scholarly journals Serum concentrations of antidepressants, antipsychotics, and antiepileptics over the bariatric surgery procedure

2021 ◽  
Author(s):  
Susanna M. Wallerstedt ◽  
Karin Nylén ◽  
Magnus A. B. Axelsson
Keyword(s):  
Bariatric Surgery ◽  
Antiepileptic Drugs ◽  
Therapeutic Drug ◽  
Serum Concentrations ◽  
Consistent Finding ◽  
Low Calorie ◽  
Post Surgery ◽  
Low Calorie Diet ◽  
Calorie Diet ◽  
The Impact

Abstract Purpose As a substantial proportion of bariatric surgery patients use psychotropic/antiepileptic drugs, we investigated the impact of this procedure on serum concentrations. Methods In a naturalistic, longitudinal, prospective case series, we compared dose-adjusted trough concentrations of antidepressants, antipsychotics, or antiepileptics in consecutive patients before and after bariatric surgery. Adherence to treatment over 2 weeks preceding each sampling was considered. Results In all, 85 participants were included (86% female, median age 45 years, median body mass index 42 kg/m2). They were being treated with 18 different psychotropic/antiepileptic drugs (7 substances: 6–17 individuals, 11 substances: 1–4 individuals) and contributed 237 samples over a median of 379 days after surgery. For four out of seven substances with pre-/post-surgery samples available from six or more individuals, the dose-adjusted concentration was reduced (sertraline: 51%, mirtazapine: 41%, duloxetine: 35%, citalopram: 19%). For sertraline and mirtazapine, the low-calorie-diet before surgery entirely explained this reduction. A consistent finding, irrespective of drug, was the association between the mean ratio of the post-/pre-diet dose-adjusted concentration and the lipophilicity of the drug (logD; correlation coefficient: −0.69, P = 0.0005), the low-calorie diet often affecting serum concentration more than the surgery itself. Conclusions Serum concentrations of psychotropic/antiepileptic drugs vary after bariatric surgery and can be hard to predict in individual patients, suggesting that therapeutic drug monitoring is of value. Conversely, effects of the pre-surgery, low-calorie diet appear generalizable, with decreased concentrations of highly lipophilic drugs and increased concentrations of highly hydrophilic drugs. Interaction effects (surgery/dose/concentration) were not evident but cannot be excluded.

scholarly journals The impact of obesity and bariatric surgery on the immune microenvironment of the endometrium

2021 ◽  
Author(s):  
Anie Naqvi ◽  
Michelle L. MacKintosh ◽  
Abigail E. Derbyshire ◽  
Anna-Maria Tsakiroglou ◽  
Thomas D. J. Walker ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Endometrial Cancer ◽  
Immune Cell ◽  
Immune Microenvironment ◽  
Low Calorie ◽  
Low Calorie Diet ◽  
Tnf Α ◽  
Calorie Diet ◽  
The Impact

Abstract Background The incidence of endometrial cancer is rising in parallel with the obesity epidemic. Obesity increases endometrial cancer risk and weight loss is protective, but the underlying mechanisms are incompletely understood. We hypothesise that the immune microenvironment may influence susceptibility to malignant transformation in the endometrium. The aim of this study was to measure the impact of obesity and weight loss on the immunological landscape of the endometrium. Methods We conducted a prospective cohort study of women with class III obesity (body mass index, BMI ≥ 40 kg/m2) undergoing bariatric surgery or medically-supervised low-calorie diet. We collected blood and endometrial samples at baseline, and two and 12 months after weight loss intervention. Serum was analysed for inflammatory markers CRP, IL-6 and TNF-α. Multiplex immunofluorescence was used to simultaneously identify cells positive for immune markers CD68, CD56, CD3, CD8, FOXP3 and PD-1 in formalin-fixed paraffin-embedded endometrial tissue sections. Kruskal–Wallis tests were used to determine whether changes in inflammatory and immune biomarkers were associated with weight loss. Results Forty-three women with matched serum and tissue samples at all three time points were included in the analysis. Their median age and BMI were 44 years and 52 kg/m2, respectively. Weight loss at 12 months was greater in women who received bariatric surgery (n = 37, median 63.3 kg) than low-calorie diet (n = 6, median 12.8 kg). There were significant reductions in serum CRP (p = 3.62 × 10−6, r = 0.570) and IL-6 (p = 0.0003, r = 0.459), but not TNF-α levels, with weight loss. Tissue immune cell densities were unchanged except for CD8+ cells, which increased significantly with weight loss (p = 0.0097, r = −0.323). Tissue CD3+ cell density correlated negatively with systemic IL-6 levels (p = 0.0376; r = −0.318). Conclusion Weight loss is associated with reduced systemic inflammation and a recruitment of protective immune cell types to the endometrium, supporting the concept that immune surveillance may play a role in endometrial cancer prevention.

Effectiveness, Compliance, and Acceptability of Preoperative Weight Loss with a Liquid Very Low-Calorie Diet Before Bariatric Surgery in Real Practice

2018 ◽  
Vol 29 (1) ◽  
pp. 54-60 ◽  
Author(s):  
Kamthorn Yolsuriyanwong ◽  
Komdej Thanavachirasin ◽  
Kimberly Sasso ◽  
Lauren Zuro ◽  
Jessica Bartfield ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Preoperative Weight Loss ◽  
Very Low Calorie Diet ◽  
Low Calorie ◽  
Low Calorie Diet ◽  
Calorie Diet ◽  
Preoperative Weight ◽  
Real Practice

scholarly journals Very low-calorie diet in candidates for bariatric surgery: change in body composition during rapid weight loss

Clinics ◽  
2019 ◽  
Vol 74 ◽  
Author(s):  
Marcela Pires Serafim ◽  
Marco Aurelio Santo ◽  
Alexandre Vieira Gadducci ◽  
Veruska Magalhães Scabim ◽  
Ivan Cecconello ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Body Composition ◽  
Rapid Weight Loss ◽  
Very Low Calorie Diet ◽  
Low Calorie ◽  
Low Calorie Diet ◽  
Calorie Diet

Effects of a very low calorie diet in the preoperative stage of bariatric surgery: a randomized trial

2015 ◽  
Vol 11 (1) ◽  
pp. 230-237 ◽  
Author(s):  
Silvia Leite Faria ◽  
Orlando Pereira Faria ◽  
Mariane de Almeida Cardeal ◽  
Marina Kiyomi Ito
Keyword(s):  
Bariatric Surgery ◽  
Randomized Trial ◽  
Very Low Calorie Diet ◽  
Low Calorie ◽  
Low Calorie Diet ◽  
Preoperative Stage ◽  
Calorie Diet

scholarly journals Effectiveness of a Low-Calorie Diet for Liver Volume Reduction Prior to Bariatric Surgery: a Systematic Review

2020 ◽  
Author(s):  
Marleen M. Romeijn ◽  
Aniek M. Kolen ◽  
Daniëlle D. B. Holthuijsen ◽  
Loes Janssen ◽  
Goof Schep ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Liver Volume ◽  
Volume Reduction ◽  
Restricted Diet ◽  
Low Calorie ◽  
Low Calorie Diet ◽  
Calorie Diet ◽  
Very Low Calorie Diets

Abstract An energy-restricted diet is often prescribed before bariatric surgery to reduce weight and liver volume. While very-low-calorie diets (VLCDs, 450–800 kcal per day) have shown to be effective, the effectiveness of low-calorie diets (LCDs, 800–1500 kcal per day) is less obvious. The objective of this systematic review was to elucidate the effectiveness of LCD on liver volume reduction in patients awaiting bariatric surgery. Eight studies (n = 251) were included describing nine different diets (800–1200 kcal, 2–8 weeks). An LCD was effective in liver volume reduction (12–27%) and weight loss (4–17%), particularly during the first weeks. The LCD showed an acceptable patients’ compliance. Based on these findings, an LCD (800–1200 kcal), instead of a VLCD, for 2 to 4 weeks should be preferred.

scholarly journals A Randomized, Controlled Trial Comparing the Impact of a Low-Calorie Ketogenic vs a Standard Low-Calorie Diet on Fat-Free Mass in Patients Receiving an Elipse™ Intragastric Balloon Treatment

2020 ◽  
Author(s):  
Luigi Schiavo ◽  
Giovanni De Stefano ◽  
Francesco Persico ◽  
Stefano Gargiulo ◽  
Federica Di Spirito ◽  
...  
Keyword(s):  
Renal Function ◽  
Intragastric Balloon ◽  
Negative Impact ◽  
Controlled Trial ◽  
Small Sample ◽  
Fat Free Mass ◽  
Low Calorie ◽  
Low Calorie Diet ◽  
Calorie Diet ◽  
The Impact

Abstract Background The Elipse™ intragastric balloon (EIGB) is a new swallowable balloon for weight loss (WL). Preserving metabolically active fat-free mass (FFM) and resting metabolic rate (RMR) during WL are crucial to maximize fat mass (FM) loss. After EIGB placement, a standard low-calorie diet (LCD) is generally prescribed. A low-calorie ketogenic diet (LCKD) has proven to be safe and effective in reducing FM while preserving FFM and RMR. Objective To prospectively compare the effects on WL, FM, FFM, and RMR in two groups of patients who were randomized to two different diets: LCKD and a standard LCD after EIGB placement. Methods WL, FM, FFM, and RMR were measured before EIGB and at 4 months in 48 patients who received either a LCKD (n = 24) or a standard LCD (n = 24). Compliance in following the prescribed diet was determined with food frequency questionnaires in all patients. The impact of LCKD and LCD on renal function was also evaluated. Results The LCKD group showed a significantly lower decrease in FFM and RMR when compared with the LCD group (3.55 vs 14.3%, p < 0.001; 9.79 vs 11.4%, p < 0.001, respectively). FM decreased more significantly with LCKD compared to LCD (41.6 vs 33.1%, p = 0.0606). Compliance in following the prescribed diets, without negative impact on renal function, was found. Conclusion Based on our findings, despite the small sample size, we were able to support the hypothesis that LCKD is associated with an increased FM loss while reducing the FFM loss and the RMR, without interfering with renal function after EIGB.

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