scholarly journals Variables Associated with Short-Term Weight Loss in a Cohort of Patients with Morbid Obesity According to Age and Three Types of Bariatric Surgery

2020 ◽  
Vol 9 (11) ◽  
pp. 3537
Author(s):  
Maria D. Alvarez-Bermudez ◽  
Flores Martin-Reyes ◽  
Luis Ocaña-Wilhelmi ◽  
Francisco J. Moreno-Ruiz ◽  
Juan Alcaide Torres ◽  
...  

Background The percentage of excess weight lost (%EWL) after bariatric surgery (BS) shows great discrepancies from one individual to another. Objective To evaluate the %EWL one year after BS and to determine the existence of baseline biomarkers associated with weight loss. Methods We studied 329 patients with morbid obesity undergoing three types of BS (biliopancreatic diversion (BPD), Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG)), depending on the %EWL one year after surgery: good responders (GR) (%EWL ≥ 50%) and non-responders (NR) (%EWL < 50%). Results The GR presented a higher percentage of change in anthropometric and biochemical variables compared to the NR group, even within each type of BS. There was a greater percentage of GR among those who underwent RYGB. The patients who underwent SG showed the lowest decrease in biochemical variables, both in GR and NR. Within the GR group, those with a lower age showed greater improvement compared to the other age groups. A %EWL ≥50% was negatively associated with the age and atherogenic index of plasma (AIP), and positively with the type of BS (RYGB). Conclusions The GR group was associated with lower age and AIP and undergoing RYGB. Additionally, those patients who underwent SG showed a lower metabolic improvement.

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 721
Author(s):  
Tannaz Jamialahmadi ◽  
Mohsen Nematy ◽  
Simona Bo ◽  
Valentina Ponzo ◽  
Ali Jangjoo ◽  
...  

Background: Obesity is a chronic inflammatory condition associated with increased circulating levels of C-reactive protein (CRP). Bariatric surgery has been reported to be effective in improving both inflammatory and liver status. Our aims were to elucidate the relationships between pre-surgery high sensitivity-CRP (hs-CRP) values and post-surgery weight loss and liver steatosis and fibrosis in patients with severe obesity undergoing Roux-en-Y gastric bypass. Methods: We conducted an observational prospective study on 90 individuals with morbid obesity, who underwent gastric bypass. Anthropometric indices, laboratory assessment (lipid panel, glycemic status, liver enzymes, and hs-CRP), liver stiffness and steatosis were evaluated at baseline and 6-months after surgery. Results: There was a significant post-surgery reduction in all the anthropometric variables, with an average weight loss of 33.93 ± 11.79 kg; the mean percentage of total weight loss (TWL) was 27.96 ± 6.43%. Liver elasticity was significantly reduced (from 6.1 ± 1.25 to 5.42 ± 1.52 kPa; p = 0.002), as well as liver aminotransferases, nonalcoholic fatty liver disease fibrosis score (NFS) and the grade of steatosis. Serum hs-CRP levels significantly reduced (from 9.26 ± 8.45 to 3.29 ± 4.41 mg/L; p < 0.001). The correlations between hs-CRP levels and liver fibrosis (elastography), steatosis (ultrasonography), fibrosis-4 index, NFS, and surgery success rate were not significant. Regression analyses showed that serum hs-CRP levels were not predictive of liver status and success rate after surgery in both unadjusted and adjusted models. Conclusions: In patients with morbid obesity, bariatric surgery caused a significant decrease in hs-CRP levels, liver stiffness and steatosis. Baseline hs-CRP values did not predict the weight-loss success rate and post-surgery liver status.


2019 ◽  
Vol 40 (1) ◽  
pp. NP21-NP31 ◽  
Author(s):  
Rodrigo P Sizenando ◽  
Marco Túlio C Diniz ◽  
Paulo Roberto da Costa ◽  
Luiz Gustavo S Manhães

Abstract Background In 1971, Ribeiro isolated a segment in the inferior pole of the ptotic breast, nourished by muscular perforating vessels, and moved it cranially to the posterior region of the remaining detached breast tissue, where it was fixed to the pectoral fascia. This maneuver created a flap with autologous implant function, independent from the rest of the breast’s support, that maintained long-term mammary projection. Objectives The objectives of this study were to measure the vertical movement of this flap 1 year after mammaplasty and to evaluate the factors involved. Methods The sample included 13 patients who had previously undergone bariatric surgery. The position of a titanium marker attached to the Ribeiro flap was compared on chest radiographs taken 1 day and 1 year after the mammaplasty. The significance level was set at 5%. Results All of the titanium markers moved 0.6 cm to 4.1 cm caudally during the study period (average, 2.4 cm ± 1.02 cm). The greater the weight loss after the plastic surgery, the further the marker’s descent. Weight loss between bariatric surgery and plastic surgery, the vertical dimension of the ptotic breast tissue immediately before plastic surgery, the vertical extent of the nipple-areola complex elevation during mammaplasty, the Ribeiro flap thickness and volume, and the breast volume after mammaplasty were not associated with the vertical movement of the flap. Conclusions The Ribeiro flap employed in mammaplasty of patients who previously underwent bariatric surgery undergoes ptosis that is exacerbated by weight loss after mammaplasty. Level of Evidence: 4


2017 ◽  
Vol 76 (11) ◽  
pp. 1870-1882 ◽  
Author(s):  
Sabrina M Nielsen ◽  
Else M Bartels ◽  
Marius Henriksen ◽  
Eva E Wæhrens ◽  
Henrik Gudbergsen ◽  
...  

ObjectivesWeight loss is commonly recommended for gout, but the magnitude of the effect has not been evaluated in a systematic review. The aim of this systematic review was to determine benefits and harms associated with weight loss in overweight and obese patients with gout.MethodsWe searched six databases for longitudinal studies, reporting the effect of weight loss in overweight/obese gout patients. Risk of bias was assessed using the tool Risk of Bias in Non-Randomised Studies of Interventions. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation.ResultsFrom 3991 potentially eligible studies, 10 were included (including one randomised trial). Interventions included diet with/without physical activity, bariatric surgery, diuretics, metformin or no intervention. Mean weight losses ranged from 3 kg to 34 kg. Clinical heterogeneity in study characteristics precluded meta-analysis. The effect on serum uric acid (sUA) ranged from −168 to 30 μmol/L, and 0%–60% patients achieving sUA target (<360 μmol/L). Six out of eight studies (75%) showed beneficial effects on gout attacks. Two studies indicated dose–response relationship for sUA, achieving sUA target and gout attacks. At short term, temporary increased sUA and gout attacks tended to occur after bariatric surgery.ConclusionsThe available evidence is in favour of weight loss for overweight/obese gout patients, with low, moderate and low quality of evidence for effects on sUA, achieving sUA target and gout attacks, respectively. At short term, unfavourable effects may occur. Since the current evidence consists of a few studies (mostly observational) of low methodological quality, there is an urgent need to initiate rigorous prospective studies (preferably randomised controlled trials).Systematic review registrationPROSPERO, CRD42016037937.


2014 ◽  
Vol 23 (3-4) ◽  
pp. 151-168
Author(s):  
Aristotelis Gioldasis ◽  
Evangelos Bekris ◽  
Ioannis Gissis

Abstract The aim of this study was to examine the anthropometric and fitness characteristics of soccer players with different positional role. Although, players’ skills are not equally distributed in each position, at elite soccer they have to perform each skill at a sufficient level. However, coaches expertise those from an early age in specific positions without giving them an holistic individualized training. In the study participated 312 Greek players aged 6 to 17 (M= 11.89; SD= 2.33) of 5 age groups (group U7-U8; group U9-U10; group U11-U12; group U13-U14; group U15-U16; group U17). Anthropometric (height, weight, body mass index and body fat) and fitness characteristics (flexibility, vertical jump, running speed, agility and VO2max) of participants were measured. The study showed that goalkeepers and central defenders tend to perform worse than players of the other positional groups in most of their fitness characteristics for almost all the age groups. Furthermore, many tendencies were observed in anthropometric and fitness characteristics between players with different positional roles. This study provides suggestions to coaches regarding their practice of positioning players according to their anthropometric and fitness characteristics for a short term success.


2020 ◽  
Vol 8 ◽  
pp. 2050313X2095300 ◽  
Author(s):  
Suzanna Connick Jamison ◽  
Kelley Aheron

A patient with morbid obesity and several psychiatric comorbidities underwent laparoscopic sleeve gastrectomy and experienced success with weight loss. However, she experienced lightheadedness, nausea, and a fall and was admitted to the hospital for encephalopathy due to lithium toxicity. The pharmacokinetics of lithium is altered following bariatric surgery. Due to these factors, adjustments were made to the patient’s lithium therapy, her levels were subsequently reduced into the therapeutic range, and she continued with no further issues. Mechanisms of lithium toxicity following bariatric surgery and a monitoring protocol to prevent toxicity are discussed.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Flavio Cadegiani

Abstract Background: Maintenance of weight loss in patients that undergo weight loss interventions is highly challenging, irrespective of the type of approach to obesity (whether surgical, pharmacological, or non-pharmacological). We proposed a protocol of an aggressive clinical treatment for obesity aiming to prevent the need of bariatric surgery, in patients unwilling to undergo this procedure, by proposing a protocol that included the combination of different anti-obesity medications and non-pharmacological modalities, for longer duration, and with an active approach to prevent weight regain. Our initial 2-year data showed that 93% (40 of 43 patients) with moderate and morbid obesity were able to avoid the need of bariatric surgery, with concomitant improvements of the biochemical profile. However, whether these patients would maintain their successful rates after five years was uncertain. Our objective is to describe the efficacy and safety of a long term (5-year data) pharmacological and multi-modal treatment for moderate and severe obesity. Methods: The 40 patients that were successful in the two-year approach in our obesity center (Corpometria Institute, Brasilia, DF, Brazil) were enrolled. A long-term anti-obesity protocol was employed, with continuous or intermittent use of anti-obesity drugs, trimestral body composition analysis, psychotherapy, visit to a nutritionist every four months, and both resistance and endurance exercises at least four times a week. Body weight (BW), total weight excess (TWE), body fat, markers of lipid and glucose metabolism, liver function, and inflammation were analyzed. Subjects that dropped out were considered as weight regain. Therapeutic success for the 5-year follow-up included as the maintenance of &gt;20% loss of the initial BW loss, and no weight regain (or &lt; 20% of the initial weight loss). Results: A total of 27 patients (67.5%) were able to maintain the body weight, seven dropped out, and six regained more than 20% of the initial weight loss. Of these, 21 (77.8%) had significant further increase of muscle mass and decrease of fat loss, while 17 (63.0%) had further weight loss (p &lt; 0.05), compared to the 2-year data. Improvements on the biochemical profile persisted in all 27 patients, and had significant further improvements in 24 (88.9%) of these patients. Conclusion: The risk of weight regain five years after a weight loss treatment for obesity was significantly lower compared to previous literature, and comparable to the long-term outcomes of bariatric procedures. An aggressive, structured, and long-term clinical weight loss approach has been shown to be feasible, even for morbidly obese patients.


2011 ◽  
Vol 56 (No. 4) ◽  
pp. 149-155 ◽  
Author(s):  
P. Alexa ◽  
L. Konstantinova ◽  
Z. Sramkova-Zajacova

A survey to estimate the prevalence of verotoxigenic E. coli (VTEC) or enterohaemorrhagic E. coli (EHEC) in rectal swabs from healthy dairy cattle aged three weeks, three months and one year was conducted in three herds from the Czech Republic. Screening for the presence of the stx1, stx2 and eaeA genes in faecal swab cultures was performed by PCR, and in positive samples, isolated colonies were examined. Immunomagnetic separation was used for the isolation of the VTEC serogroup O157 from samples. VTEC were detected in animals from all three herds under study. In the group of 3-week-old calves, VTEC were only detected in samples collected in the summer months. However, in the other age-groups, VTEC were detected in both the summer and winter months. EHEC shedding was observed in 30 to 100% of the total samples collected from cattle aged three months and one year in the summer months, and in 30 to 60% of samples taken in the winter months. EHEC strains of serogroup O157 were detected in two herds. The range of verotoxins shed by VTEC isolates of serogroup O157 differed between herds. Besides serogroup O157, additional EHEC belonging to the antigen groups O26, O103, O128 and O153 have been identified, and in some of them, no somatic antigen was detected.


Author(s):  
Yeon Lee ◽  
Yoonseok Heo ◽  
Ji-Ho Choi ◽  
Sunghyouk Park ◽  
Kyoung Kim ◽  
...  

Irisin is a myokine with potential anti-obesity properties that has been suggested to increase energy expenditure in obese patients. However, there is limited clinical information on the biology of irisin in humans, especially in morbidly obese patients undergoing bariatric surgery. We aimed to assess the association of circulating irisin concentrations with weight loss in obese patients undergoing bariatric surgery. This was a pilot, single-centre, longitudinal observational study. We recruited 25 morbidly obese subjects who underwent Roux-en-Y gastric bypass surgery (RYGBP), and blood samples from 12 patients were taken to measure serum irisin concentrations before, and one and nine months after surgery. Their clinical characteristics were measured for one year. The preoperative serum irisin concentration (mean 1.01 ± 0.23 μg/mL, range 0.73–1.49) changed bidirectionally one month after RYGBP. The mean concentration at nine months was 1.11 ± 0.15 μg/mL (range 0.92–1.35). Eight patients had elevated irisin levels compared with their preoperative values, but four did not. Elevations of irisin levels nine months, but not one month, after surgery, were associated with lower preoperative levels (p = 0.016) and worse weight reduction rates (p = 0.006 for the percentage excess weight loss and p = 0.032 for changes in body mass index). The preoperative serum irisin concentrations were significantly correlated with the percentage of excess weight loss for one year (R2 = 0.612; p = 0.04) in our study. Our results suggest that preoperative circulating irisin concentrations may be at least in part associated with a weight loss effect of bariatric surgery in morbidly obese patients. Further large-scale clinical studies are needed to ratify these findings.


1980 ◽  
Vol 46 (1) ◽  
pp. 331-338
Author(s):  
A. Ivinskis

A study was carried out to examine heart-rate changes and changes in performance levels in Hebb-Williams maze in three different age groups of rats (21, 43, and 83 days old). Heart rate was recorded using a miniature FM radio transmitter. The rats were first exposed to 6 odd Hebb-Williams maze items and were retested 12 days later using 6 even test items. The main findings were: over-all the heart rate was significantly higher in the 21-day-old group and heart rate in this group decreased during the running of the maze while it increased in the other two groups. Heart-rate responses increased as a function of trials in all the groups and increased most sharply for the 21-day-old group. On retest a significant over-all decrease occurred in the heart-rate responses. The short-term reliability of heart rate was quite high for all the age groups. The 21-day-old group rats made significantly fewer errors in the Hebb-Williams maze when compared with the two older groups but the test-retest reliability of the Hebb-Williams maze scores was very low in the 21-day group relative to the other two. The results are discussed in terms of response inhibition and changes in drive level as a function of age. Questions are also raised concerning the validity of the Hebb-Williams maze test as a measure of problem-solving behavior.


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