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Mehri K, Hamidian G, Zavvari Oskuye Z, Nayebirad S, Farajdokht F. The role of apelinergic system in metabolism and reproductive system in normal and pathological conditions: an overview. Front Endocrinol (Lausanne) 2023; 14:1193150. [PMID: 37424869 PMCID: PMC10324965 DOI: 10.3389/fendo.2023.1193150] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/06/2023] [Indexed: 07/11/2023] Open
Abstract
Lifestyle changes have made metabolic disorders as one of the major threats to life. Growing evidence demonstrates that obesity and diabetes disrupt the reproductive system by affecting the gonads and the hypothalamus-pituitary-gonadal (HPG) axis. Apelin, an adipocytokine, and its receptor (APJ) are broadly expressed in the hypothalamus nuclei, such as paraventricular and supraoptic, where gonadotropin-releasing hormone (GnRH) is released, and all three lobes of the pituitary, indicating that apelin is involved in the control of reproductive function. Moreover, apelin affects food intake, insulin sensitivity, fluid homeostasis, and glucose and lipid metabolisms. This review outlined the physiological effects of the apelinergic system, the relationship between apelin and metabolic disorders such as diabetes and obesity, as well as the effect of apelin on the reproductive system in both gender. The apelin-APJ system can be considered a potential therapeutic target in the management of obesity-associated metabolic dysfunction and reproductive disorders.
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Affiliation(s)
- Keyvan Mehri
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Gholamreza Hamidian
- Department of Basic Sciences, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
| | | | - Sepehr Nayebirad
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereshteh Farajdokht
- Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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2
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Fielder S, Nickkho-Amiry M, Seif MW. Obesity and menstrual disorders. Best Pract Res Clin Obstet Gynaecol 2023; 89:102343. [PMID: 37279629 DOI: 10.1016/j.bpobgyn.2023.102343] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/13/2023] [Accepted: 04/19/2023] [Indexed: 06/08/2023]
Abstract
Obesity is a growing public health concern and is associated with a range of menstrual disorders, including heavy menstrual bleeding, oligomenorrhea, dysmenorrhea, and endometrial pathology. Investigations may be more logistically challenging in those in the population with obesity, and because of the heightened risk of endometrial malignancy, there should be a low threshold for biopsy to exclude endometrial hyperplasia. Although treatment modalities for women with obesity are broadly similar to those with a normal BMI, additional consideration must be given to the risks associated with estrogen in obesity. Outpatient management of heavy menstrual bleeding is a developing field and outpatient treatment modalities are preferable in the population with obesity to avoid the morbidity associated with anesthetics.
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Affiliation(s)
- Stella Fielder
- Gynaecological Division, St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
| | | | - Mourad W Seif
- Gynaecological Division, St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
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3
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Medenica S, Spoltore ME, Ormazabal P, Marina LV, Sojat AS, Faggiano A, Gnessi L, Mazzilli R, Watanabe M. Female infertility in the era of obesity: The clash of two pandemics or inevitable consequence? Clin Endocrinol (Oxf) 2023; 98:141-152. [PMID: 35644933 PMCID: PMC10084349 DOI: 10.1111/cen.14785] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/07/2022] [Accepted: 05/25/2022] [Indexed: 01/04/2023]
Abstract
Obesity is an epidemic that has led to a rise in the incidence of many comorbidities: among others, reduced fertility is often under-evaluated in clinical practice. The mechanisms underlying the link between reduced fertility and obesity are numerous, with insulin resistance, hyperglycaemia and the frequent coexistence of polycystic ovary syndrome being the most acknowledged. However, several other factors concur, such as gut microbiome alterations, low-grade chronic inflammation and oxidative stress. Not only do women with obesity take longer to conceive, but in vitro fertilization (IVF) is also less likely to succeed. We herein provide an updated state-of-the-art regarding the molecular bases of what we could define as dysmetabolic infertility, focusing on the clinical aspects, as well as possible treatment.
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Affiliation(s)
- Sanja Medenica
- Department of Internal Medicine, Endocrinology Section, Clinical Center of Montenegro, Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
| | - Maria Elena Spoltore
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - Paulina Ormazabal
- Institute of Health Sciences, Universidad de O'Higgins, Rancagua, Chile
- Laboratory of Obesity and Metabolism in Geriatrics and Adults (OMEGA), Institute of Nutrition and Food Technology (INTA), Universidad de Chile, Macul, Santiago, Chile
| | - Ljiljana V Marina
- Department for Obesity, Metabolic and Reproductive Disorders, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Antoan Stefan Sojat
- Department for Obesity, Metabolic and Reproductive Disorders, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, Belgrade, Serbia
| | - Antongiulio Faggiano
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, AOU Sant'Andrea, Rome, Italy
| | - Lucio Gnessi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - Rossella Mazzilli
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, AOU Sant'Andrea, Rome, Italy
| | - Mikiko Watanabe
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
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Liu F, Li Y, Ye Z, Jiang X, Liu R, Li Z, Ma C. The predictive value of preoperative luteinizing hormone to follicle stimulating hormone ratio for ovulation abnormalities recovery after laparoscopic sleeve gastrectomy: A prospective cohort study. Front Endocrinol (Lausanne) 2023; 13:1043173. [PMID: 36686491 PMCID: PMC9849597 DOI: 10.3389/fendo.2022.1043173] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/16/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction Obesity-related ovulation abnormalities (OA) affect fertility. LSG is the most frequent bariatric operation. However, no research has identified a reliable indicator for predicting OA recovery after LSG. The purpose of this research was to examine the prognostic usefulness of preoperative the luteinizing hormone (LH) to follicle-stimulating hormone (FSH) ratio (LFR). Methods Our department conducted a prospective study from 2016 to 2021. Venous blood was typically tested 3 days before surgery to get the preoperative LFR. Descriptive data, preoperative and postoperative variables were also collected. Binary logistic regression related preoperative LFR with OA recovery. The receiver operating characteristic (ROC) curve evulated preoperative LFR's predictive capability. Results A total of 157 women with a complete follow-up of one year were included. LFR was the only factor linked with OA (P < 0.001). AUC (area under the ROC curve) = 0.915, cutoff = 1.782, sensitivity = 0.93, and specificity = 0.82. Discussion Overall, LSG has a favorable surgical result, with a %TWL of 66.082 ± 12.012 at 12 months postoperatively. Preoperative sexual hormone levels, as expressed by LFR, has the potential to predict the fate of OA following LSG at one year post-operatively.
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Affiliation(s)
- Fashun Liu
- Department of General Surgery, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yue Li
- Department of General Surgery, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zhenxiong Ye
- Department of General Surgery, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaohua Jiang
- Department of General Surgery, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ruichen Liu
- Binhai College, Nankai University, Tianjin, China
| | - Zhen Li
- Department of General Surgery, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chiye Ma
- Department of General Surgery, East Hospital, Tongji University School of Medicine, Shanghai, China
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Beiglböck H, Mörth E, Reichardt B, Stamm T, Itariu B, Harreiter J, Eichelter J, Prager G, Kautzky-Willer A, Wolf P, Krebs M. The Timing of Pregnancies After Bariatric Surgery has No Impact on Children's Health-a Nationwide Population-based Registry Analysis. Obes Surg 2023; 33:149-155. [PMID: 36344726 PMCID: PMC9834372 DOI: 10.1007/s11695-022-06346-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 10/16/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE Bariatric surgery has a favorable effect on fertility in women. However, due to a lack of data regarding children's outcomes, the ideal time for conception following bariatric surgery is unknown. Current guidelines advise avoiding pregnancy during the initial weight loss phase (12-24 months after surgery) as there may be potential risks to offspring. Thus, we aimed to analyze health outcomes in children born to mothers who had undergone bariatric surgery. The surgery-to-delivery interval was studied. MATERIALS AND METHODS A nationwide registry belonging to the Austrian health insurance funds and containing health-related data claims was searched. Data for all women who had bariatric surgery in Austria between 01/2010 and 12/2018 were analyzed. A total of 1057 women gave birth to 1369 children. The offspring's data were analyzed for medical health claims based on International Classification of Diseases (ICD) codes and number of days hospitalized. Three different surgery-to-delivery intervals were assessed: 12, 18, and 24 months. RESULTS Overall, 421 deliveries (31%) were observed in the first 2 years after surgery. Of these, 70 births (5%) occurred within 12 months after surgery. The median time from surgery to delivery was 34 months. Overall, there were no differences noted in frequency of hospitalization and diagnoses leading to hospitalization in the first year of life, regardless of the surgery-to-delivery interval. CONCLUSION Pregnancies in the first 24 months after bariatric surgery were common. Importantly, the surgery-to-delivery interval had no significant impact on the health outcome of the children.
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Affiliation(s)
- Hannes Beiglböck
- grid.22937.3d0000 0000 9259 8492Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Eric Mörth
- grid.7914.b0000 0004 1936 7443Department of Informatics, University of Bergen, 5008 Bergen, Norway ,grid.412008.f0000 0000 9753 1393Mohn Medical Imaging and Visualization Centre, Haukeland University Hospital, 5021 Bergen, Norway
| | | | - Tanja Stamm
- grid.22937.3d0000 0000 9259 8492Center for Medical Statistics, Informatics and Intelligent Systems, Institute for Outcomes Research, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria ,grid.491977.5Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Bianca Itariu
- grid.22937.3d0000 0000 9259 8492Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Jürgen Harreiter
- grid.22937.3d0000 0000 9259 8492Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Jakob Eichelter
- grid.22937.3d0000 0000 9259 8492Department of General Surgery, Division of Visceral Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Gerhard Prager
- grid.22937.3d0000 0000 9259 8492Department of General Surgery, Division of Visceral Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Alexandra Kautzky-Willer
- grid.22937.3d0000 0000 9259 8492Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Peter Wolf
- grid.22937.3d0000 0000 9259 8492Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Michael Krebs
- grid.22937.3d0000 0000 9259 8492Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
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6
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Yu Y, Ma Q, Groth SW. Risk factors for preterm birth in pregnancies following bariatric surgery: an analysis of the Longitudinal Assessment of Bariatric Surgery-2. Surg Obes Relat Dis 2022; 18:1304-1312. [PMID: 35995663 PMCID: PMC9617754 DOI: 10.1016/j.soard.2022.07.013] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 06/15/2022] [Accepted: 07/20/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Bariatric surgery has been shown to increase the risk for preterm birth in a subsequent pregnancy. Determining factors that contribute to this heightened risk will inform the development of targeted interventions to improve birth outcomes postbariatric surgery. OBJECTIVES This study aimed to identify risk factors of preterm birth in pregnancies following bariatric surgery. Factors being considered were preoperative medical conditions and behaviors (e.g., obesity-associated co-morbidities, gastrointestinal symptoms, substance use), antenatal factors (e.g., prepregnancy body mass index, gestational weight gain), and surgery-specific factors (e.g., surgery type, surgery-to-conception interval). SETTING Bariatric surgery centers in the United States. METHODS This is a retrospective analysis of the Longitudinal Assessment of Bariatric Surgery-2. Participants were women who reported at least 1 singleton live birth during the 7-year postoperative period. Logistic regressions were used to identify risk factors of preterm birth, adjusting for covariates such as maternal age, race, and ethnicity. RESULTS Participants (n = 97) were mostly White (84.5%) and non-Hispanic (88.7%). At the time of surgery, the mean age was 29.4 ± 4.6 years, and the mean body mass index was 47.6 ± 6.3 kg/m2. The prevalence of preterm birth was 13.4%. Preoperative gastrointestinal symptoms significantly increased (odds ratio: 1.12; 95% confidence interval: 1.00-1.26), while unexpectedly, excessive versus adequate gestational weight gain (odds ratio: .12; 95% confidence interval: .02-1.00) decreased the odds of preterm birth following bariatric surgery. CONCLUSIONS This analysis identified potential risk and protective factors of preterm birth among pregnancies postbariatric surgery. However, given the small sample size, findings should be regarded as hypothesis-generating and merit further study.
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Affiliation(s)
- Yang Yu
- School of Nursing, University of Rochester, Rochester, New York.
| | - Qianheng Ma
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Susan W Groth
- School of Nursing, University of Rochester, Rochester, New York
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8
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Al-yasiry R, Jwad M, Hasan M, Alsayigh H. How obesity affects female fertility. Med J Babylon 2022. [DOI: 10.4103/mjbl.mjbl_8_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
The presence of obesity may significantly influence female fertility through various mechanisms. Impairment of the hypothalamic-pituitary-ovarian axis in obese women may induce anovulation and infertility. Obesity may have an effect on women’s spontaneous and assisted conception rates, increased miscarriage rates, premature labor, stillbirth and perinatal risks, and menstrual irregularity. It has been suggested that weight loss improves reproductive outcomes due to fertility amelioration and an improvement in menstrual irregularity and ovulation. It is still not known which weight reduction procedures (changes in lifestyle, pharmacological management or bariatric intervention) result in optimal outcome on infertility. Currently, bariatric surgery is defined as the best available method for the management of obesity and its associated diseases. We have analyzed literature facts about effects of bariatric surgery on the function of the hypothalamic-pituitary-ovarian axis, polycystic ovary syndrome (PCOS), anti-Mullerian hormone (AMH) and sexual dysfunction in obesity and pregnancy in obesity. Immediate positive effects of bariatric surgery are evident at the moment, while for long-term outcomes more prolonged follow-up investigations should be done.
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10
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Casals G, Andreu A, Barral Y, Ventosa S, Redondo M, Torres F, Ibarzábal A, Manau D, Carmona F, Vidal J, Flores L. Bariatric Surgery on Reproductive Outcomes: the Impact According to the Diagnosis of Polycystic Ovarian Syndrome and Surgical Procedures. Obes Surg 2021; 31:2590-8. [PMID: 33629226 DOI: 10.1007/s11695-021-05297-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 02/10/2021] [Accepted: 02/10/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND There is limited evidence on the impact of bariatric surgery (BS) on reproductive outcomes in the general population and specifically in patients with polycystic ovarian syndrome (PCOS) or the effect of different BS techniques. PURPOSE The study aims to investigate the impact of BS on fertility, pregnancy, and newborn outcomes in reproductive age women who have undergone BS and the outcomes according to surgical procedure and PCOS diagnosis. MATERIALS AND METHODS This was a retrospective, descriptive, cross-sectional study performed in women from 18-39 years undergoing BS in our centre from January 2005 to December 2010. We performed a telephone interview including a structured reproductive health survey on fertility, pregnancy, and offspring outcomes before and after BS. RESULTS Of the women, 872 underwent BS during the study period, 298 were 18-39 years old, and reproductive data was obtained from 217. Women with regular menstrual cycles increased from 52.9% before BS to 72.9% 1 year after surgery. The percentage of patients with a time-to-pregnancy longer than 12 months was higher after laparoscopic sleeve gastrectomy (LSG) (17.8%) compared to laparoscopic Roux-en-Y gastric bypass (7.1%; p = 0.02). Menstrual regularity was less frequent in PCOS (n = 43) (26.0%) compared to non-PCOS women before BS (60.1%; p = 0.01), with no differences after surgery. Several perinatal results showed an improvement after BS, with a reduction in macrosomia rate and birth weight. CONCLUSION BS was associated with an improvement in several reproductive outcomes. Menstrual regularity was especially improved in PCOS women. Further research may clarify the impact of LSG on fertility.
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11
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Maric T, Kanu C, Mandalia S, Johnson MR, Savvidou MD. Fetal fractional limb volumes in pregnancies following bariatric surgery. Acta Obstet Gynecol Scand 2020; 100:272-278. [PMID: 32880891 DOI: 10.1111/aogs.13988] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 04/27/2020] [Revised: 07/12/2020] [Accepted: 08/13/2020] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Obesity rates have reached an epidemic level and bariatric surgery is the most effective method of sustainable weight loss. Pregnancy following bariatric surgery is associated with an increased prevalence of small babies. The objective of the study is to compare the fetal fat distribution, as assessed by fractional arm and thigh volume using three-dimensional ultrasonography, in pregnancies following maternal bariatric surgery with those without such history. MATERIAL AND METHODS This is a prospective, longitudinal, observational study conducted in a Maternity Unit in the UK. The study included 189 pregnant women; 63 with previous bariatric surgery [27 restrictive (13 with gastric band, 14 with sleeve gastrectomy) and 36 malabsorptive procedures] and 126 with no previous surgery but similar maternal booking body mass index. Fetal arm and thigh volume were obtained at 30-33 and 35-37 weeks' gestation and fractional limb volumes were calculated using a commercially available software. Women underwent a 75 g, 2 h oral glucose tolerance test at 28-31 weeks of gestation. RESULTS Overall, adjusted fetal arm and thigh volume were smaller in the post-bariatric, compared to the no surgery, group and this was more marked in women who had undergone a previous sleeve gastrectomy (P < .001 and P = .002, respectively) or a malabsorptive procedure (P < .001 for both). There was a strong positive correlation between maternal fasting/post-prandial (2 h) glucose levels, at the time of the oral glucose tolerance test, and arm and thigh volume at both 30-33 and 35-37 weeks (P < .01 for all). CONCLUSIONS The study has demonstrated that in the third trimester of pregnancy, fetuses of women with previous bariatric surgery have smaller fractional limb volumes, therefore less soft tissue, compared to fetuses of women without such surgery and this may be related to the lower maternal glucose levels seen in the former pregnancies.
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Affiliation(s)
- Tanya Maric
- Fetal Medicine Unit, Chelsea and Westminster Hospital, London, UK.,Academic Department of Obstetrics & Gynecology, Institute of Reproductive Developmental Biology, Department of Metabolism, Digestion & Reproduction, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, UK
| | - Chidimma Kanu
- Academic Department of Obstetrics & Gynecology, Institute of Reproductive Developmental Biology, Department of Metabolism, Digestion & Reproduction, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, UK
| | - Sundhiya Mandalia
- Research and Development, Chelsea and Westminster Hospital, London, UK
| | - Mark R Johnson
- Academic Department of Obstetrics & Gynecology, Institute of Reproductive Developmental Biology, Department of Metabolism, Digestion & Reproduction, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, UK
| | - Makrina D Savvidou
- Fetal Medicine Unit, Chelsea and Westminster Hospital, London, UK.,Academic Department of Obstetrics & Gynecology, Institute of Reproductive Developmental Biology, Department of Metabolism, Digestion & Reproduction, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, UK
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12
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Amiri M, Ramezani Tehrani F. Potential Adverse Effects of Female and Male Obesity on Fertility: A Narrative Review. Int J Endocrinol Metab 2020; 18:e101776. [PMID: 33257906 PMCID: PMC7695350 DOI: 10.5812/ijem.101776] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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: 02/12/2020] [Revised: 09/15/2020] [Accepted: 09/19/2020] [Indexed: 12/16/2022] Open
Abstract
CONTEXT Despite several studies documenting that obesity affects female and male fertility and leads to multiple adverse reproductive outcomes, the mechanisms involved are not elucidated. We aimed to summarize the potential adverse effects of female and male obesity, as well as the impact of weight loss on their fertility status. EVIDENCE ACQUISITION This review summarizes papers investigating the potential adverse effects of female and male obesity and the impact of weight-loss interventions on fertility among reproductive age populations. PubMed, Scopus, Web of Science, and Google Scholar databases were searched for retrieving studies published up to November 2019 on obesity/overweight among reproductive age populations. RESULTS The review of 68 studies revealed that female and male obesity/overweight increases the risk of sub-fecundity and infertility. The destructive effects of female obesity on reproduction are attributed to a variety of ovarian and extra-ovarian factors. In women with overweight or obesity, the time taken to conceive is longer, and they have a decreased fertility rate, increased requirement for gonadotropins, and higher miscarriage rate when compared to those with normal weight. Male obesity may lead to subfertility, mainly because of the disruption of the hypothalamus-pituitary-gonadal (HPG) axis, increased testicular temperature, impairment of the physical and molecular structure of sperm, decreased sperm quality, and erectile dysfunction due to peripheral vascular disease. Most studies recommend lifestyle interventions as first-line therapy in the general population of women and men with obesity and infertility. CONCLUSIONS This study shows the negative effects of female and male overweight and obesity on fertility. Therefore, educational interventions on the adverse effects of obesity and the benefits of weight reduction, such as increasing pregnancy rate, should be considered for couples seeking fertility.
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Affiliation(s)
- Mina Amiri
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding Author: Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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13
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Zhong YM, Luo XC, Chen Y, Lai DL, Lu WT, Shang YN, Zhang LL, Zhou HY. Acupuncture versus sham acupuncture for simple obesity: a systematic review and meta-analysis. Postgrad Med J 2020; 96:221-227. [PMID: 32015189 PMCID: PMC7146934 DOI: 10.1136/postgradmedj-2019-137221] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 12/08/2019] [Accepted: 12/20/2019] [Indexed: 12/13/2022]
Abstract
Obesity is a growing chronic health problem worldwide. Studies about acupuncture for obesity treatment are many. But there are some doubts about the effectiveness of acupuncture versus sham acupuncture in treating obesity due to its lack of medical evidence. Therefore, the aim of this study is to assess the efficacy of acupuncture for obesity treatment and provide clinic evidence. Four English databases (PubMed, EMBASE, Web of Science and Cochrane Central Register of Controlled Trials) and four Chinese databases (China National Knowledge Infrastructure, Chinese BioMedical Database, Chinese Scientific Journal Database and Wan-Fang Data) were searched from their receptions to August 2019. Randomized controlled trials (RCTs) using the comparison between acupuncture and sham acupuncture to treat simple obesity were included. The primary outcome of body mass index (BMI) would be used to measure the effect of acupuncture on obesity. According to the trial data extraction form based on the Cochrane Handbook, two reviewers separately extracted the data. Risk of bias of the RCTs was assessed by the Cochrane Risk of Bias Tool. The study included 8 RCTs with 403 patients. When compared with sham acupuncture, acupuncture showed obviously effect in BMI reduction (MD=1.0kg/m2, 95% CI=0.6 to 1.4, P<0.001). There was also significant reduction in body weight (MD=1.85kg, 95%CI=0.82 to 2.88, p<0.001), WC (MD=0.97cm, 95%CI=0.24 to 1.71, p=0.01) and body fat mass percentage (MD=1.01, 95%CI=0.25 to 1.77, p<0.05). However, WHR (MD=0.01, 95%CI=0 to 0.03, p>0.05) was not statistically and significantly different between the acupuncture and control groups. Adverse effects were reported in 3 studies. The review suggests that acupuncture is an effective therapy for simple obesity rather than a placebo effect. This potential benefit needs to be further evaluated by longer-term and more rigorous RCTs.
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Affiliation(s)
- Yu-Mei Zhong
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiao-Chao Luo
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yang Chen
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - De-Li Lai
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,The Affiliated Hospital, School of Medicine, UESTC, Chengdu Women's and Children's Central Hospital, Chengdu, China
| | - Wen-Ting Lu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ya-Nan Shang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lin-Lin Zhang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hai-Yan Zhou
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Kheirvari M, Dadkhah Nikroo N, Jaafarinejad H, Farsimadan M, Eshghjoo S, Hosseini S, Anbara T. The advantages and disadvantages of sleeve gastrectomy; clinical laboratory to bedside review. Heliyon 2020; 6:e03496. [PMID: 32154399 PMCID: PMC7052082 DOI: 10.1016/j.heliyon.2020.e03496] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 12/01/2019] [Accepted: 02/24/2020] [Indexed: 02/06/2023] Open
Abstract
Sleeve gastrectomy is a surgical technique and a leading method in metabolic surgery. Sleeve gastrectomy gained ever-increasing popularity among laparoscopic surgeons involved in bariatric surgery and has proved to be a successful method in achieving considerable weight loss in a short time. There are some disparate effects that patients may experience after sleeve gastrectomy including a reduction in BMI, weight, blood pressure, stroke, and cancer and also a significant remission in obesity-related diseases including type 2 diabetes (T2D), Non-alcoholic fatty liver (NAFLD), cardiovascular disease, obstructive sleep apnea, and craniopharyngioma-related hypothalamic obesity as well as non-obesity-related diseases such as gout, musculoskeletal problems, ovarian disorders and urinary incontinence. The most common complications of sleeve gastrectomy are bleeding, nutrient deficiencies, and leakage. There are several studies on the impact of gender and ethnic disparities on post-operative complications. This study collects state of the art of reports on sleeve gastrectomy. The aim of this study was to analyze recent studies and review the advantages and disadvantages of sleeve gastrectomy.
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Affiliation(s)
- Milad Kheirvari
- Microbiology Research Centre, Pasteur Institute of Iran, Tehran, Iran
| | | | - Habib Jaafarinejad
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Marziye Farsimadan
- Department of Biology, Faculty of Sciences, University of Guilan, Rasht Iran
| | - Sahar Eshghjoo
- Department of Microbial Pathogenesis and Immunology, College of Medicine, Texas A&M University, Health Science Center, Bryan, TX, USA
| | - Sara Hosseini
- Department of Surgery, Erfan Niayesh Hospital, Tehran, Iran
| | - Taha Anbara
- Department of Surgery, Erfan Niayesh Hospital, Tehran, Iran
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15
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Zhong YM, Lai DL, Chen Y, Luo XC, Lu WT, Shang YN, Zhang LL, Zhou HY. Acupuncture vs sham acupuncture for simple obesity: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e17562. [PMID: 31626121 PMCID: PMC6824781 DOI: 10.1097/md.0000000000017562] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 09/19/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Obesity is a growing chronic health problem worldwide. Studies about acupuncture for obesity treatment are many. But there are some doubts about the effectiveness of acupuncture vs sham acupuncture in treating obesity due to its lack of an evidence-based medical proof. Therefore, the aim of this study is to assess the efficacy of acupuncture for obesity treatment and provide clinic evidence. METHODS This protocol was based on the previous reporting items for systematic review and meta-analysis agreements. Four English databases (PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials) and 4 Chinese databases (China National Knowledge Infrastructure, Chinese BioMedical Database, Chinese Scientific Journal Database, Wan-Fang Data) will be searched from their receptions to August 2019. Randomized controlled trials (RCTs) using acupuncture compared sham acupuncture (or no treatment) to treat simple obesity will be included. The primary outcome of body mass index (BMI) and body weight (BW) will be used to measure the effect of acupuncture on obesity. According to the trial data extraction form based on the Cochrane Handbook, 2 reviewers will separately extract the data. Risk of bias of the RCTs will be assessed by the Cochrane Risk of Bias Tool. Publication bias will be assessed with funnel plots. RESULTS This study will be to evaluate whether acupuncture is an effective intervention for simple obesity when compared with sham acupuncture. CONCLUSION The conclusion of this study will help clinicians provide effective treatment options for obese patients. ETHICS AND DISSEMINATION Ethical approval is not required for systematic review and meta- analysis. The results of this review will be disseminated in a peer-review journal. PROSPERO REGISTRATION NUMBER PROSPERO CRD42019129825.
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Affiliation(s)
- Yu-Mei Zhong
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - De-Li Lai
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
- The Affiliated Hospital, School of Medicine, UESTC, Chengdu Women's and Children's Central Hospital, Chengdu, China
| | - Yang Chen
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Xiao-Chao Luo
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Wen-Ting Lu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Ya-Nan Shang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Lin-Lin Zhang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Hai-Yan Zhou
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
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