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Salman AA, Salman MA, Aon MH, Mahdy RE, Abdallah A, Shemy GG, Hassan AM, Amin FAS, Labib S. Impact of Weight Loss on the Severity of Albuminuria in Obese Diabetic Patients Undergoing Laparoscopic Sleeve Gastrectomy and One-Anastomosis Gastric Bypass. Int J Gen Med 2022; 15:6405-6413. [PMID: 35957758 PMCID: PMC9359793 DOI: 10.2147/ijgm.s365113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/21/2022] [Indexed: 11/23/2022] Open
Abstract
AIM To examine the effect of weight-loss induced bariatric procedures on albuminuria levels among diabetic patients suffering from obesity. METHODS Adults patients who suffer from morbid obesity and type 2 diabetes mellitus (T2DM) were included in a prospective cohort study. Subjects were scheduled to undergo laparoscopic sleeve gastrectomy (LSG) or one-anastomosis gastric bypass (OAGB). The albumin-to-creatinine ratio (ACR) was adopted to assess the degree of albuminuria. Microalbuminuria was determined as a ratio of >2.5-30 mg/mmol and >3.5-30 mg/mmol for males and females, respectively, while macroalbuminuria was diagnosed when the ACR exceeded >30 mg/mmol. RESULTS The mean uACR decreased significantly from 20.95±16.89 to 9.92±12.69mg/mmol in LSG cohort (p <0.001), and from 19.52±16.65 to 9.34±11.77mg/mmol in the OAGB cohort, with no statistically considerable differences between both cohorts at the end of follow-up (p = 0.78). Twelve months after the procedures, the percentages of cases with microalbuminuria decreased significantly to 23.8% and 23.9%, respectively (p < 0.001); likewise, the percentages of cases with macroalbuminuria significantly decreased to 7.9% and 7.5% in the LSG and OAGB groups, respectively (p < 0.001). There were no statistically considerable differences between LSG and OAGB regarding the percentages of patients with micro or macroalbuminuria at the end of follow-up. Besides, there were no significant associations between the degree of weight loss and improvement (p = 0.959) or remission (p = 0.73) of microalbuminuria. CONCLUSION Bariatric surgery significantly reduced the severity of albuminuria 1-year after the procedure, with no preference for one procedure over the other.
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Affiliation(s)
| | | | - Mohamed H Aon
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Reem Ezzat Mahdy
- Internal Medicine Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ahmed Abdallah
- General Surgery Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Gamal Galal Shemy
- General Surgery Department, Faculty of Medicine, Al-Azhar University, Assiut Branch, Assiut, Egypt
| | - Ahmed M Hassan
- General Surgery Department, Faculty of Medicine, Al-Azhar University, Assiut Branch, Assiut, Egypt
| | | | - Safa Labib
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Benaiges D, Bisbe M, Pedro-Botet J, de Vargas-Machuca A, Ramon JM, Pera M, Villatoro M, Fontané L, Julià H, Climent E, Castañer O, Roux JAFL, Goday A. Additional Metabolic Effects of Bariatric Surgery in Patients with a Poor Mid-Term Weight Loss Response: A 5-Year Follow-Up Study. J Clin Med 2020; 9:jcm9103193. [PMID: 33019725 PMCID: PMC7600546 DOI: 10.3390/jcm9103193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/15/2020] [Accepted: 09/28/2020] [Indexed: 11/16/2022] Open
Abstract
To ascertain the 5-year metabolic effects of bariatric surgery in poor weight loss (WL) responders and establish associated factors. Methods: Retrospective analysis of a non-randomised prospective cohort of bariatric surgery patients completing a 5-year follow-up. Mid-term poor WL was considered when 5-year excess weight loss was <50%. Results: Forty-three (20.3%) of the 212 included patients were mid-term poor WL responders. They showed an improvement in all metabolic markers at 2 years, except for total cholesterol. This improvement with respect to baseline was maintained at 5 years for plasma glucose, HbA1c, HOMA, HDL and diastolic blood pressure; however, LDL cholesterol, triglycerides and systolic blood pressure were similar to presurgical values. Comorbidity remission rates were comparable to those obtained in the good WL group except for hypercholesterolaemia (45.8% vs. poor WL, p = 0.005). On multivariate analysis, lower baseline HDL cholesterol levels, advanced age and lower preoperative weight loss were independently associated with poor mid-term WL. Conclusions: Although that 1 in 5 patients presented suboptimal WL 5 years after bariatric surgery, other important metabolic benefits were maintained.
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Affiliation(s)
- David Benaiges
- Departament de Medicina, Universitat Autònoma de Barcelona, 08139 Barcelona, Spain; (M.B.); (J.P.-B.); (A.d.V.-M.); (H.J.); (E.C.); (J.A.F.-L.R.); (A.G.)
- Cardiovascular Risk and Nutrition Research Group (CARIN-ULEC), IMIM-Hospital del Mar, Barcelona, Biomedical Research Park (Parc de Recerca Biomèdica de Barcelona-PRBB), 08003 Barcelona, Spain;
- Department of Endocrinology and Nutrition, Hospital del Mar, 08003 Barcelona, Spain; (M.V.); (L.F.)
- Consorci Sanitari de l’Alt Penedès i Garraf, 08720 Vilafranca del Pendès, Spain
- Correspondence: ; Tel.: +34-932483902; Fax: +34-932483254
| | - Maria Bisbe
- Departament de Medicina, Universitat Autònoma de Barcelona, 08139 Barcelona, Spain; (M.B.); (J.P.-B.); (A.d.V.-M.); (H.J.); (E.C.); (J.A.F.-L.R.); (A.G.)
| | - Juan Pedro-Botet
- Departament de Medicina, Universitat Autònoma de Barcelona, 08139 Barcelona, Spain; (M.B.); (J.P.-B.); (A.d.V.-M.); (H.J.); (E.C.); (J.A.F.-L.R.); (A.G.)
- Cardiovascular Risk and Nutrition Research Group (CARIN-ULEC), IMIM-Hospital del Mar, Barcelona, Biomedical Research Park (Parc de Recerca Biomèdica de Barcelona-PRBB), 08003 Barcelona, Spain;
- Department of Endocrinology and Nutrition, Hospital del Mar, 08003 Barcelona, Spain; (M.V.); (L.F.)
| | - Aleix de Vargas-Machuca
- Departament de Medicina, Universitat Autònoma de Barcelona, 08139 Barcelona, Spain; (M.B.); (J.P.-B.); (A.d.V.-M.); (H.J.); (E.C.); (J.A.F.-L.R.); (A.G.)
| | - Jose M. Ramon
- Unit of Gastrointestinal Surgery, Hospital del Mar, Institut de Recerca IMIM-Hospital del Mar, 08003 Barcelona, Spain; (J.M.R.); (M.P.)
| | - Manuel Pera
- Unit of Gastrointestinal Surgery, Hospital del Mar, Institut de Recerca IMIM-Hospital del Mar, 08003 Barcelona, Spain; (J.M.R.); (M.P.)
| | - Montserrat Villatoro
- Department of Endocrinology and Nutrition, Hospital del Mar, 08003 Barcelona, Spain; (M.V.); (L.F.)
| | - Laia Fontané
- Department of Endocrinology and Nutrition, Hospital del Mar, 08003 Barcelona, Spain; (M.V.); (L.F.)
- Consorci Sanitari de l’Alt Penedès i Garraf, 08720 Vilafranca del Pendès, Spain
| | - Helena Julià
- Departament de Medicina, Universitat Autònoma de Barcelona, 08139 Barcelona, Spain; (M.B.); (J.P.-B.); (A.d.V.-M.); (H.J.); (E.C.); (J.A.F.-L.R.); (A.G.)
- Department of Endocrinology and Nutrition, Hospital del Mar, 08003 Barcelona, Spain; (M.V.); (L.F.)
| | - Elisenda Climent
- Departament de Medicina, Universitat Autònoma de Barcelona, 08139 Barcelona, Spain; (M.B.); (J.P.-B.); (A.d.V.-M.); (H.J.); (E.C.); (J.A.F.-L.R.); (A.G.)
- Cardiovascular Risk and Nutrition Research Group (CARIN-ULEC), IMIM-Hospital del Mar, Barcelona, Biomedical Research Park (Parc de Recerca Biomèdica de Barcelona-PRBB), 08003 Barcelona, Spain;
- Department of Endocrinology and Nutrition, Hospital del Mar, 08003 Barcelona, Spain; (M.V.); (L.F.)
| | - Olga Castañer
- Cardiovascular Risk and Nutrition Research Group (CARIN-ULEC), IMIM-Hospital del Mar, Barcelona, Biomedical Research Park (Parc de Recerca Biomèdica de Barcelona-PRBB), 08003 Barcelona, Spain;
- Centro de Investigaciones Biomédicas en Red de Obesidad y Nutrición, CIBERobn, 28029 Madrid, Spain
| | - Juana A. Flores-Le Roux
- Departament de Medicina, Universitat Autònoma de Barcelona, 08139 Barcelona, Spain; (M.B.); (J.P.-B.); (A.d.V.-M.); (H.J.); (E.C.); (J.A.F.-L.R.); (A.G.)
- Cardiovascular Risk and Nutrition Research Group (CARIN-ULEC), IMIM-Hospital del Mar, Barcelona, Biomedical Research Park (Parc de Recerca Biomèdica de Barcelona-PRBB), 08003 Barcelona, Spain;
- Department of Endocrinology and Nutrition, Hospital del Mar, 08003 Barcelona, Spain; (M.V.); (L.F.)
| | - Alberto Goday
- Departament de Medicina, Universitat Autònoma de Barcelona, 08139 Barcelona, Spain; (M.B.); (J.P.-B.); (A.d.V.-M.); (H.J.); (E.C.); (J.A.F.-L.R.); (A.G.)
- Cardiovascular Risk and Nutrition Research Group (CARIN-ULEC), IMIM-Hospital del Mar, Barcelona, Biomedical Research Park (Parc de Recerca Biomèdica de Barcelona-PRBB), 08003 Barcelona, Spain;
- Department of Endocrinology and Nutrition, Hospital del Mar, 08003 Barcelona, Spain; (M.V.); (L.F.)
- Centro de Investigaciones Biomédicas en Red de Obesidad y Nutrición, CIBERobn, 28029 Madrid, Spain
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