Impact of rapid weight loss after bariatric surgery on the prevalence of arterial hypertension in severely obese patients with chronic kidney disease

2019 ◽  
Vol 34 (7) ◽  
pp. 3197-3203 ◽  
Author(s):  
Camila Ortiz-Gomez ◽  
David Romero-Funes ◽  
David Gutierrez-Blanco ◽  
Joel S. Frieder ◽  
Maria Fonseca-Mora ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Chronic Kidney Disease ◽  
Weight Loss ◽  
Kidney Disease ◽  
Arterial Hypertension ◽  
Rapid Weight Loss ◽  
Obese Patients ◽  
Severely Obese

scholarly journals Lipidomic and Metabolomic Signature of Progression of Chronic Kidney Disease in Patients with Severe Obesity

Metabolites ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 836
Author(s):  
Borja Lanzon ◽  
Marina Martin-Taboada ◽  
Victor Castro-Alves ◽  
Rocio Vila-Bedmar ◽  
Ignacio González de Pablos ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Bariatric Surgery ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Severe Obesity ◽  
Urine Analysis ◽  
Obese Patients ◽  
Lipid Species ◽  
Severely Obese ◽  
The Impact

Severe obesity is a major risk for chronic kidney disease (CKD). Early detection and careful monitoring of renal function are critical for the prevention of CKD during obesity, since biopsies are not performed in patients with CKD and diagnosis is dependent on the assessment of clinical parameters. To explore whether distinct lipid and metabolic signatures in obesity may signify early stages of pathogenesis toward CKD, liquid chromatography-mass spectrometry (LC-MS) and gas chromatography-high resolution accurate mass-mass spectrometry (GC-HRAM-MS) analyses were performed in the serum and the urine of severely obese patients with and without CKD. Moreover, the impact of bariatric surgery (BS) in lipid and metabolic signature was also studied, through LC-MS and GC-HRAM-MS analyses in the serum and urine of patients with severe obesity and CKD before and after undergoing BS. Regarding patients with severe obesity and CKD compared to severely obese patients without CKD, serum lipidome analysis revealed significant differences in lipid signature. Furthermore, serum metabolomics profile revealed significant changes in specific amino acids, with isoleucine and tyrosine, increased in CKD patients compared with patients without CKD. LC-MS and GC-HRAM-MS analysis in serum of patients with severe obesity and CKD after BS showed downregulation of levels of triglycerides (TGs) and diglycerides (DGs) as well as a decrease in branched-chain amino acid (BCAA), lysine, threonine, proline, and serine. In addition, BS removed most of the correlations in CKD patients against biochemical parameters related to kidney dysfunction. Concerning urine analysis, hippuric acid, valine and glutamine were significantly decreased in urine from CKD patients after surgery. Interestingly, bariatric surgery did not restore all the lipid species, some of them decreased, hence drawing attention to them as potential targets for early diagnosis or therapeutic intervention. Results obtained in this study would justify the use of comprehensive mass spectrometry-based lipidomics to measure other lipids aside from conventional lipid profiles and to validate possible early markers of risk of CKD in patients with severe obesity.

Abstract P084: Influence Of Amount And Rapidity Of Weight Loss On The Risk Of Subsequently Regaining Weight And Drop-out From Treatment Among Patients With Severe Obesity Dieting In Hospital Without Bariatric Surgery

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Tomohide Yamada ◽  
Kazuo Hara ◽  
Takashi Kadowaki
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Severe Obesity ◽  
Cohort Analysis ◽  
Antidepressant Medication ◽  
Drop Out ◽  
Rapid Weight Loss ◽  
Obese Patients ◽  
Duration Of Hospitalization ◽  
Severely Obese

Although many obese patients with type 2 diabetes lose weight by dieting, most subsequently regain it. We performed a retrospective cohort analysis to assess the influence of the amount and rapidity of weight loss during hospitalization on the risk of subsequently regaining weight and stopping treatment in patients with severe obesity who dieted without bariatric surgery. A total of 131 severely obese patients (48±14 years old; BMI: 41.7±8.8; 75% with diabetes) received inpatient treatment that included diet, exercise, behavioral modification (charting weight four times daily), and educational seminars, and were followed after discharge. Regaining weight and drop-out were defined as returning to baseline body weight and failing to keep outpatient appointments, respectively. Patients lost an average of 5.3±3.0kg (4.9±2.4%) in hospital (mean: 19 days). Over the median 2-year follow-up period, unadjusted analysis showed that patients with >3% weight loss in hospital had significantly less risk of regaining weight than patients losing≤3%. The risk decreased further with greater weight loss (>7% loss; hazard ratio (HR):0.06; 95% confidence interval:0.007-0.47). Adjusted analysis revealed that >5% weight loss was associated with significantly less risk of regaining weight after adjustment for age, sex, BMI, smoke, diabetes, insulin, sulfonylurea, antidepressant medication, and duration of hospitalization (>7% loss; HR 0.04(0.004-0.36, p=0.004), 7%≥loss>5%; HR 0.3(0.11-0.85, p=0.02)). No significant relation was observed between weight loss and drop-out. Among patients with >3% weight loss during hospitalization, rapid weight loss (>3% within 7 days) did not increase the risk of subsequently regaining weight compared with patients showing slower weight loss. In conclusion, achieving >5% weight loss during comparatively brief hospitalization predicts subsequent maintenance of lower weight. Experiencing success in hospital might increase the motivation of obese patients.

Differential impact of bariatric surgery-induced weight loss on upper leg tissue composition in severely obese patients

2011 ◽  
Vol 35 (2) ◽  
pp. 188
Author(s):  
A. Auclair ◽  
J. Martin ◽  
M. Bastien ◽  
N. Bonneville ◽  
S. Marceau ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Obese Patients ◽  
Tissue Composition ◽  
Differential Impact ◽  
Severely Obese

Effects of bariatric surgery on the glomerular integrity of morbidly obese patients with chronic kidney disease (CKD)

2018 ◽  
Vol 14 (11) ◽  
pp. S2 ◽  
Author(s):  
David Romero Funes ◽  
David Gutierrez Blanco ◽  
Mauricio F Sarmiento-Cobos ◽  
Rama Ganga ◽  
Emanuele Lo Menzo ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Morbidly Obese ◽  
Obese Patients

Restored insulin inhibition on insulin secretion in nondiabetic severely obese patients after weight loss induced by bariatric surgery

2003 ◽  
Vol 27 (4) ◽  
pp. 463-468 ◽  
Author(s):  
J A Pereira ◽  
B M Claro ◽  
J C Pareja ◽  
E A Chaim ◽  
B D Astiarraga ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Insulin Secretion ◽  
Obese Patients ◽  
Severely Obese ◽  
Insulin Inhibition

Abstract 16319: Large Weight Loss Improves Left Ventricular Geometry but Not Myocardial Function 6 Months After Bariatric Surgery (the Fatwest Study)

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Lisa M Grymyr ◽  
Saied Nadirpour ◽  
Eva Gerdts ◽  
Johannes Hjertaas ◽  
Bjørn Nedrebø ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Heart Rate ◽  
Weight Loss ◽  
Systolic Function ◽  
Wall Stress ◽  
Left Ventricular ◽  
Obese Patients ◽  
Large Weight Loss ◽  
Lv Mass ◽  
Severely Obese

Background: Bariatric surgery causes rapid and large weight loss and improves cardiovascular risk profile, yet the effect on left ventricular (LV) systolic function has been less explored. Methods: In the prospective FatWest (Bariatric Surgery on the West Coast of Norway) study 98 severely obese patients (44±10 years, 72% women, preoperative body mass index [BMI] 41.8±4.8 kg/m 2 , 36% with hypertension) underwent echocardiography before and 5.9 months after gastric bypass surgery. We assessed changes in LV geometry and systolic function by biplane ejection fraction (EF), midwall shortening (MWS) and mitral annular systolic velocity (s′). LV hypertrophy was defined based on LV mass/height 2.7 . Myocardial O 2 demand was derived from the LV mass-wall stress-heart rate product. Results: Patients experienced on average a 10 kg/m 2 reduction in BMI, and a significant drop in heart rate and blood pressure (all p<0.001). LV mass (-12 g) and myocardial O 2 demand improved significantly (all p<0.01). However, LV EF (60 vs. 61%), s’ (8.5 vs. 8.3cm/s) and MWS (16.1 vs. 15.7%) remained unchanged, and 45% of patients had low MWS 6 months after surgery (Figure). In multivariable regression analyses, LV mass reduction was predicted by weight loss and female sex, independent of changes in blood pressure and heart rate (R 2 0.24, p <0.001) while lower myocardial O2 demand was explained by improvement in its three components, particularly lower LV end-systolic wall stress (R 2 0.9, p<0.001). Conclusion: In severely obese patients with normal EF, bariatric surgery induces a significant reduction in BMI, LV mass and myocardial O 2 demand, but no improvement in LV myocardial systolic function 6 months after surgery.

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