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Pujol-Rafols J, Carmona-Maurici J, Felsenreich DM, Shikora SA, Prager G, Di Lorenzo N, De Luca M, Uyanik O, Mazzarella M, D'Arco S, Angrisani L, Pardina E, Balibrea JM. Indications and Coverage of Metabolic and Bariatric Surgery: A Worldwide IFSO Survey Comparing Different National Guidelines. Obes Surg 2024; 34:1395-1404. [PMID: 38472706 DOI: 10.1007/s11695-024-07142-3] [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: 12/19/2023] [Revised: 01/19/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION Knowing how metabolic and bariatric surgery (MBS) is indicated in different countries is essential information for the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). AIM To analyze the indications for MBS recommended by each of the national societies that comprise the IFSO and how MBS is financed in their countries. METHODS All IFSO societies were asked to fill out a survey asking whether they have, and which are their national guidelines, and if MBS is covered by their public health service. RESULTS Sixty-three out of the 72 IFSO national societies answered the form (87.5%). Among them, 74.6% have some kind of guidelines regarding indications for MBS. Twenty-two percent are still based on the US National Institute of Health (NIH) 1991 recommendations, 43.5% possess guidelines midway the 1991s and ASMBS/IFSO 2022 ones, and 34% have already adopted the latest ASMBS/IFSO 2022 guidelines. MBS was financially covered in 65% of the countries. CONCLUSIONS Most of the IFSO member societies have MBS guidelines. While more than a third of them have already shifted to the most updated ASMBS/IFSO 2022 ones, another significant number of countries are still following the NIH 1991 guidelines or even do not have any at all. Besides, there is a significant number of countries in which surgical treatment is not yet financially covered. More effort is needed to standardize indications worldwide and to influence insurers and health policymakers to increase the coverage of MBS.
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Affiliation(s)
- J Pujol-Rafols
- Metabolic and Bariatric Surgery Unit (UCOM), Clínica Mi Tres Torres and Hospital HM Delfos, Barcelona, Spain.
| | - J Carmona-Maurici
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - D M Felsenreich
- Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria
| | - S A Shikora
- Harvard Medical School, Department of Surgery Brigham and Women's Hospital, Boston, MA, USA
| | - G Prager
- Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria
| | - N Di Lorenzo
- Dept. of Surgical Sciences, Università di Roma Tor Vergata, Roma, Italy
| | - M De Luca
- Department of Surgery, Rovigo Hospital, Italy
| | - O Uyanik
- Department of General and Digestive Surgery, Hospital Consorci Alt Penedes i Garraf, Hospital Residencia Sant Camil, Sant Pere de Ribes, Barcelona, Spain
| | | | - S D'Arco
- IFSO Headquarters, Naples, Italy
| | - L Angrisani
- Department of Public Health, Federico II" University of Naples, Naples, Italy
| | - E Pardina
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - J M Balibrea
- Endocrine, Metabolic and Bariatric Surgery Unit, Department of Surgery, Germans Trias i Pujol University Hospital, Badalona, Barcelona, Spain
- Department of Surgery, Universitat Autònoma de Barcelona, Barcelona, Spain
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Abás E, Gómez-Bachiller M, Colom E, Pardina E, Rodríguez-Diéguez A, Grasa L, Laguna M. Cyclometallated gold(III) complexes against colon cancer. X-ray structure of [Au(C,NPhenylpyridine)(OAc)2]. J Organomet Chem 2020. [DOI: 10.1016/j.jorganchem.2020.121340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Viñas A, Pardina E, Targarona J, Ruiz J, Pita AM, Virgili N, López-Tejero MD. Apolipoprotein A-IV measurements in paired venous and fingerprick blood samples: Agreement analysis. Clin Chim Acta 2019; 502:261-262. [PMID: 31758932 DOI: 10.1016/j.cca.2019.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 11/08/2019] [Accepted: 11/09/2019] [Indexed: 11/19/2022]
Affiliation(s)
- A Viñas
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona (UB), Barcelona, Spain.
| | - E Pardina
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona (UB), Barcelona, Spain.
| | - J Targarona
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona (UB), Barcelona, Spain
| | - J Ruiz
- MIXeSTAT S.L., Barcelona, Spain.
| | - A M Pita
- Unitat de Nutrició i Dietètica, Servei d'Endocrinologia i Nutrició, Hospital Universitari de Bellvitge (HUB), IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - N Virgili
- Unitat de Nutrició i Dietètica, Servei d'Endocrinologia i Nutrició, Hospital Universitari de Bellvitge (HUB), IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - M D López-Tejero
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona (UB), Barcelona, Spain.
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Maurici JC, Cuello E, Pardina E, Betriu A, Baena-Fustegueras J, Peinado-Onsurbe J. Atherosclerotic Plaque In Morbidly Obese Patients Determines The Improvement In Endothelial And Vascular Profile And The Remission Of Comorbidities One Year After Bariatric Surgery. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.414] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Pardina E, Ferrer R, Rossell J, Ricart-Jané D, Méndez-Lara KA, Baena-Fustegueras JA, Lecube A, Julve J, Peinado-Onsurbe J. Hepatic CD36 downregulation parallels steatosis improvement in morbidly obese undergoing bariatric surgery. Int J Obes (Lond) 2017; 41:1388-1393. [PMID: 28555086 DOI: 10.1038/ijo.2017.115] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 12/26/2016] [Revised: 02/28/2017] [Accepted: 04/02/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND The notion that hepatic expression of genes involved in lipid metabolism is altered in obese patients is relatively new and its relationship with hepatic steatosis and cardiometabolic alterations remains unclear. OBJECTIVE We assessed the impact of Roux-en-Y gastric bypass surgery (RYGB) on the expression profile of genes related to metabolic syndrome in liver biopsies from morbidly obese individuals using a custom-made, focused cDNA microarray, and assessed the relationship between the expression profile and hepatic steatosis regression. MATERIALS AND METHODS Plasma and liver samples were obtained from patients at baseline and 12 months after surgery. Samples were assayed for chemical and gene expression analyses, as appropriate. Gene expression profiles were assessed using custom-made, focused TaqMan low-density array cards. RESULTS RYGB-induced weight loss produced a favorable reduction in fat deposits, insulin resistance (estimated by homeostasis model assessment of insulin resistance (HOMA-IR)), and plasma and hepatic lipid levels. Compared with the baseline values, the gene expression levels of key targets of lipid metabolism were significantly altered: CD36 was significantly downregulated (-40%; P=0.001), whereas APOB (+27%; P=0.032) and SCARB1 (+37%; P=0.040) were upregulated in response to surgery-induced weight reduction. We also observed a favorable reduction in the expression of the PAI1 gene (-80%; P=0.007) and a significant increase in the expression of the PPARA (+60%; P=0.014) and PPARGC1 genes (+36%; P=0.015). Notably, the relative fold decrease in the expression of the CD36 gene was directly associated with a concomitant reduction in the cholesterol (Spearman's r=0.92; P=0.001) and phospholipid (Spearman's r=0.76; P=0.04) contents in this tissue. CONCLUSIONS For the first time, RYGB-induced weight loss was shown to promote a favorable downregulation of CD36 expression, which was proportional to a favorable reduction in the hepatic cholesterol and phospholipid contents in our morbidly obese subjects following surgery.
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Affiliation(s)
- E Pardina
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - R Ferrer
- Unitat d'Hormones, Servei de Bioquímica, Hospital Universitari de la Vall d'Hebron, Barcelona, Spain
| | - J Rossell
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - D Ricart-Jané
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - K A Méndez-Lara
- Institut de Recerca de l'Hospital de La Santa Creu i Sant Pau, Institut d'Investigacions Biomèdiques de l'Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain.,Departament de Bioquímica i Biologia Molecular, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | | | - A Lecube
- Departament d'Endocrinologia i Nutrició, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, Lleida, Spain.,Unitat de Recerca en Diabetes i Metabolisme, Institut de Recerca Hospital Universitari Vall d'Hebron, Barcelona, Spain.,CIBER de Diabetes y Enfermedades Metabólicas Asociadas, CIBERDEM, Barcelona, Spain
| | - J Julve
- Institut de Recerca de l'Hospital de La Santa Creu i Sant Pau, Institut d'Investigacions Biomèdiques de l'Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain.,Departament de Bioquímica i Biologia Molecular, Universitat Autònoma de Barcelona, Bellaterra, Spain.,CIBER de Diabetes y Enfermedades Metabólicas Asociadas, CIBERDEM, Barcelona, Spain
| | - J Peinado-Onsurbe
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
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Julve J, Pardina E, Ferrer R, Rossell J, Baena-Fustegueras J, Fort J, Lecube A, Peinado-Onsurbe J. Bariatric surgery-induced weight loss in morbidly obese patients promotes a favorable decrease in the gene expression of markers of subcutaneous adipose tissue homeostasis. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.185] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pinto H, Ricart-Jane D, Pardina E. X-ray diffraction study confirms intra-adipocitary lipid crystallization after lipocryolysis stimulus. Cryo Letters 2013; 34:619-623. [PMID: 24441372] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Lipocryolysis always claimed localized-fat-reduction to be a consequence of local apoptotic adipocyte destruction triggered by intracellular triglyceride crystallization. The idea is now under debate, for it has been suggested that the physical changes occurring in adipocytes after lipocryolysis could be better explained by a lipid gel-like transition process rather than by lipid crystallization. Since a) lipocryolysis claims apoptosis to be the key to adipocyte destruction and clinical-result achievement and b) it considers crystallization to be a necessary step for the apoptotic stimulus unleashing, any effort to untangle, prove or discard this process is very important.
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Affiliation(s)
- H Pinto
- Instituto de Investigaciones para las Especialidades Estéticas y del Envejecimiento, Barcelona; Spain.
| | - D Ricart-Jane
- Centre de Recerca en Metabolisme, Barcelona (CEREMET)
| | - E Pardina
- Centre de Recerca en Metabolisme, Barcelona (CEREMET)
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