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Nonino CB, Oliveira BAPD, Chaves RCP, Silva LTPE, Pinhel MADS, Ferreira FDC, Rocha GDC, Donadelli SP, Marchini JS, Salgado-Junior W, Nicoletti CF. IS THERE ANY CHANGE IN PHENOTYPIC CHARACTERISTICS COMPARING 5 TO 10 YEARS OF FOLLOW-UP IN OBESE PATIENTS UNDERGOING ROUX-EN-Y GASTRIC BYPASS? ACTA ACUST UNITED AC 2019; 32:e1453. [PMID: 31644673 PMCID: PMC6812142 DOI: 10.1590/0102-672020190001e1453] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 02/28/2019] [Indexed: 12/15/2022]
Abstract
Background
: Bariatric surgery promotes significant weight loss and
improvement of associated comorbidities; however, nutrients deficiencies and
weight regain may occur in the middle-late postoperative period.
Aim:
To investigate nutritional status in 10 years follow-up.
Methods
: Longitudinal retrospective study in which anthropometric,
biochemical indicators and nutritional intake were assessed before and after
one, two, three, four, five and ten years of Roux-en Y gastric bypass
through analysis of medical records.
Results
: After ten years there was a reduction of 29.2% of initial
weight; however, 87.1% of patients had significant weight regain. Moreover,
there was an increase of incidence of iron (9.2% to 18.5%), vitamin B12
(4.2% to 11.1%) and magnesium deficiency (14.1% to 14.8%). Folic acid
concentrations increased and the percentage of individuals with glucose
(40.4% to 3.7%), triglycerides (38% to 7.4%), HDL cholesterol (31 % to 7.4%)
and uric acid (70.5% to 11.1%) abnormalities reduced. Also, there is a
reduction of food intake at first year postoperative. After 10 years, there
was an increase in energy, protein and lipid intake, also a reduction in
folid acid intake.
Conclusions
: Roux-en Y gastric bypass is an effective procedure to
promote weight loss and improve comorbidities associated with obesity.
However, comparison between postoperative period of five and 10 years showed
a high prevalence of minerals deficiency and a significant weight regain,
evidencing the need for nutritional follow-up in the postoperative
period.
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Affiliation(s)
- Carla Barbosa Nonino
- Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Raoana Cássia Paixão Chaves
- Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | | | - Flávia de Campos Ferreira
- Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Gabriela da Costa Rocha
- Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Simara Paganini Donadelli
- Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Julio Sergio Marchini
- Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Wilson Salgado-Junior
- Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Carolina Ferreira Nicoletti
- Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
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Nascimento TM, Alves-Júnior A, Nunes MAP, de Freitas TRP, da Silva MAFS, Alves MRM. COMPARISON OF HEPATIC PROFILE IN PRE AND POSTOPERATIVE OF BARIATRIC SURGERY: PRIVATE VS PUBLIC NETWORK. ABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA 2016; 28:274-7. [PMID: 26734800 PMCID: PMC4755182 DOI: 10.1590/s0102-6720201500040014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 09/03/2015] [Indexed: 11/22/2022]
Abstract
Background: Obesity is associated to several comorbidities, including nonalcoholic fatty liver
disease, which implicates in isolated steatosis to steatohepatitis. The latter may
progress to severe manifestations such as liver fibrosis, cirrhosis and
hepatocellular carcinoma. Aim: To compare the presence of advanced liver fibrosis before and after bariatric
surgery in patients of private and public health system. Methods: Patients from public and privative networks were studied before and after
bariatric surgery. The presence or absence of advanced hepatic fibrosis was
evaluated by NAFLD Fibrosis Score, a non-invasive method that uses age, BMI,
AST/ALT ratio, albumin, platelet count and the presence or absence of
hyperglycemia or diabetes. The characteristics of the two groups were compared.
The established statistical significance criterion was p<0.05. Results: Were analyzed 40 patients with a mean age of 34.6±9.5 years for private network
and 40.6± 10.2 years for public. The study sample, 35% were treated at private
health system and 65% in the public ones, 38% male and 62% female. Preoperatively
in the private network one (7.1%) patient had advanced liver fibrosis and
developed to the absence of liver fibrosis after surgery. In the public eight
(30.8%) patients had advanced liver fibrosis preoperatively, and at one year after
the proportion fell to six (23%). Conclusion: The non-alcoholic fatty liver disease in its advanced form is more prevalent in
obese patients treated in the public network than in the treated at the private
network and bariatric surgery may be important therapeutic option in both
populations.
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Peroxidação lipídica e obesidade: Métodos para aferição do estresse oxidativo em obesos. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.jpg.2013.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Gastric bypass surgery attenuates ethanol consumption in ethanol-preferring rats. Biol Psychiatry 2012; 72:354-60. [PMID: 22444202 DOI: 10.1016/j.biopsych.2012.01.035] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Revised: 01/30/2012] [Accepted: 01/30/2012] [Indexed: 11/22/2022]
Abstract
BACKGROUND Roux-en-Y gastric bypass (RYGB) surgery is an effective weight loss strategy employed to treat obesity and associated complications. Importantly, the RYGB procedure has been reported to attenuate reward-related consummatory behaviors. The present work examined the hypothesis that RYGB surgery attenuates ethanol intake and reward in the context of frequent ethanol consumption. METHODS To do this, self-report of ethanol intake was examined in human bariatric patients (n = 6165) before and following the RYGB procedure. In addition, we utilized a rodent model of RYGB and examined ethanol consumption and ethanol reward in male ethanol-preferring (P) rats, which are selectively bred to consume large volumes of ethanol. RESULTS Patients that reported frequent consumption of ethanol before RYGB reported decreased consumption following RYGB surgery. Moreover, the RYGB procedure decreased ethanol intake and the reinforcing properties of ethanol in P rats. Notably, the attenuating effect of RYGB surgery on ethanol consumption was associated with ethanol-induced increases in the gut hormone glucagon-like peptide-1 (GLP-1). Pharmacologic administration of GLP-1 agonists attenuated ethanol consumption in sham P rats. In addition, pharmacologic replacement of the gut hormone ghrelin restored drinking behavior in P rats following RYGB. CONCLUSIONS Collectively, these findings unveil the potential of RYGB surgery to attenuate ethanol consumption in some humans and rats. Furthermore, our data indicate that this regulation is achieved, in part, through reduction of reward and is modified by the gut hormones GLP-1 and ghrelin.
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Bonotto Orso IR, Pereira JC, D’Albuquerque LA, Cecconello I, Jukemura J. Critical analysis of the use of statistical tests in Brazilian publications related to digestive tract surgery. Rev Assoc Med Bras (1992) 2011. [DOI: 10.1016/s0104-4230(11)70013-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Orso IRB, Pereira JC, D’Albuquerque LA, Cecconello I, Jukemura J. Critical analysis of the use of statistical tests in Brazilian publications related to digestive tract surgery. Rev Assoc Med Bras (1992) 2011. [DOI: 10.1590/s0104-42302011000100013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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Nassif PAN, Lopes AD, Lopes GL, Martins PR, Pedri LE, Varaschim M, Bopp DS. Alterações nos parâmetros pré e pós-operatórios de pacientes com síndrome metabólica, submetidos a Bypass gastrointestinal em Y de Roux. ABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA 2009. [DOI: 10.1590/s0102-67202009000300006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RACIONAL: A epidemia mundial de sobrepeso e obesidade afeta aproximadamente 1,7 bilhão de pessoas, havendo aumento nos casos de obesidade mórbida de 80% para mulheres e de 400% para homens desde 1970. A síndrome metabólica é transtorno complexo relacionado com resistência à insulina e obesidade abdominal, provocando alterações no metabolismo da glicose em vários tecidos e hiperinsulinemia. OBJETIVO: Verificar as alterações nos parâmetros pré e pós-operatórios em pacientes obesos mórbidos com síndrome metabólica, submetidos a bypass gastrointestinal em Y de Roux. MÉTODO: Casuística de 74 pacientes obesos, que apresentavam síndrome metabólica e submetidos a procedimento cirúrgico. Foram avaliados, além do IMC, a relação cintura-quadril, pressão arterial, colesterol total, HDL, LDL, triglicerídeos, glicemia de jejum no pré-operatório e no 1º e 4º meses de pós-operatório. Para variáveis que apresentaram simetria na sua distribuição, foi usado o teste t de Student para amostras pareadas. Para variáveis com distribuição assimétrica, foi usado o teste não-paramétrico de Wilcoxon. Valores de P<0,05 indicaram significância estatística. RESULTADOS: Obteve-se redução no 1º mês do pós-operatório no peso de 7,96%, IMC de 8%, relação cintura/quadril de 1,35%, colesterol total de 17,95%, HDL de 14,5%, LDL de 15,31%, TAG's de 30,29% e glicemia de 9,75%; no 4º mês, observou-se redução no peso de 14,94%, IMC de 20,08%, relação cintura/quadril de 5,96%, colesterol total de 21,27%, HDL de 3,53%, LDL de 23,72%, TAG's de 29,6% e na glicemia de 10,34%. CONCLUSÃO: Os parâmetros avaliados neste estudo tiveram melhora estatisticamente significante, com exceção do HDL-colesterol.
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de Freitas ACT, Campos ACL, Coelho JCU. The impact of bariatric surgery on nonalcoholic fatty liver disease. Curr Opin Clin Nutr Metab Care 2008; 11:267-74. [PMID: 18403923 DOI: 10.1097/mco.0b013e3282fbd33f] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW To analyze the effects of bariatric surgery on nonalcoholic fatty liver disease by reviewing the most important and recent studies. RECENT FINDINGS The prevalence of obesity has increased dramatically over the last decades. Comorbidities related to obesity, such as nonalcoholic fatty liver disease are also increasing. Nonalcoholic fatty liver disease is a progressive disease with potential evolution to liver cirrhosis and hepatocellular carcinoma. Overweight patients who have nonalcoholic fatty liver disease should be considered for a weight loss program; however, long-term result with dietary interventions and drug therapy has been disappointing. Bariatric surgery is effective in promoting long-term weight loss in morbidly obese patients with control of comorbidities, especially those associated with the metabolic syndrome. On the basis of the early experience with extensive intestinal bypass, it was believed that rapid weight loss could cause liver damage. In contrast, recent prospective and retrospective observational studies and case series have demonstrated that bariatric surgery is well tolerated and is associated with nonalcoholic fatty liver disease regression in a significant number of patients. SUMMARY There is good level of evidence that bariatric surgery is associated with nonalcoholic fatty liver disease regression in morbidly obese patients.
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