involves complex interactions between hormonal, environmental, behavioral and genetic factors. The purpose of this study was to analyze the association between single nucleotide polymorphisms (SNPs) of 13 genes encoding gastrointestinal peptides, their receptors or the proteins involved in their expression, with long-term weight response in a cohort of 375 patients undergoing bariatric surgery (BS). To evaluate weight response, we combined several variables to define specific response phenotypes six years after surgery. The study protocol was registered in ISRCTN (ID80961259). The analysis of the selected SNPs was performed via allelic discrimination using Taqman® probes (Applied Biosystems, Foster City, CA, USA). The genotype association study was performed using the SNPstat program, with comparisons adjusted for sex, age, initial body mass index, type 2 diabetes, hypertension diagnosis and the type of surgery. We identified eight genetic variants associated with the weight response to BS, independently of the presurgery patient profile and the type of surgical technique, from which we calculated the unweighted risk score (RS) for each phenotype. The highest scoring category in each RS was significantly associated with lower weight loss (p = 0.0001) and greater weight regain (p = 0.0012) at the end of the follow-up.
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Affiliation(s)
| | - Ana Barabash
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain
- Faculty of Medicine, Department of Medicine, Universidad Complutense, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28040 Madrid, Spain
| | - Pilar Matía-Martín
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain
- Faculty of Medicine, Department of Medicine, Universidad Complutense, 28040 Madrid, Spain
| | - Andrés Sánchez-Pernaute
- Faculty of Medicine, Department of Medicine, Universidad Complutense, 28040 Madrid, Spain
- Department of Surgery, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain
| | - Antonio J Torres
- Faculty of Medicine, Department of Medicine, Universidad Complutense, 28040 Madrid, Spain
- Department of Surgery, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain
| | - Alfonso L Calle-Pascual
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain
- Faculty of Medicine, Department of Medicine, Universidad Complutense, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28040 Madrid, Spain
| | - Miguel A Rubio-Herrera
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain
- Faculty of Medicine, Department of Medicine, Universidad Complutense, 28040 Madrid, Spain
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Elhag W, Lock M, El Ansari W. When Definitions Differ, are Comparisons Meaningful? Definitions of Weight Regain After Bariatric Surgery and Their Associations with Patient Characteristics and Clinical Outcomes - A Need for a Revisit? Obes Surg 2023; 33:1390-1400. [PMID: 36995562 PMCID: PMC10156838 DOI: 10.1007/s11695-023-06528-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 03/31/2023]
Abstract
INTRODUCTION Definitions and prevalence of weight regain (WR) after bariatric surgery remains inconsistent and their clinical significance unclear. OBJECTIVES To assess WR five years after sleeve gastrectomy (LSG), employing six definitions; and appraise their association with patient characteristics/clinical outcomes. METHODS Consecutive patients (N = 589) who underwent LSG were followed up for 5 years. WR prevalence was calculated yearly employing six definitions. Regression analysis assessed associations between WR at 5 years, and patient characteristics (age, sex, preop BMI, number of follow-up visits, number of comorbidities) and remission of comorbidities (type 2 diabetes, hypertension, and dyslipidemia). RESULTS Sample's mean age and BMI were 34 ± 11.6 years and 43.13 ± 5.77 kg/m2, and 64% were females. Percentage of patients with WR at 2, 3, 4, and 5 years fluctuated between 2.53% and 94.18%, subject to definition, and time point. The definition "Any WR" generated the highest prevalence of WR (86-94%) across all time points. At 5 years, for patient characteristics, preoperative BMI was associated with three definitions (P 0.49 to < 0.001), sex was associated with two (P < 0.026-0.032), and number of comorbidities was associated with one definition (P = 0.01). In terms of comorbidities, only hypertension was associated with WR (one definition, P = 0.025). No other definitions of WR were associated with any of the variables under examination. CONCLUSION Weight regain is reasonably expected after BMS. WR definitions were of minor clinical significance due to weak associations with limited comorbidities. Dichotomous definitions might offer some guidance while managing individual patients. However, its utility as a comparator metric across patients/procedures requires refinements.
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Affiliation(s)
- Wahiba Elhag
- Department of Bariatric Surgery/Bariatric Medicine, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Merilyn Lock
- Division of Exercise Science, Health and Epidemiology, College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Walid El Ansari
- Weill Cornell Medicine-Qatar, Doha, Qatar.
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar.
- College of Medicine, Qatar University, Doha, Qatar.
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Translation and Validation of the Arabic Version of the Eating Behavior After Bariatric Surgery (EBBS) Questionnaire. Obes Surg 2023; 33:1108-1120. [PMID: 36781595 PMCID: PMC10079758 DOI: 10.1007/s11695-023-06480-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/20/2023] [Accepted: 01/20/2023] [Indexed: 02/15/2023]
Abstract
PURPOSE Complications after metabolic and bariatric surgery are common due to the patient's poor commitment to postoperative lifestyle changes. Therefore, intensive follow-up from a multidisciplinary team might improve outcomes. The present study aimed to translate and validate the Eating Behavior after Bariatric Surgery (EBBS) questionnaire into Arabic for use in clinical and research settings. MATERIALS AND METHODS The study followed World Health Organization guidelines for translation and questionnaire adaptation, including forward translation, back translation, pilot testing, and the creation of the final version of the tool. A total of 390 patients who had undergone metabolic and bariatric surgery 3 years ago or more were involved in testing the questionnaire's validity and reliability. RESULTS The mean age of participants was 36 years (range: 20 to 70 years), 56% were females, 94.1% were Saudis, and 56% had bachelor's degrees. The internal consistency of the questionnaire was tested using Cronbach's alpha. One item (alcohol consumption) was excluded during the reliability analysis due to low variance. The reliability analysis results showed that the 10 items were internally consistent, with a Cronbach's α of 0.851. CONCLUSION The validation and reliability of the Arabic-language version of the EBBS questionnaire were found to be satisfactory. The presence of a validated Arabic version of this instrument may help practitioners estimate patients' adherence to dietary and lifestyle recommendations after metabolic and bariatric surgery. Furthermore, the questionnaire may aid in identifying factors that influence the efficacy of these procedures.
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New Insights on the Association Between Socioeconomic Status and Weight Loss After Bariatric Surgery: a Systematic Review and Meta-analysis. Obes Surg 2022; 32:3752-3770. [DOI: 10.1007/s11695-022-06269-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/01/2022] [Accepted: 09/01/2022] [Indexed: 10/14/2022]
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Abstract
During the past decade, several effective antiobesity medications and devices have been developed. In addition, new information regarding the mechanism of action, benefits, and long-term efficacy of bariatric surgery continues to emerge. More than 90% of patients who qualify for therapy for obesity remain untreated. This article aims to provide an overview of the indications and efficacy of currently available medical and surgical therapies for obesity, along with a look toward promising therapies on the horizon.
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Affiliation(s)
- Tirissa J Reid
- Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA; Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, 161 Fort Washington Avenue, Room 512, New York, NY 10032, USA.
| | - Judith Korner
- Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA; Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, 650 West 168th Street, Black Building, Room 20-08, New York, NY 10032, USA
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Abdul Wahab R, le Roux CW. A review on the beneficial effects of bariatric surgery in the management of obesity. Expert Rev Endocrinol Metab 2022; 17:435-446. [PMID: 35949186 DOI: 10.1080/17446651.2022.2110865] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 08/03/2022] [Indexed: 10/15/2022]
Abstract
INTRODUCTION Obesity is a chronic disease with a complex interplay of multiple factors such as genetic, metabolic, behavioral, and environmental factors. The management of obesity includes; lifestyle modification, psychological therapy, pharmacological therapy, and bariatric surgery. To date, bariatric surgery is the most effective treatment for obesity by offering a long-term reduction in weight, remission of obesity-related complications, and improving quality of life. However, bariatric surgery is not equally effective in all patients. Thus, if we can predict who would benefit most, it will improve the risk versus benefit ratio of having surgery. AREAS COVERED In this narrative review, we explore the question on who will benefit the most from bariatric surgery by examining the recent evidence in the literature. In addition, we investigate the predisposing predictors of bariatric surgery response. Finally, we offer the best strategies in the clinic to explain the potential benefits of bariatric surgery to patients. EXPERT OPINION Bariatric surgery is an effective obesity management approach. Despite its efficacy, considerable variation of individual response exists. Thus, it is important to recognize patients that will benefit most, but at present very few predictors are available which can be clinically useful.
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Affiliation(s)
- Roshaida Abdul Wahab
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Belfied, Ireland
| | - Carel W le Roux
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Belfied, Ireland
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Lorden HM, Parajuli S. Bariatric Surgery Decreases Barriers for Kidney Transplant: Are There Other Weight-Loss Options? KIDNEY360 2022; 3:1299-1301. [PMID: 36176650 PMCID: PMC9416833 DOI: 10.34067/kid.0003622022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/05/2022] [Indexed: 01/11/2023]
Affiliation(s)
- Heather M. Lorden
- Division of Transplantation, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Sandesh Parajuli
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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Influence of CLOCK Gene Variants on Weight Response after Bariatric Surgery. Nutrients 2022; 14:nu14173472. [PMID: 36079729 PMCID: PMC9460349 DOI: 10.3390/nu14173472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 12/02/2022] Open
Abstract
The Circadian Locomotor Output Cycles Kaput (CLOCK) gene has been linked to metabolic dysfunction and obesity. The purpose of this study was to analyze the association between single nucleotide polymorphisms (SNPs) of CLOCK gene with obesity and with long-term weight response after different bariatric surgery (BS) techniques. The cohort includes 375 patients with morbid obesity (MO) and 230 controls. In the association study of SNPs with weight response we combined several variables as phenotype at 6 years after surgery. The study protocol was registered in ISRCTN (ID80961259). The analysis of the selected SNPs was performed by allelic discrimination using Taqman® probes. The genotype association study was performed using the SNPStats program, with comparisons adjusted for sex, age, initial Body Mass Index, type 2 diabetes and hypertension diagnosis, and type of surgery. In the case-control study two of three SNPs were significantly associated with MO. The variant rs1801260 had a protective effect for MO whereas the TT genotype of rs3749474 variant had the strongest association with MO (OR = 2.25 (1.39–3.66); p = 0.0006). In the linear regression analysis both variants showed significant association with long-term weight loss and weight regain after BS, independently of the pre-surgery patient profile.
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Comparison of Weight Loss Outcomes between Roux-en-Y Gastric Bypass and Sleeve Gastrectomy in a Racially Mixed Urban Patient Population. Surg Obes Relat Dis 2022; 18:1218-1227. [DOI: 10.1016/j.soard.2022.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/19/2022] [Accepted: 05/23/2022] [Indexed: 11/22/2022]
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Adipositas und Ernährung. DIABETOLOGE 2022. [DOI: 10.1007/s11428-022-00890-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bariatric Surgery and Liver Disease: General Considerations and Role of the Gut-Liver Axis. Nutrients 2021; 13:nu13082649. [PMID: 34444807 PMCID: PMC8399840 DOI: 10.3390/nu13082649] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/23/2021] [Accepted: 07/27/2021] [Indexed: 02/07/2023] Open
Abstract
Weight loss is a therapeutic solution for many metabolic disorders, such as obesity and its complications. Bariatric surgery aims to achieve lasting weight loss in all patients who have failed after multiple dietary attempts. Among its many benefits, it has been associated with the regression of non-alcoholic fatty liver disease (NAFLD), which is often associated with obesity, with evidence of substantial improvement in tissue inflammation and fibrosis. These benefits are mediated not only by weight loss, but also by favorable changes in systemic inflammation and in the composition of the gut microbiota. Changes in microbial metabolites such as short-chain fatty acids (SCFAs), capable of acting as endocrine mediators, and bile acids (BAs) as well as modifications of the gut-brain axis, are among the involved mechanisms. However, not all bariatric surgeries show beneficial effects on the liver; those leading to malabsorption can cause liver failure or a marked worsening of fibrosis and the development of cirrhosis. Nevertheless, there are still many unclear aspects, including the extent of the benefits and the magnitude of the risks of bariatric surgery in cirrhotic patients. In addition, the usefulness and the safety of these procedures in patients who are candidates to or who have undergone liver transplant need solid supporting evidence. This paper aims to review literature data on the use of bariatric surgery in the setting of chronic liver disease.
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