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Meulendijks ER, Krul SPJ, Baalman SW, de Vries TAC, Wesselink R, Ernault AC, Kawasaki M, Al-Shama R, Neefs J, Limpens J, de Groot JR. Circulating adipose tissue proteins involved in atrial fibrillation: An explorative scoping review. Trends Cardiovasc Med 2024; 34:148-158. [PMID: 36538994 DOI: 10.1016/j.tcm.2022.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
Obesity increases the risk of atrial fibrillation (AF), potentially through proteins secreted by adipose tissue (AT) that affect atrial electrical and structural remodeling. We aim to give a comprehensive overview of circulating AT proteins involved in inflammation and fibrosis, that are associated with prevalent AF (paroxysmal or persistent) and the risk on developing new-onset AF. These include adipokines, defined as proteins enriched in AT as adiponectin, but also proteins less specific to AT. We systematically performed an explorative search for studies reporting associations between proteins secreted from cells residing in the AT and AF, and additionally assessed the effect of obesity on these proteins by a secondary search. The AT proteins involved in inflammation were mostly increased in patients with prevalent and new-onset AF, and with obesity, while the AT enriched adipokines were mostly not associated with AF. This review provides insight into circulating adipose tissue proteins involved in AF substrate formation.
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Affiliation(s)
- Eva R Meulendijks
- Amsterdam UMC, University of Amsterdam, Heart Center, department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105, the Netherlands; Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, the Netherlands.
| | - Sébastien P J Krul
- Amsterdam UMC, University of Amsterdam, Heart Center, department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105, the Netherlands
| | - Sarah W Baalman
- Amsterdam UMC, University of Amsterdam, Heart Center, department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105, the Netherlands
| | - Tim A C de Vries
- Amsterdam UMC, University of Amsterdam, Heart Center, department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105, the Netherlands; Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, the Netherlands
| | - Robin Wesselink
- Amsterdam UMC, University of Amsterdam, Heart Center, department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105, the Netherlands; Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, the Netherlands
| | - Auriane C Ernault
- Amsterdam UMC, University of Amsterdam, Heart Center, department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105, the Netherlands; Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, the Netherlands
| | - Makiri Kawasaki
- Amsterdam UMC, University of Amsterdam, Heart Center, department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105, the Netherlands
| | - Rushd Al-Shama
- Amsterdam UMC, University of Amsterdam, Heart Center, department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105, the Netherlands; Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, the Netherlands
| | - Jolien Neefs
- Amsterdam UMC, University of Amsterdam, Heart Center, department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105, the Netherlands
| | - Jacqueline Limpens
- Amsterdam UMC, University of Amsterdam, Heart Center, department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105, the Netherlands
| | - Joris R de Groot
- Amsterdam UMC, University of Amsterdam, Heart Center, department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam 1105, the Netherlands; Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, the Netherlands
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Alamdari NM, Sadegh GHM, Farsi Y, Besharat S, Hajimirzaie SH, Abbasi M. The impact of sleeve gastrectomy on polycystic ovarian syndrome: a single-center 1-year cohort study. Ir J Med Sci 2024; 193:721-724. [PMID: 37574528 DOI: 10.1007/s11845-023-03488-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/01/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND AND AIM Obesity is one of the risk factors for polycystic ovarian syndrome (PCOS), and weight loss is the mainstay of treatment. This study investigates the effects of sleeve gastrectomy on clinical and paraclinical signs and symptoms of PCOS patients referred to a tertiary hospital. METHODS Female patients with a definite diagnosis of PCOS and body mass index (BMI) > 40 kg/m2 who were candidates for sleeve gastrectomy were enrolled in this cohort study and followed for 1 year postoperatively. Clinical signs and symptoms of PCOS, sonographic examination, and laboratory hormonal assessments were assessed preoperatively and 1 year following surgery. RESULTS Fifty patients enrolled in the study. The mean age of patients was 31.69 ± 9.54 years. The mean BMI before and after the surgery was 44.28 ± 3.03 and 29.37 ± 2.41 kg/m2, respectively. Oligomenorrhea was improved in 66% of patients. According to the sonographic criteria, PCOS was improved in 74% of patients. After a year post-operation, while the mean serum levels of the follicular stimulating hormone (FSH), testosterone, and dehydroepiandrostenedione have improved significantly in all patients (p < 0.001 in all), the significant decrease in serum luteinizing hormone (LH), LH/ FSH ratio, and estrogen was only noted in patients with improved clinical response (p < 0.05, p < 0.001, and p < 0.001 respectively). CONCLUSION Weight loss and improvements in hyperandrogenism following sleeve gastrectomy result in clinical and paraclinical improvement of PCOS signs and symptoms, including oligomenorrhea and ovulation induction.
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Affiliation(s)
- Nasser Malekpour Alamdari
- Critical Care Quality Improvement Research Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gholam Hossein Monavar Sadegh
- Critical Care Quality Improvement Research Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yeganeh Farsi
- Critical Care Quality Improvement Research Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Besharat
- Department of Radiology, Shahid Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Seyed Hossein Hajimirzaie
- Critical Care Quality Improvement Research Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Abbasi
- Critical Care Quality Improvement Research Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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McLaughlin AP, Lambert E, Milton R, Mariani N, Kose M, Nikkheslat N, Patsalos O, Ferraro L, Chamseddine G, Panagiotopoulos S, Chang A, Ramar S, Patel A, Rubino F, Mondelli V. Peripheral inflammation associated with depression and reduced weight loss: a longitudinal study of bariatric patients. Psychol Med 2024; 54:601-610. [PMID: 37652080 DOI: 10.1017/s0033291723002283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
BACKGROUND Research implicates inflammation in the vicious cycle between depression and obesity, yet few longitudinal studies exist. The rapid weight loss induced by bariatric surgery is known to improve depressive symptoms dramatically, but preoperative depression diagnosis may also increase the risk for poor weight loss. Therefore, we investigated longitudinal associations between depression and inflammatory markers and their effect on weight loss and clinical outcomes in bariatric patients. METHODS This longitudinal observational study of 85 patients with obesity undergoing bariatric surgery included 41 cases with depression and 44 controls. Before and 6 months after surgery, we assessed depression by clinical interview and measured serum high-sensitivity C-reactive protein (hsCRP) and inflammatory cytokines, including interleukin (IL)-6 and IL-10. RESULTS Before surgery, depression diagnosis was associated with significantly higher serum hsCRP, IL-6, and IL-6/10 ratio levels after controlling for confounders. Six months after surgery, patients with pre-existing depression still had significantly higher inflammation despite demonstrating similar weight loss to controls. Hierarchical regression showed higher baseline hsCRP levels predicted poorer weight loss (β = -0.28, p = 0.01) but had no effect on depression severity at follow-up (β = -0.02, p = 0.9). Instead, more severe baseline depressive symptoms and childhood emotional abuse predicted greater depression severity after surgery (β = 0.81, p < 0.001; and β = 0.31, p = 0.001, respectively). CONCLUSIONS Depression was significantly associated with higher inflammation beyond the effect of obesity and other confounders. Higher inflammation at baseline predicted poorer weight loss 6 months after surgery, regardless of depression diagnosis. Increased inflammation, rather than depression, may drive poor weight loss outcomes among bariatric patients.
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Affiliation(s)
- Anna P McLaughlin
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
- National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, and King's College London, London, UK
| | - Ellen Lambert
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
- National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, and King's College London, London, UK
| | - Rebecca Milton
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Nicole Mariani
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Melisa Kose
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Naghmeh Nikkheslat
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Olivia Patsalos
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
- National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, and King's College London, London, UK
| | - Luca Ferraro
- ASST Santi Paolo e Carlo, Azienda Socio Sanitaria Territorale Santi Paolo e Carlo, Milan, Italy
- Department of Metabolic & Bariatric Surgery, Diabetes & Nutritional Science Division, King's College Hospital, London, UK
| | - Ghassan Chamseddine
- Department of Metabolic & Bariatric Surgery, Diabetes & Nutritional Science Division, King's College Hospital, London, UK
| | - Spyros Panagiotopoulos
- Department of Metabolic & Bariatric Surgery, Diabetes & Nutritional Science Division, King's College Hospital, London, UK
| | - Avril Chang
- Department of Metabolic & Bariatric Surgery, Diabetes & Nutritional Science Division, King's College Hospital, London, UK
| | - Sasindran Ramar
- Department of Metabolic & Bariatric Surgery, Diabetes & Nutritional Science Division, King's College Hospital, London, UK
| | - Ameet Patel
- Department of Metabolic & Bariatric Surgery, Diabetes & Nutritional Science Division, King's College Hospital, London, UK
| | - Francesco Rubino
- Department of Metabolic & Bariatric Surgery, Diabetes & Nutritional Science Division, King's College Hospital, London, UK
| | - Valeria Mondelli
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
- National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, and King's College London, London, UK
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4
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Roberts R, Williams DM, Min T, Barry J, Stephens JW. Benefits in routinely measured liver function tests following bariatric surgery: a retrospective cohort study. J Diabetes Metab Disord 2023; 22:1763-1768. [PMID: 37975098 PMCID: PMC10638127 DOI: 10.1007/s40200-023-01311-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 09/12/2023] [Indexed: 11/19/2023]
Abstract
Background Bariatric surgery is well-established to support long-term metabolic health benefits associated with considerable weight loss. Here, we aim to determine the longer-term impact of bariatric surgery on liver enzymes and associations with other metabolic improvements. Methods One hundred patients who underwent bariatric surgery between 2007 and 2014 were included, and changes in liver enzymes, anthropometric measures and other parameters were observed over a mean 9.8 years. Results At the time of surgery, the mean age was 45.4 ± 9.6 years, weight 141.2 ± 31.6 kg, and body mass index (BMI) 50.2 ± 10.1 kg/m2. Most patients underwent sleeve gastrectomy [n = 71] with a mean follow-up duration 9.8 ± 2.3 years. From baseline, alanine transaminase (ALT) reduced by 41.3% within 12 months post-operatively (36.6 ± 29.2 U/L to 21.5 ± 14.9 U/L, p < 0.001), which was sustained at recent follow-up (20.2 ± 10.7 U/L, p < 0.001). There were associated reductions in body weight, BMI, HbA1c, blood pressure and triglycerides. Patients with greater baseline ALT had the greatest reduction in ALT over follow-up. Conclusions Bariatric surgery is associated with rapid and sustained improvements in routine liver enzymes at 10 years, and sustained improvements in features of the metabolic syndrome. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01311-4.
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Affiliation(s)
- Richard Roberts
- Diabetes Centre, Morriston Hospital, Swansea Bay University Health Board, Swansea, SA6 6NL UK
| | - David M Williams
- Diabetes Centre, Morriston Hospital, Swansea Bay University Health Board, Swansea, SA6 6NL UK
- Diabetes Centre, Singleton Hospital, Swansea Bay University Health Board, Swansea, UK
| | - Thinzar Min
- Diabetes Centre, Singleton Hospital, Swansea Bay University Health Board, Swansea, UK
- Diabetes Research Group, Swansea University Medical School, Swansea University, Swansea, UK
- Diabetes Centre, Neath Port Talbot Hospital, Baglan Way, Port Talbot, SA12 7BX UK
| | - Jonathan Barry
- Welsh Institute of Metabolic & Obesity Surgery, Morriston Hospital, Swansea Bay UHB, Swansea, SA6 6NL UK
| | - Jeffrey W Stephens
- Diabetes Centre, Morriston Hospital, Swansea Bay University Health Board, Swansea, SA6 6NL UK
- Diabetes Research Group, Swansea University Medical School, Swansea University, Swansea, UK
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Yu Y, Lyo V, Groth SW. The impact of maternal bariatric surgery on long-term health of offspring: a scoping review. Pediatr Res 2023; 94:1619-1630. [PMID: 37340100 DOI: 10.1038/s41390-023-02698-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 06/22/2023]
Abstract
While pregnancy post-bariatric surgery has become increasingly common, little is known about whether and how maternal bariatric surgery affects the next generation. This scoping review aimed to collate available evidence about the long-term health of offspring following maternal bariatric surgery. A literature search was conducted using three databases (PubMed, PsycINFO, EMBASE) to obtain relevant human and animal studies. A total of 26 studies were included: 17 were ancillary reports from five "primary" studies (three human, two animal studies) and the remaining nine were "independent" studies (eight human, one animal studies). The human studies adopted sibling-comparison, case-control, and single-group descriptive designs. Despite limited data and inconsistent results across studies, findings suggested that maternal bariatric surgery appeared to (1) modify epigenetics (especially genes involved in immune, glucose, and obesity regulation); (2) alter weight status (unclear direction of alteration); (3) impair cardiometabolic, immune, inflammatory, and appetite regulation markers (primarily based on animal studies); and (4) not affect the neurodevelopment in offspring. In conclusion, this review supports that maternal bariatric surgery has an effect on the health of offspring. However, the scarcity of studies and heterogenous findings highlight that more research is required to determine the scope and degree of such effects. IMPACT: There is evidence that bariatric surgery modifies epigenetics in offspring, especially genes involved in immune, glucose, and obesity regulation. Bariatric surgery appears to alter weight status in offspring, although the direction of alteration is unclear. There is preliminary evidence that bariatric surgery impairs offspring's cardiometabolic, immune, inflammatory, and appetite regulation markers. Therefore, extra care may be needed to ensure optimal growth in children born to mothers with previous bariatric surgery.
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Affiliation(s)
- Yang Yu
- School of Nursing, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
| | - Victoria Lyo
- Department of Surgery, University of California Davis, Sacramento, CA, 95817, USA
- Center for Alimentary and Metabolic Science, University of California Davis, Sacramento, CA, 95817, USA
| | - Susan W Groth
- School of Nursing, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, USA
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Qadhi AH, Almuqati AH, Alamro NS, Azhri AS, Azzeh FS, Azhar WF, Alyamani RA, Almohmadi NH, Alkholy SO, Alhassani WE, Abusudah WF, Babateen AM, Tashkandi B, Alharbi NA, Al-Slaihat AH, Ghafouri KJ. The effect of bariatric surgery on dietary Behaviour, dietary recommendation Adherence, and micronutrient deficiencies one year after surgery. Prev Med Rep 2023; 35:102343. [PMID: 37554351 PMCID: PMC10404799 DOI: 10.1016/j.pmedr.2023.102343] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/10/2023] Open
Abstract
Bariatric surgery (BS) is associated with vitamin and mineral deficiencies, which might be augmented by low adherence to dietary guidelines and inappropriate dietary behaviours. The aim of this study was to determine the influence of BS on eating behaviour, prevalence of nutrient deficiency, level of commitment to diet, and lifestyle recommendations one-year post-BS. A cross-sectional study was conducted among adult patients who underwent BS in 2019 and had follow-up for a year. Age, gender, and clinical data were collected from the hospital system and other information was obtained from questionnaires during phone interviews. A total of 160 patients participated in the study. At 12 months, a significant increase from the baseline values in plasma levels of vitamin B12, folate, vitamin D, iron, corrected calcium, albumin, CRP, and MCV, as well as a significant decrease in BMI was observed. Adherence to dietary and lifestyle recommendations was moderate to high. Emotional, and restrained eating behaviours were moderate with 64.4%, and 77.5%, respectively. External eating was low at 58.1%. The study concluded that pre-and post-bariatric surgery nutrients should be closely monitored.
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Affiliation(s)
- Alaa H. Qadhi
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Asma H. Almuqati
- Clinical Nutrition Administration, King Abdullah Medical City Hospital, Makkah, Saudi Arabia
| | - Nuha S. Alamro
- Clinical Nutrition Administration, King Abdullah Medical City Hospital, Makkah, Saudi Arabia
| | - Afnan S. Azhri
- Clinical Nutrition Administration, King Abdullah Medical City Hospital, Makkah, Saudi Arabia
| | - Firas S. Azzeh
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Wedad F. Azhar
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Reema A. Alyamani
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Najlaa H. Almohmadi
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Sarah O. Alkholy
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Walaa E. Alhassani
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Wafaa F. Abusudah
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abrar M. Babateen
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Bayan Tashkandi
- Food and Nutrition Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nouf A. Alharbi
- Department of Nutrition and Food Science, Northern Border University, Arar 91431, Saudi Arabia
| | - Abed H. Al-Slaihat
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Khloud J. Ghafouri
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
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7
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Latteri S, Sofia M, Puleo S, Di Vincenzo A, Cinti S, Castorina S. Mechanisms linking bariatric surgery to adipose tissue, glucose metabolism, fatty liver disease and gut microbiota. Langenbecks Arch Surg 2023; 408:101. [PMID: 36826628 PMCID: PMC9957865 DOI: 10.1007/s00423-023-02821-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 01/25/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE In the last 20 years, bariatric surgery has achieved an important role in translational and clinical research because of obesity comorbidities. Initially, a tool to lose weight, bariatric surgery now has been shown to be involved in several metabolic pathways. METHODS We conducted a narrative review discussing the underlying mechanisms that could explain the impact of bariatric surgery and the relationship between obesity and adipose tissue, T2D, gut microbiota, and NAFLD. RESULTS Bariatric surgery has an impact in the relation between obesity and type 2 diabetes, but in addition it induces the white-to-brown adipocyte trans-differentiation, by enhancing thermogenesis. Another issue is the connection of bariatric surgery with the gut microbiota and its role in the complex mechanism underlying weight gain. CONCLUSION Bariatric surgery modifies gut microbiota, and these modifications influence lipid metabolism, leading to improvement of non-alcoholic fatty liver disease.
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Affiliation(s)
- Saverio Latteri
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, Italy
| | - Maria Sofia
- Department of General Surgery, Cannizzaro Hospital, Via Messina 829, 95126, Catania, Italy.
| | - Stefano Puleo
- Mediterranean Foundation "GB Morgagni", Catania, Italy
| | - Angelica Di Vincenzo
- Department of Experimental and Clinical Medicine, Center of Obesity, Marche Polytechnic University, Via Tronto 10A, 60020, Ancona, Italy
| | - Saverio Cinti
- Department of Experimental and Clinical Medicine, Center of Obesity, Marche Polytechnic University, Via Tronto 10A, 60020, Ancona, Italy
| | - Sergio Castorina
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, Italy
- Mediterranean Foundation "GB Morgagni", Catania, Italy
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Kuckuck S, van der Valk ES, Scheurink AJW, Lengton R, Mohseni M, Visser JA, Iyer AM, van den Berg SAA, van Rossum EFC. Levels of hormones regulating appetite and energy homeostasis in response to a 1.5-Year combined lifestyle intervention for obesity. Front Physiol 2023; 14:1010858. [PMID: 36891140 PMCID: PMC9986487 DOI: 10.3389/fphys.2023.1010858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 01/30/2023] [Indexed: 02/22/2023] Open
Abstract
Background: Weight loss can induce changes in appetite-regulating hormone levels, possibly linked to increases in appetite and weight regain. However, hormonal changes vary across interventions. Here, we studied levels of appetite-regulating hormones during a combined lifestyle intervention (CLI: healthy diet, exercise and cognitive behavioral therapy). Methods: We measured levels of long-term adiposity-related hormones (leptin, insulin, high-molecular-weight (HMW) adiponectin) and short-term appetite hormones (PYY, cholecystokinin, gastric-inhibitory polypeptide, pancreatic polypeptide, FGF21, AgRP) in overnight-fasted serum of 39 patients with obesity. Hormone levels were compared between T0 (baseline), T1 (after 10 weeks) and T2 (end of treatment, 1.5 years). T0-T1 hormone changes were correlated with T1-T2 anthropometric changes. Results: Initial weight loss at T1 was maintained at T2 (-5.0%, p < 0.001), and accompanied by decreased leptin and insulin levels at T1 and T2 (all p < 0.05) compared to T0. Most short-term signals were not affected. Only PP levels were decreased at T2 compared to T0 (p < 0.05). Most changes in hormone levels during initial weight loss did not predict subsequent changes in anthropometrics, except for T0-T1 decreases in FGF21 levels and T0-T1 increases in HMW adiponectin levels tended to be associated with larger T1-T2 increases in BMI (p < 0.05 and p = 0.05, respectively). Conclusion: CLI-induced weight loss was associated with changes in levels of long-term adiposity-related hormones towards healthy levels, but not with orexigenic changes in most short-term appetite signals. Our data indicates that the clinical impact of alterations in appetite-regulating hormones during modest weight loss remains questionable. Future studies should investigate potential associations of weight-loss-induced changes in FGF21 and adiponectin levels with weight regain.
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Affiliation(s)
- Susanne Kuckuck
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Eline S van der Valk
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Anton J W Scheurink
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, Netherlands
| | - Robin Lengton
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Mostafa Mohseni
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Jenny A Visser
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Anand M Iyer
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Sjoerd A A van den Berg
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Elisabeth F C van Rossum
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
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Muacevic A, Adler JR, Allami HA, Almousa HM, Alobaid AS, Ismail DH, Bin Onayq AI. The Prevalence of Depression and Anxiety in Post-bariatric Surgery Patients at King Khalid University Hospital, Riyadh. Cureus 2022; 14:e32500. [PMID: 36644066 PMCID: PMC9837663 DOI: 10.7759/cureus.32500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Background Obesity negatively impacts mental and physical health and is a leading cause of disease worldwide. Obesity affects 33% of Saudi adults, with 10% being morbidly obese (body mass index, BMI >40 kg/m2). This study explored the association between bariatric surgery (BS) and a predisposition or exacerbation of depressive and anxiety symptoms. Material and methods A cross-sectional study of patients who underwent bariatric surgery at the King Khalid University Hospital in Riyadh, Saudi Arabia, was conducted between February 2016 and December 2021. The patients were contacted by phone to complete a self-administered questionnaire on demographic information, chronic medical diseases, psychiatric diseases, body mass index, and type of bariatric surgery. In addition, they completed the patient health questionnaire-9 (PHQ-9) and general anxiety disorder-7 (GAD-7) questionnaire to screen for patients' depression and anxiety symptoms. Results The findings of the 367 BS patients showed that 20.7% of the patients were considered to have mild anxiety, 11.2% had moderate anxiety, and 8.7% had high anxiety levels. However, regarding depression, 46.9% had extremely low levels of depression, followed by mild depression in 29.4% and moderate depression in 11.2%. Furthermore, another 8.2% of BS patients had moderately high depression levels, and 4.4% had severe depression. The anxiety and depression levels of the patients in this study did not show any statistically significant changes postoperatively in the short, medium, or long term. On the other hand, almost all of the patients 97% who underwent bariatric surgery were satisfied with the outcome of their surgery. Conclusion Few BS patients had high symptoms of depression and anxiety. We recommend pre- and postoperative psychiatric assessment for all bariatric surgery patients as surgical protocol.
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10
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Nielsen C, Elander A, Staalesen T, Al Nouh M, Fagevik Olsén M. Depressive symptoms before and after abdominoplasty among post-bariatric patients - a cohort study. J Plast Surg Hand Surg 2022; 56:381-386. [PMID: 35294844 DOI: 10.1080/2000656x.2022.2050251] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The majority of post-bariatric patients suffer from excess skin after weight loss, impairing physical, psychosocial and mental health. The abdomen is the most common location for excess skin, and abdominoplasty is the most commonly required reconstructive procedure. Abdominoplasty removes excess abdominal skin and attenuates related symptoms, but knowledge regarding mental health-related effects is scarce. Here, we aimed to evaluate the symptoms and severity of depression before and after abdominoplasty in post-bariatric patients and to analyse the relationships between depressive symptoms, quality of life (QoL) and experience of excess skin. We enrolled 110 former obese patients undergoing abdominoplasty. Three questionnaires evaluating the symptoms of depression (Beck Depression Inventory (BDI-II)), experience of excess skin (Sahlgrenska Excess Skin Questionnaire (SESQ)) and QoL (36-item Short-Form Health Survey (SF-36)) were completed preoperatively and 1 year postoperatively. After abdominoplasty, symptoms of depression (BDI sum score) significantly decreased (5.8 vs. 3.0, p = .037). Scores on three BDI questions improved (p < .05), and the SESQ score normalised (p < .001), while the SF-36 score was unaffected. The BDI sum score was moderately correlated with the SF-36 mental composite score (preoperatively, rs = -0.69; postoperatively, rs = -0.66) and fairly correlated with the SF-36 physical composite score (rs = 0.32, rs = 0.26). The correlation between the BDI sum and SESQ scores was poor preoperatively (rs = -0.106) and fair postoperatively (rs = 0.232). The results indicate that abdominoplasty may reduce symptoms of depression in post-bariatric patients. However, the procedure did not affect SF-36 scores. Further studies are required to validate these results.
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Affiliation(s)
- Christina Nielsen
- Department of Clinical Sciences/Plastic Surgery, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Anna Elander
- Department of Clinical Sciences/Plastic Surgery, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Trude Staalesen
- Department of Clinical Sciences/Plastic Surgery, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | | | - Monika Fagevik Olsén
- Department of Clinical Sciences/Surgery, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,Department of Neuroscience and Physiology/Physical Therapy, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
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11
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Elkan H, Baş MM, Kaya B, Nguyen TN. Impact of Laparoscopic Sleeve Gastrectomy on Thrombomodulin Concentration and Early Markers of Atherosclerosis. J Interv Cardiol 2022; 2022:1-7. [PMID: 35855391 PMCID: PMC9286949 DOI: 10.1155/2022/6152571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/06/2022] [Indexed: 11/26/2022] Open
Abstract
Background Thrombomodulin, an integral membrane protein functioning as a cofactor in the anticoagulant pathways, has recently emerged as a marker of endothelial dysfunction. This study aimed to investigate the impact of laparoscopic sleeve gastrectomy (LSG) on thrombomodulin concentration and early markers of atherosclerosis. Methods Forty-four subjects undergoing LSG were prospectively examined. The change in thrombomodulin concentration from baseline (preoperative) to the sixth postoperative month following the LSG and the relationship between the change in thrombomodulin concentration and BMI, CIMT, ABI, and blood lipids were examined. Results The medical records were available for 44 patients (mean age: 37.2 ± 10.9 years, 65.9% male). LSG led to significant reductions in total body weight and body mass index (BMI) at postoperative six months (37.0 ± 5.6 kg/m2 vs. 47.1 ± 5.8 kg/m2, p < 0.001). Markers of early atherosclerotic events, including carotid intima-media thickness (CIMT) and ABI, improved. The change in thrombomodulin concentration (Δ TMD) was significantly correlated with the change in Δ BMI (r = 0.500, p=0.011), Δ LDL (r = 0.389, p=0.032), Δ systolic blood pressure (r = 0.384, p=0.012), and Δ CIMT (r = 0.327, p=0.012) and was negatively correlated with Δ HDL (r = −0.344, p=0.020) and Δ ABI (r = −0.357, p=0.020). Conclusion LSG leads to significant improvements in blood lipids, systolic and diastolic blood pressure, and in surrogate markers of atherosclerotic burden and endothelial function, including thrombomodulin, ABI, and CIMT, at postoperative six months. LSG might prevent or reduce atherogenesis in the early stages by stopping endothelial dysfunction.
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12
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Alyahya RA, Alnujaidi MA. Prevalence and Outcomes of Depression After Bariatric Surgery: A Systematic Review and Meta-Analysis. Cureus 2022; 14:e25651. [PMID: 35784972 PMCID: PMC9249077 DOI: 10.7759/cureus.25651] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2022] [Indexed: 11/05/2022] Open
Abstract
Surgeons often focus on weight loss and improvement of obesity-related conditions as a primary outcome after bariatric surgery. However, the success of bariatric surgery also relies on the improvement of mental health status. Therefore, the current meta-analysis was carried out to reveal the prevalence of depressive symptoms and their subsequent impact on bariatric surgery outcomes. This study was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and the recommendation of Cochrane Collaboration. All clinical studies reporting the prevalence and/or the outcomes of depression after bariatric surgery were included in the current meta-analysis. This meta-analysis encompassed 33 articles, including a total of 101,223 patients. The prevalence of post-bariatric surgery depression was 15.3% (95% confidence intervals {CI}: 15.0-15.5%, p<0.001) among which severe, moderate, and minimal depression accounted for 1.9% (95% CI: 1.5-2.4%, p<0.001), 5.1% (95% CI: 4.4-5.8%, p<0.001), and 64.9% (95% CI: 63.3-66.5%, p<0.001), respectively. Depression is negatively correlated with weight loss (correlation -0.135; 95% CI: -0.176 to 0.093; p<0.001) and positively correlated with eating disorder (correlation 0.164; 95% CI: 0.079-0.248; p<0.001). The prevalence of post-bariatric surgery depression is relatively high reaching up to 64.9%, with almost one in five patients affected by it. Depression is associated with weight regain, eating disorders, and quality of life.
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13
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Sjöholm K, Carlsson LMS, Svensson PA, Andersson-Assarsson JC, Kristensson F, Jacobson P, Peltonen M, Taube M. Association of Bariatric Surgery With Cancer Incidence in Patients With Obesity and Diabetes: Long-term Results From the Swedish Obese Subjects Study. Diabetes Care 2022; 45:444-450. [PMID: 34799430 PMCID: PMC8914410 DOI: 10.2337/dc21-1335] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 10/28/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Obesity and type 2 diabetes are associated with serious adverse health effects, including cancer. Although bariatric surgery has been shown to reduce cancer risk in patients with obesity, the effect of bariatric surgery on cancer risk in patients with obesity and diabetes is less studied. We therefore examined the long-term incidence of cancer after bariatric surgery and usual care in patients with obesity and diabetes in the matched prospective Swedish Obese Subjects (SOS) study. RESEARCH DESIGN AND METHODS The SOS study examines long-term outcomes following bariatric surgery or usual care. The current analysis includes 701 patients with obesity and type 2 diabetes at baseline, 393 of whom underwent bariatric surgery and 308 who received conventional obesity treatment. Information on cancer events was obtained from the Swedish National Cancer Register. Median follow-up time was 21.3 years (interquartile range 17.6-24.8 years, maximum 30.7 years). RESULTS During follow-up, the incidence rate for first-time cancer was 9.1 per 1,000 person-years (95% CI 7.2-11.5) in patients with obesity and diabetes treated with bariatric surgery and 14.1 per 1,000 person-years (95% CI 11.2-17.7) in patients treated with usual obesity care (adjusted hazard ratio 0.63 [95% CI 0.44-0.89], P = 0.008). Moreover, surgery was associated with reduced cancer incidence in women (0.58 [0.38-0.90], P = 0.016), although the sex-treatment interaction was nonsignificant (P = 0.630). In addition, diabetes remission at the 10-year follow-up was associated with reduced cancer incidence (0.40 [0.22-0.74], P = 0.003). CONCLUSIONS These results suggest that bariatric surgery prevents cancer in patients with obesity and diabetes and that durable diabetes remission is associated with reduced cancer risk.
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Affiliation(s)
- Kajsa Sjöholm
- Department of Molecular and Clinical medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Lena M S Carlsson
- Department of Molecular and Clinical medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Per-Arne Svensson
- Department of Molecular and Clinical medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Institute of Health and Care Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Johanna C Andersson-Assarsson
- Department of Molecular and Clinical medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Felipe Kristensson
- Department of Molecular and Clinical medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Peter Jacobson
- Department of Molecular and Clinical medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Markku Peltonen
- Department of Chronic Disease Prevention, National Institute of Health and Welfare, Helsinki, Finland.,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
| | - Magdalena Taube
- Department of Molecular and Clinical medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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14
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Zarkasi KA, Abdul Murad NA, Ahmad N, Jamal R, Abdullah N. Coronary Heart Disease in Type 2 Diabetes Mellitus: Genetic Factors and Their Mechanisms, Gene-Gene, and Gene-Environment Interactions in the Asian Populations. Int J Environ Res Public Health 2022; 19:647. [PMID: 35055468 PMCID: PMC8775550 DOI: 10.3390/ijerph19020647] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 02/04/2023]
Abstract
Asians are more susceptible to type 2 diabetes mellitus (T2D) and its coronary heart disease (CHD) complications than the Western populations, possibly due to genetic factors, higher degrees of obesity, insulin resistance, and endothelial dysfunction that could occur even in healthy individuals. The genetic factors and their mechanisms, along with gene-gene and gene-environment interactions associated with CHD in T2D Asians, are yet to be explored. Therefore, the objectives of this paper were to review the current evidence of genetic factors for CHD, summarize the proposed mechanisms of these genes and how they may associate with CHD risk, and review the gene-gene and gene-environment interactions in T2D Asians with CHD. The genetic factors can be grouped according to their involvement in the energy and lipoprotein metabolism, vascular and endothelial pathology, antioxidation, cell cycle regulation, DNA damage repair, hormonal regulation of glucose metabolism, as well as cytoskeletal function and intracellular transport. Meanwhile, interactions between single nucleotide polymorphisms (SNPs) from different genes, SNPs within a single gene, and genetic interaction with environmental factors including obesity, smoking habit, and hyperlipidemia could modify the gene's effect on the disease risk. Collectively, these factors illustrate the complexities of CHD in T2D, specifically among Asians.
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Affiliation(s)
- Khairul Anwar Zarkasi
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur 56000, Malaysia; (K.A.Z.); (N.A.A.M.); (R.J.)
- Biochemistry Unit, Preclinical Department, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, Kuala Lumpur 57000, Malaysia
| | - Nor Azian Abdul Murad
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur 56000, Malaysia; (K.A.Z.); (N.A.A.M.); (R.J.)
| | - Norfazilah Ahmad
- Epidemiology and Statistics Unit, Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur 56000, Malaysia;
| | - Rahman Jamal
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur 56000, Malaysia; (K.A.Z.); (N.A.A.M.); (R.J.)
| | - Noraidatulakma Abdullah
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur 56000, Malaysia; (K.A.Z.); (N.A.A.M.); (R.J.)
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur 50300, Malaysia
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15
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Jung HN, Jung CH. The Role of Anti-Inflammatory Adipokines in Cardiometabolic Disorders: Moving beyond Adiponectin. Int J Mol Sci 2021; 22:ijms222413529. [PMID: 34948320 PMCID: PMC8707770 DOI: 10.3390/ijms222413529] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 02/07/2023] Open
Abstract
The global burden of obesity has multiplied owing to its rapidly growing prevalence and obesity-related morbidity and mortality. In addition to the classic role of depositing extra energy, adipose tissue actively interferes with the metabolic balance by means of secreting bioactive compounds called adipokines. While most adipokines give rise to inflammatory conditions, the others with anti-inflammatory properties have been the novel focus of attention for the amelioration of cardiometabolic complications. This review compiles the current evidence on the roles of anti-inflammatory adipokines, namely, adiponectin, vaspin, the C1q/TNF-related protein (CTRP) family, secreted frizzled-related protein 5 (SFRP5), and omentin-1 on cardiometabolic health. Further investigations on the mechanism of action and prospective human trials may pave the way to their clinical application as innovative biomarkers and therapeutic targets for cardiovascular and metabolic disorders.
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Affiliation(s)
- Han Na Jung
- Asan Medical Center, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea;
- Asan Diabetes Center, Asan Medical Center, Seoul 05505, Korea
| | - Chang Hee Jung
- Asan Medical Center, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea;
- Asan Diabetes Center, Asan Medical Center, Seoul 05505, Korea
- Correspondence:
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16
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Luna M, Pereira S, Saboya C, Cruz S, Matos A, Ramalho A. Body Composition, Basal Metabolic Rate and Leptin in Long-Term Weight Regain After Roux-en-Y Gastric Bypass Are Similar to Pre-surgical Obesity. Obes Surg 2021; 32:302-310. [PMID: 34787767 DOI: 10.1007/s11695-021-05780-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 11/01/2021] [Accepted: 11/08/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The purpose of this study is to evaluate the relationship between body composition, basal metabolic rate (BMR), and serum concentrations of leptin with long-term weight regain after Roux-en-Y gastric bypass (RYGB) and compare it with obesity before surgery. MATERIALS AND METHODS Prospective longitudinal analytical study. Three groups were formed: individuals 60 months post RYGB, with weight regain (G1) and without it (G2), and individuals with obesity who had not undergone bariatric surgery (G3). Body fat (BF), body fat mass (BFM), visceral fat (VF), fat-free mass (FFM), skeletal muscle mass (SMM), and BMR were assessed by octapolar and multi-frequency electrical bioimpedance. Fasting serum concentrations of leptin were measured. RESULTS Seventy-two individuals were included, 24 in each group. Higher means of BF, BFM, VF, and leptin levels were observed in G1, when compared to G2 (BF: 47.5 ± 5.6 vs. 32.0 ± 8.0, p < 0.05; FBM: 47.8 ± 11.6 vs. 23.9 ± 7.0, p < 0.05; VF: 156.8 ± 30.2 vs. 96.1 ± 23.8, p < 0.05; leptin: 45,251.2 pg/mL ± 20,071.8 vs. 11,525.7 pg/mL ± 9177.5, p < 0.000). G1 and G2 did not differ in FFM, SMM, and BMR. G1 and G3 were similar according to BF, FFM, BMR, and leptin levels. Body composition, but not leptin, was correlated with %weight regain in G1 (FBM: r = 0.666, p < 0.000; BF: r = 0.428, p = 0.037; VF: r = 0.544, p = 0.006). CONCLUSION Long-term weight regain after RYGB is similar to pre-surgical obesity in body composition, BMR, and leptin concentrations, indicating relapse of metabolic and hormonal impairments associated with excessive body fat.
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Affiliation(s)
- Mariana Luna
- Postgraduate Program in Internal Medicine, Medical School, Universidade Federal Do Rio de Janeiro (UFRJ), Cidade Universitária da Universidade Federal Do Rio de Janeiro, Av. Carlos Chagas Filho, Rio de Janeiro, RJ, 37321044-020, Brazil. .,Micronutrients Research Center (NPqM), Institute of Nutrition, Universidade Federal Do Rio de Janeiro (UFRJ), Cidade Universitária da Universidade Federal Do Rio de Janeiro, Av. Carlos Chagas Filho, Rio de Janeiro, RJ, 37321941-902, Brazil.
| | - Silvia Pereira
- Micronutrients Research Center (NPqM), Institute of Nutrition, Universidade Federal Do Rio de Janeiro (UFRJ), Cidade Universitária da Universidade Federal Do Rio de Janeiro, Av. Carlos Chagas Filho, Rio de Janeiro, RJ, 37321941-902, Brazil
| | - Carlos Saboya
- Micronutrients Research Center (NPqM), Institute of Nutrition, Universidade Federal Do Rio de Janeiro (UFRJ), Cidade Universitária da Universidade Federal Do Rio de Janeiro, Av. Carlos Chagas Filho, Rio de Janeiro, RJ, 37321941-902, Brazil
| | - Sabrina Cruz
- Micronutrients Research Center (NPqM), Institute of Nutrition, Universidade Federal Do Rio de Janeiro (UFRJ), Cidade Universitária da Universidade Federal Do Rio de Janeiro, Av. Carlos Chagas Filho, Rio de Janeiro, RJ, 37321941-902, Brazil
| | - Andrea Matos
- Micronutrients Research Center (NPqM), Institute of Nutrition, Universidade Federal Do Rio de Janeiro (UFRJ), Cidade Universitária da Universidade Federal Do Rio de Janeiro, Av. Carlos Chagas Filho, Rio de Janeiro, RJ, 37321941-902, Brazil
| | - Andrea Ramalho
- Micronutrients Research Center (NPqM), Institute of Nutrition, Universidade Federal Do Rio de Janeiro (UFRJ), Cidade Universitária da Universidade Federal Do Rio de Janeiro, Av. Carlos Chagas Filho, Rio de Janeiro, RJ, 37321941-902, Brazil.,Social Applied Nutrition Department, Micronutrients Research Center (NPqM), Institute of Nutrition, Universidade Federal Do Rio de Janeiro (UFRJ), Universitária da Universidade Federal Do Rio de Janeiro, Av. Carlos Chagas Filho, 373 - Cidade, Rio de Janeiro, RJ, 21941-902, Brazil
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17
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Coleman KJ, Schlundt DG, Bonnet KR, Holmquist KJ, Dunne J, Crull E, Hanaoka BY, Lent MR, Nadglowski J, Sylvia L, Venkatachalam S, Xanthakos SA, Zeiger R, Arterburn D, Williams N, Courcoulas A, Anau J, McTigue KM, Blalock C, Malanga E, McClay J, McBride CL, Schlundt D, Emiliano A, Nemr R, McTigue K, Courcoulas A, Xanthakos SA, Michalsky M, Coleman KJ, Murali S, Tavakkoli A, Desai N, Apovian C, Clark J, Nauman E, Cirielli E, Nadglowski J, St Clair T, Tice J, Vitello J, Zeiger R, Arterburn D, Anau J, Janning C, Williams N. Understanding the Bariatric Patient Perspective in the National Patient-Centered Clinical Research Network (PCORnet) Bariatric Study. Obes Surg 2021; 30:1837-1847. [PMID: 31965490 DOI: 10.1007/s11695-020-04404-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In 2016, the Patient-Centered Outcomes Research Institute funded the National Patient Centered Clinical Research Network (PCORnet) Bariatric Study (PBS). Understanding the experience of postoperative patients was a key component of this study. METHODS Nine focus groups were conducted in Southern California, Louisiana, Pennsylvania, and Ohio and in a national advocacy conference for patients with obesity. Participants were identified and recruited in both clinical and community settings. Focus group transcripts were analyzed using an iterative inductive-deductive approach to identify global overarching themes. RESULTS There were 76 focus group participants. Participants were mostly women (81.4%), had primarily undergone gastric sleeve (47.0%), were non-Hispanic white (51.4%), had some college education (44.3%), and made $100,000 annual income or less (65.7%). Qualitative findings included negative reactions patients received from friends, family, and co-workers once they disclosed that they had bariatric surgery to lose weight; and barriers to follow-up care included insurance coverage, emotional and situational challenges, and physical pain limiting mobility. CONCLUSIONS These findings confirm the other qualitative findings in this area. The approach to bariatric surgery should be expanded to provide long-term comprehensive care that includes in-depth postoperative lifetime monitoring of emotional and physical health.
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Affiliation(s)
- Karen J Coleman
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
| | - David G Schlundt
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | | | - Kimberly J Holmquist
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | | | | | | | - Michelle R Lent
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | | | - Louisa Sylvia
- Massachusetts General Hospital, Boston, MA and Harvard Medical School, Cambridge, MA, USA
| | | | | | | | - David Arterburn
- Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA
| | | | | | - Jane Anau
- Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA
| | | | - Cynthia Blalock
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Elisha Malanga
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - James McClay
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Corrigan L McBride
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - David Schlundt
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Ana Emiliano
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Rabih Nemr
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | | | | | | | - Marc Michalsky
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Karen J Coleman
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Sameer Murali
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Ali Tavakkoli
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Nirav Desai
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Caroline Apovian
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Jeanne Clark
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Elizabeth Nauman
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Elizabeth Cirielli
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | | | - Tammy St Clair
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Julie Tice
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Joseph Vitello
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | | | - David Arterburn
- Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA
| | - Jane Anau
- Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA
| | - Cheri Janning
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
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18
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Bratti LDOS, do Carmo ÍAR, Vilela TF, Souza LC, Moraes ACRD, Filippin-Monteiro FB. Bariatric surgery improves clinical outcomes and adiposity biomarkers but not inflammatory cytokines SAA and MCP-1 after a six-month follow-up. Scand J Clin Lab Invest 2021; 81:230-236. [PMID: 33827327 DOI: 10.1080/00365513.2021.1904278] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Obesity is a global health problem and is associated with a chronic low-grade inflammatory state. Surgical obesity treatment is being increasingly common due to its efficacy. From this, we evaluate the metabolic state improvement and inflammation remission in patients with obesity undergoing bariatric surgery. Methods: The clinical data and serum levels of leptin and adiponectin were assessed in patients with obesity before and one, three and six months after bariatric surgery. Also, serum amyloid A (SAA), monocyte chemoattractant protein-1 (MCP-1) levels were measured during the follow-up surgery and compared with a lean group of individuals. Results: Weight loss decreased body mass index (BMI), comorbidities percentage, drugs use and leptin levels. Adiponectin levels increased after surgery. SAA and MCP-1 showed no difference after surgery, but a trend decrease for MCP-1 and a significant decrease was observed when the patients with obesity were compared to the lean participants. Conclusion: Bariatric surgery alters metabolic status improving obesity-related comorbidities and the adiposity biomarkers leptin and adiponectin, but not inflammatory cytokines SAA and MCP-1.
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Affiliation(s)
- Letícia de Oliveira Souza Bratti
- Programa de Pós-Gaduação em Farmácia, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
| | - Ícaro Andrade Rodrigues do Carmo
- Departamento de Análises Clínicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
| | - Taís Ferreira Vilela
- Departamento de Clínica Médica, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
| | - Liliete Canes Souza
- Departamento de Análises Clínicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
| | - Ana Carolina Rabello de Moraes
- Departamento de Análises Clínicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
| | - Fabíola Branco Filippin-Monteiro
- Departamento de Análises Clínicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
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Cabrera LO, Trindade EN, Leite C, Abegg EH, Trindade MRM. Preoperative Level of Leptin Can Be a Predictor of Glycemic Control for Patients with Diabetes Undergoing Bariatric Surgery. Obes Surg 2020; 30:4829-4833. [PMID: 32996102 DOI: 10.1007/s11695-020-05011-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Bariatric surgery is a first-line treatment for patients with obesity and diabetes. It is uncertain whether leptin has an influence on glycemia in the postoperative period. METHODS A cohort study of thirty-eight individuals with obesity and diabetes who underwent laparoscopic Roux-en-Y gastric bypass was undertaken. The levels of leptin, glucose, and glycosylated hemoglobin were verified in the preoperative period and in the first and third postoperative months. RESULTS The majority of patients were women (81.6%), and the mean age was 47.3 years (SD 8.8). The mean BMI was reduced by 17.75% (from 47.3 to 38.9 kg/m2) and the mean glycemia by 26.76%. Preoperative leptin had a moderate positive correlation with glucose level at the third month (Pearson r = 0.46, P = 0.02), but not with HbA1c. Patients with leptin above 27.34 ng/mL had a higher glucose level at the end of observation (101.9 versus 88.9, t test, P = 0.042). CONCLUSION The search for factors that influence diabetes control after bariatric surgery is of major importance in clinical practice. Our study reported a level of leptin that can predict the prognosis of glycemic control after the intervention. This finding still needs to be validated and confirmed in other populations.
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Affiliation(s)
- Luisa Ortiz Cabrera
- Post-Graduate Program on Surgery, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Eduardo Neubarth Trindade
- Post-Graduate Program on Surgery, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Department of Surgery, Moinhos de Vento Hospital, Porto Alegre, RS, Brazil
| | - Carine Leite
- Department of Gastroenterology, Moinhos de Vento Hospital, Porto Alegre, RS, Brazil.
- , Porto Alegre, Brazil.
| | | | - Manoel Roberto Maciel Trindade
- Post-Graduate Program on Surgery, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Department of Surgery, Moinhos de Vento Hospital, Porto Alegre, RS, Brazil
- School of Medicine, UFRGS, Porto Alegre, RS, Brazil
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Głuszek S, Bociek A, Suliga E, Matykiewicz J, Kołomańska M, Bryk P, Znamirowski P, Nawacki Ł, Głuszek-Osuch M, Wawrzycka I, Kozieł D. The Effect of Bariatric Surgery on Weight Loss and Metabolic Changes in Adults with Obesity. Int J Environ Res Public Health 2020; 17:ijerph17155342. [PMID: 32722225 PMCID: PMC7432000 DOI: 10.3390/ijerph17155342] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/16/2020] [Accepted: 07/21/2020] [Indexed: 12/15/2022]
Abstract
Methods of treating obesity, such as changes in lifestyle, physical activity, restrictive diets, and psychotherapy, are not sufficient. Currently, it is considered that in the case of patients who meet the eligibility criteria for surgery, the treatment of choice should be bariatric surgery. The aim of this study was to assess the weight loss and metabolic changes in a group of adults with obesity undergoing bariatric surgery. The study involved 163 patients whose body mass index (BMI) exceeded 40 or 35 kg/m2, concurrent with at least one metabolic sequelae. In 120 of the cases (74%), sleeve gastrectomy was used; in 35 (21%), gastric banding was used; and in 8 (5%), laparoscopic Roux-en-Y gastric bypass was used. Metabolic parameters such as total cholesterol, LDL-cholesterol (low-density lipoprotein cholesterol), HDL-cholesterol (high-density lipoprotein cholesterol), triglycerides, and glucose were measured preoperatively and postoperatively, as well as the creatinine, creatine kinase (CK-MB), and leptin activity. In patients undergoing bariatric surgery, a significant decrease in excess weight (p < 0.001) was observed at all the analyzed time points, compared to the pre-surgery value. Weight loss after surgery was associated with a significant improvement in glycemia (109.6 ± 48.0 vs. 86.6 ± 7.9 mg/dL >24 months after surgery; p = 0.003), triglycerides (156.9 ± 79.6 vs. 112.7 ± 44.3 mg/dL >24 months after surgery; p = 0.043) and leptin (197.50 ± 257.3 vs. 75.98 ± 117.7 pg/mL 12 months after surgery; p = 0.0116) concentration. The results of the research confirm the thesis on the effectiveness of bariatric surgery in reducing excess body weight and improving metabolic parameters in patients with extreme obesity.
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Affiliation(s)
- Stanisław Głuszek
- The Institute of Medical Sciences, Medical College, Jan Kochanowski University, 25-369 Kielce, Poland; (S.G.); (J.M.); (M.K.); (P.B.); (Ł.N.); (I.W.)
- Clinic of General, Oncological and Endocrinological Surgery, Provincial Hospital in Kielce, 25-736 Kielce, Poland;
| | - Arkadiusz Bociek
- The Institute of Medical Sciences, Medical College, Jan Kochanowski University, 25-369 Kielce, Poland; (S.G.); (J.M.); (M.K.); (P.B.); (Ł.N.); (I.W.)
- Correspondence: ; Tel.: +48-41-349-69-11
| | - Edyta Suliga
- The Institute of Health Sciences, Medical College, Jan Kochanowski University, 25-369 Kielce, Poland; (E.S.); (M.G.-O.); (D.K.)
| | - Jarosław Matykiewicz
- The Institute of Medical Sciences, Medical College, Jan Kochanowski University, 25-369 Kielce, Poland; (S.G.); (J.M.); (M.K.); (P.B.); (Ł.N.); (I.W.)
- Clinic of Oncological Surgery of the Swiętokrzyskie Center of Oncology in Kielce, 25-734 Kielce, Poland
| | - Magdalena Kołomańska
- The Institute of Medical Sciences, Medical College, Jan Kochanowski University, 25-369 Kielce, Poland; (S.G.); (J.M.); (M.K.); (P.B.); (Ł.N.); (I.W.)
- Clinic of General, Oncological and Endocrinological Surgery, Provincial Hospital in Kielce, 25-736 Kielce, Poland;
| | - Piotr Bryk
- The Institute of Medical Sciences, Medical College, Jan Kochanowski University, 25-369 Kielce, Poland; (S.G.); (J.M.); (M.K.); (P.B.); (Ł.N.); (I.W.)
- Clinic of General, Oncological and Endocrinological Surgery, Provincial Hospital in Kielce, 25-736 Kielce, Poland;
| | - Przemysław Znamirowski
- Clinic of General, Oncological and Endocrinological Surgery, Provincial Hospital in Kielce, 25-736 Kielce, Poland;
| | - Łukasz Nawacki
- The Institute of Medical Sciences, Medical College, Jan Kochanowski University, 25-369 Kielce, Poland; (S.G.); (J.M.); (M.K.); (P.B.); (Ł.N.); (I.W.)
- Clinic of General, Oncological and Endocrinological Surgery, Provincial Hospital in Kielce, 25-736 Kielce, Poland;
| | - Martyna Głuszek-Osuch
- The Institute of Health Sciences, Medical College, Jan Kochanowski University, 25-369 Kielce, Poland; (E.S.); (M.G.-O.); (D.K.)
| | - Iwona Wawrzycka
- The Institute of Medical Sciences, Medical College, Jan Kochanowski University, 25-369 Kielce, Poland; (S.G.); (J.M.); (M.K.); (P.B.); (Ł.N.); (I.W.)
- Clinic of General, Oncological and Endocrinological Surgery, Provincial Hospital in Kielce, 25-736 Kielce, Poland;
| | - Dorota Kozieł
- The Institute of Health Sciences, Medical College, Jan Kochanowski University, 25-369 Kielce, Poland; (E.S.); (M.G.-O.); (D.K.)
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Faramia J, Ostinelli G, Drolet-Labelle V, Picard F, Tchernof A. Metabolic adaptations after bariatric surgery: adipokines, myokines and hepatokines. Curr Opin Pharmacol 2020; 52:67-74. [PMID: 32688292 DOI: 10.1016/j.coph.2020.06.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/13/2020] [Accepted: 06/15/2020] [Indexed: 12/23/2022]
Abstract
This review addresses the impact of bariatric surgery on the endocrine aspects of white adipose tissue, muscle and the liver. We describe literature supporting the notion that adipokines, myokines and hepatokines likely act in concert and drive many of the long-term metabolic improvements following surgery. Circulating adiponectin is increased while secretion of pro-inflammatory interleukins (1, 6 and 8) decreases, alongside leptin secretion. The metabolic improvements observed in the muscle might relate to reduction of myokines contributing to insulin resistance (including myostatin, brain-derived neurotrophic factor and fibroblast growth factor-21). Subject to exception, hepatokine secretion is generally increased (such as insulin-like growth factor-binding protein 2, adropin and sex hormone-binding globulin). In conclusion, bariatric surgery restores metabolic functions by enhancing the time-dependent secretion of anti-inflammatory, insulin-sensitizing and antilipemic factors. Further research is needed to understand the molecular mechanisms by which these factors may trigger the remission of obesity-related comorbidities following bariatric surgery.
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Seyyedi J, Alizadeh S. Effect of Surgically Induced Weight Loss on Biomarkers of Endothelial Dysfunction: a Systematic Review and Meta-Analysis. Obes Surg 2020; 30:3549-60. [DOI: 10.1007/s11695-020-04710-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Abstract
Neurological complications such as peripheral neuropathies are the most common complications among patients with morbid obesity following bariatric surgery. Reduction in nutrient intake especially thiamin may develop polyneuropathy, while neuropathic symptoms improved in patients with diabetes independent of glycemic control after bariatric surgery. The aim of the present review is to investigate the effect of bariatric surgery on peripheral neuropathy. Electronic literature search was done via scientific search engines. After the removal of duplicates and selection of articles of interest, 4 studies were included. A random effects model was applied in this meta-analysis. Considering the pooled analysis, bariatric surgery was significantly associated with Neuropathy Symptoms Score (NSS) (ES = - 3.393, 95% CI (- 4.507, - 2.278), and P value < 0.0001). Reduction in NSS for patients with type 2 diabetes and BMI < 35 kg/m2 who were insulin-dependent was more than patients with morbid obesity without diabetes. Furthermore, neuropathy disability score (NDS) significantly decreased in patients having bariatric surgery (ES = - 0.626, 95% CI (- 1.120, - 0.132), and P value < 0.013). The NDS significantly decreased in patients with type 2 diabetes and BMI < 35 kg/m2 treated with insulin as well as patients with morbid obesity and type 2 diabetes. In subgroup of patients with follow-up of more than 6 months after surgery, a significant reduction in NDS was detected while this reduction was not significant in patients with a follow-up of 6 months or less. Bariatric surgery had a positive effect on peripheral neuropathy, though many studies showed neuropathy as one of the complications of bariatric surgery.
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Affiliation(s)
- Rokhsareh Aghili
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Malek
- Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology & Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Kiarash Tanha
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Azadeh Mottaghi
- Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology & Metabolism, Iran University of Medical Sciences, Tehran, Iran.
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Farias G, Netto BDM, Boritza K, Bettini SC, Vilela RM, Dâmaso AR. Impact of Weight Loss on Inflammation State and Endothelial Markers Among Individuals with Extreme Obesity After Gastric Bypass Surgery: a 2-Year Follow-up Study. Obes Surg 2020; 30:1881-90. [DOI: 10.1007/s11695-020-04411-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Sanches E, Timmermans M, Topal B, Celik A, Sundbom M, Ribeiro R, Parmar C, Ugale S, Proczko M, Stepaniak PS, Pujol Rafols J, Mahawar K, Buise MP, Neimark A, Severin R, Pouwels S. Cardiac remodeling in obesity and after bariatric and metabolic surgery; is there a role for gastro-intestinal hormones? Expert Rev Cardiovasc Ther 2019; 17:771-790. [PMID: 31746657 DOI: 10.1080/14779072.2019.1690991] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction: Obesity is associated with various diseases such as type 2 diabetes, hypertension, obstructive sleep apnea syndrome (OSAS), metabolic syndrome, and cardiovascular diseases. It affects several organ systems, including the pulmonary and cardiac systems. Furthermore, it induces pulmonary and cardiac changes that can result in right and/or left heart failure.Areas covered: In this review, authors provide an overview of obesity and cardiovascular remodeling, the individual actions of the gut hormones (like GLP-1 and PYY), the effects after bariatric/metabolic surgery and its influence on cardiac remodeling. In this review, we focussed and searched for literature in Pubmed and The Cochrane library (from the earliest date until April 2019), regarding cardiac function changes before and after bariatric surgery and literature regarding changes in gastrointestinal hormones.Expert opinion: Regarding the surgical treatment of obesity and metabolic diseases there is recognition of the importance of both weight loss (bariatric surgery) and improvement in metabolic milieu (metabolic surgery). A growing body of evidence further suggests that bariatric surgical procedures [like the Sleeve Gastrectomy (SG), Roux-en Y Gastric Bypass (RYGB), or One Anastomosis Gastric Bypass (OAGB)] have can improve outcomes of patients suffering from a number of cardiovascular diseases, including heart failure.
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Affiliation(s)
- Elijah Sanches
- Department of Surgery, Haaglanden Medical Center, The Hague, The Netherlands
| | - Marieke Timmermans
- Department of Surgery, Haaglanden Medical Center, The Hague, The Netherlands
| | - Besir Topal
- Department of Cardiothoracic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Alper Celik
- Department of Bariatric and Metabolic Surgery, Metabolic Surgery Clinic, Sisli, Turkey
| | - Magnus Sundbom
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Rui Ribeiro
- Centro Multidisciplinar da Doença Metabólica, Clínica de Santo António, Lisbon, Portugal
| | - Chetan Parmar
- Department of Surgery, Whittington Hospital, London, UK
| | - Surendra Ugale
- Bariatric & Metabolic Surgery Clinic, Kirloskar Hospital, Hyderabad, India
| | - Monika Proczko
- Department of General, Endocrine and Transplant Surgery, University Medical Center, Gdansk University, Gdansk, Poland
| | - Pieter S Stepaniak
- Department of Operating Rooms, Catharina Hospital, Eindhoven, The Netherlands
| | | | - Kamal Mahawar
- Bariatric Unit, Sunderland Royal Hospital, Sunderland, UK
| | - Marc P Buise
- Department of Anesthesiology, Intensive Care and Pain Medicine, Catharina Hospital, Eindhoven, The Netherlands
| | - Aleksandr Neimark
- Department of Surgery, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Rich Severin
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA.,Doctor of Physical Therapy Program, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Sjaak Pouwels
- Department of Surgery, Haaglanden Medical Center, The Hague, The Netherlands
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Barrichello S, Hourneaux de Moura DT, Hourneaux de Moura EG, Jirapinyo P, Hoff AC, Fittipaldi-Fernandez RJ, Baretta G, Felício Lima JH, Usuy EN, de Almeida LS, Ramos FM, Matz F, Galvão Neto MDP, Thompson CC. Endoscopic sleeve gastroplasty in the management of overweight and obesity: an international multicenter study. Gastrointest Endosc 2019; 90:770-780. [PMID: 31228432 DOI: 10.1016/j.gie.2019.06.013] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 06/07/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Obesity is a pandemic affecting approximately 700 million adults worldwide, with an additional 2 billion overweight. Endoscopic sleeve gastroplasty (ESG) is a minimally invasive endoscopic bariatric therapy that involves remodeling of the greater curvature in an effort to reduce gastric capacity and delay gastric emptying. A variety of ESG suture patterns has been reported. This study is the first to use a uniform "U" stitch pattern across all centers to simplify technical aspects of the procedure and limit cost. This also uniquely assessed outcomes in all body mass index (BMI) categories and changes in metabolic rate, lean body mass, and adipose tissue composition. METHODS This is a multicenter analysis of prospectively collected data from 7 centers including patients with overweight and obesity who underwent ESG. Primary outcomes included absolute weight loss, percent total body weight loss (%TWL), change in BMI, and percent excess weight loss (%EWL) at 6 and 12 months in overweight and obese classes I, II, and III. Secondary outcomes included adipose tissue, lean body mass reduction, and metabolic rate analyzed by bioimpedance. Additionally, immediate or delayed adverse events (AEs) were analyzed. Clinical success was defined as achieving ≥25% EWL at 1 year with ≤5% serious AE (SAE) rate following the American Society for Gastrointestinal Endoscopy (ASGE)/American Society for Metabolic and Bariatric Surgery (ASMBS) threshold. RESULTS A total of 193 patients underwent ESG during the study period. All groups had >10% TWL and >25% EWL at 6 months of follow-up. On average, %TWL was 14.25% ± 5.26% and 15.06% ± 5.22% and the %EWL 56.15% ± 22.93% and 59.41% ± 25.69% at 6 months and 1 year of follow-up, respectively. %TWL was 8.91% ± .3%, 13.92% ± 5.76%, 16.22% ± 7.69%, and 19.01% ± .95% and %EWL 56.21% ± 2.0%, 62.03% ± 27.63%, 54.13% ± 23.46%, and 46.78% ± 2.43% for overweight and obesity classes I, II, and III, respectively, at 1 year. Male sex, age <41 years, and higher BMI were predictors of achieving a TWL ≥10% at 1-year follow-up. There was a significant reduction in adipose tissue from baseline. SAEs occurred in 1.03%, including 2 perigastric collections needing surgery. CONCLUSIONS ESG appears to be feasible, safe, and effective in the treatment of patients with overweight and obesity according to ASGE/ASMBS thresholds.
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Affiliation(s)
| | - Diogo Turiani Hourneaux de Moura
- Endoscopy Unit, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil; Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Pichamol Jirapinyo
- Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | | | | | - Eduardo N Usuy
- Healthme gerenciamento de perda de peso, Sao Paulo, Brazil
| | | | | | - Felipe Matz
- Endodiagnostic Clinic, Rio de Janeiro, Brazil
| | | | - Christopher C Thompson
- Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Concon MM, Jimenez LS, Callejas GH, Chaim EA, Cazzo E. Influence of post-Roux-en-Y gastric bypass weight recidivism on insulin resistance: a 3-year follow-up. Surg Obes Relat Dis 2019; 15:1912-1916. [PMID: 31631000 DOI: 10.1016/j.soard.2019.08.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 08/18/2019] [Accepted: 08/20/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although some early metabolic benefits provided by bariatric surgery are known to occur regardless of weight loss, the impact of mid- to long-term weight recidivism after Roux-en-Y gastric bypass (RYGB) on metabolic outcomes is not profoundly understood. OBJECTIVE To investigate the effect of weight recidivism on insulin resistance among nondiabetic individuals with morbid obesity after RYGB during a 3-year follow-up. SETTING Public tertiary university hospital. METHODS This is a cohort study based on a prospectively collected database of a public tertiary university hospital, which enrolled individuals with morbid obesity who underwent RYGB and were followed-up for 3 years. Weight loss was classified into the following 3 categories: (1) no weight regain; (2) expected regain (regain ≤20% of the maximum weight loss); and (3) obesity recidivism (regain >20% of the maximum weight loss). Homeostasis model assessment (HOMA) values were compared over time. RESULTS Of 100 patients, 20% presented obesity recidivism and 52% an expected regain after 3 years of surgery; 28% showed no regain. The recidivism group presented a significant increase in HOMA 3 years after surgery (P = .02). The recidivism group presented a significantly higher HOMA 3 years after surgery than the observed in the other groups (P < .001), as well as a significantly higher percentage of HOMA variation throughout the follow-up (P = .02). CONCLUSION Weight recidivism after RYGB was significantly associated with a worsening of insulin resistance among nondiabetic individuals with morbid obesity. Thus, weight loss seems to play a significant role in the maintenance of the early metabolic improvement achieved after RYGB.
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Affiliation(s)
- Matheus Mathedi Concon
- Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas-SP, Brazil
| | - Laísa Simakawa Jimenez
- Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas-SP, Brazil
| | - Guilherme Hoverter Callejas
- Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas-SP, Brazil
| | - Elinton Adami Chaim
- Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas-SP, Brazil
| | - Everton Cazzo
- Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas-SP, Brazil.
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Sun W, Zhang Y, Shen Q, Zhang W, Yao Q, Yang Y. Prevalence and risk factors for symptoms suggestive of hypoglycemia and early dumping syndrome after sleeve gastrectomy. Surg Obes Relat Dis 2019; 15:1439-1446. [DOI: 10.1016/j.soard.2019.06.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 05/25/2019] [Accepted: 06/12/2019] [Indexed: 02/06/2023]
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Abstract
PURPOSE OF REVIEW Individuals with morbid obesity benefit from bariatric surgery with respect to weight loss and decreases in obesity-related somatic disorders. This paper focuses on psychosocial outcomes and provides a narrative review of recent meta-analyses and controlled studies concerning postoperative depression and suicide. RECENT FINDINGS Considerable evidence shows short- and medium-term improvement in depressive symptoms after surgery. However, a subgroup of patients exhibits erosion of these improvements or new onset of depression in the long run. Some studies have found an increased risk for suicide among postoperative patients. Prospective longitudinal examinations of factors contributing to the increased risk for postoperative depression and suicide and the interaction between these factors are warranted. The inclusion of mental health professionals in bariatric teams would help to monitor patients for negative psychosocial outcomes and to identify those patients who are vulnerable to depression, suicide, and any other forms of deliberated self-harm following surgery.
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de Moura DTH, de Moura EGH, Thompson CC. Endoscopic sleeve gastroplasty: From whence we came and where we are going. World J Gastrointest Endosc 2019; 11:322-328. [PMID: 31205593 PMCID: PMC6556490 DOI: 10.4253/wjge.v11.i5.322] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 04/16/2019] [Accepted: 04/19/2019] [Indexed: 02/06/2023] Open
Abstract
The most effective and durable treatment for obesity is bariatric surgery. However, less than 2% of eligible patients who fulfill the criteria for bariatric surgery undergo the procedure. As a result, there is a drive to develop less invasive therapies to combat obesity. Endoscopic bariatric therapies (EBT) for weight loss are important since they are more effective than pharmacological treatments and lifestyle changes and present lower adverse event rates compared to bariatric surgery. Endoscopic sleeve gastroplasty (ESG) is a minimally invasive EBT that involves remodeling of the greater curvature. ESG demonstrated favorable outcomes in several centers, with up to 20.9% total body weight loss and 60.4% excess weight loss (EWL) on 2-year follow-up, with a low rate of severe adverse events (SAE). As such, it could be considered safe and effective in light of ASGE/ASMBS thresholds of > 25% EWL and ≤ 5% SAE, although there are no comparative trials to support this. Additionally, ESG showed improvement in diabetes mellitus type 2, hypertension, and other obesity-related comorbidities. As this procedure continues to develop there are several areas that can be addressed to improve outcomes, including device improvements, technique standardization, patient selection, personalized medicine, combination therapies, and training standardization. In this editorial we discuss the origins of the ESG, current data, and future developments.
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Affiliation(s)
- Diogo Turiani Hourneaux de Moura
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, United States
- Department of Endoscopy of Clinics Hospital of São Paulo University, São Paulo 05403-00, Brazil
| | | | - Christopher C Thompson
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, United States
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Yanai H, Yoshida H. Beneficial Effects of Adiponectin on Glucose and Lipid Metabolism and Atherosclerotic Progression: Mechanisms and Perspectives. Int J Mol Sci 2019; 20:E1190. [PMID: 30857216 DOI: 10.3390/ijms20051190] [Citation(s) in RCA: 242] [Impact Index Per Article: 48.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 03/01/2019] [Accepted: 03/05/2019] [Indexed: 12/14/2022] Open
Abstract
Circulating adiponectin concentrations are reduced in obese individuals, and this reduction has been proposed to have a crucial role in the pathogenesis of atherosclerosis and cardiovascular diseases associated with obesity and the metabolic syndrome. We focus on the effects of adiponectin on glucose and lipid metabolism and on the molecular anti-atherosclerotic properties of adiponectin and also discuss the factors that increase the circulating levels of adiponectin. Adiponectin reduces inflammatory cytokines and oxidative stress, which leads to an improvement of insulin resistance. Adiponectin-induced improvement of insulin resistance and adiponectin itself reduce hepatic glucose production and increase the utilization of glucose and fatty acids by skeletal muscles, lowering blood glucose levels. Adiponectin has also β cell protective effects and may prevent the development of diabetes. Adiponectin concentration has been found to be correlated with lipoprotein metabolism; especially, it is associated with the metabolism of high-density lipoprotein (HDL) and triglyceride (TG). Adiponectin appears to increase HDL and decrease TG. Adiponectin increases ATP-binding cassette transporter A1 and lipoprotein lipase (LPL) and decreases hepatic lipase, which may elevate HDL. Increased LPL mass/activity and very low density lipoprotein (VLDL) receptor and reduced apo-CIII may increase VLDL catabolism and result in the reduction of serum TG. Further, adiponectin has various molecular anti-atherosclerotic properties, such as reduction of scavenger receptors in macrophages and increase of cholesterol efflux. These findings suggest that high levels of circulating adiponectin can protect against atherosclerosis. Weight loss, exercise, nutritional factors, anti-diabetic drugs, lipid-lowering drugs, and anti-hypertensive drugs have been associated with an increase of serum adiponectin level.
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Malek M, Yousefi R, Safari S, Seyyedi SHS, Mottaghi A. Dietary Intakes and Biochemical Parameters of Morbidly Obese Patients Prior to Bariatric Surgery. Obes Surg 2019; 29:1816-1822. [DOI: 10.1007/s11695-019-03759-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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