scholarly journals Follow-up Study of Microflora Changes in Crevicular Gingival Fluid in Obese Subjects After Bariatric Surgery

2020 ◽  
Vol 30 (12) ◽  
pp. 5157-5161
Author(s):  
Bettina Balogh ◽  
Sándor Somodi ◽  
Miklós Tanyi ◽  
Cecília Miszti ◽  
Ildikó Márton ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Control Group ◽  
Obese Subjects ◽  
Obese Control ◽  
The Mean ◽  
Crevicular Fluid ◽  
Gingival Fluid ◽  
Repeat Sampling

AbstractThe objective of our study was to investigate the effect of weight loss on the crevicular microflora following bariatric surgery. Crevicular fluid samples were taken from 57 subjects: 22 were in the normal control group; 18 in the obese control group; and 17 patients had had bariatric surgery, who underwent a repeat sampling 6 to 12 months after the operation. Crevicular fluid samples were analyzed by MALDI-TOF MS analysis. After surgery and weight loss, the mean germ count increased, albeit not significantly. Also, Candida albicans and non-albicans Candida species: C. dubliniensis, C. kefyr, and C. lusitaniae appeared after surgery (p < 0.05) in subjects where Neisseria was either absent throughout or eliminated after surgery. However, periodontitis did not develop during this time in our subjects.

Abstract 018: Two-year Changes of Adiponectin after Bariatric Surgery and Their Association with Incident Type 2 Diabetes, Cardiovascular Disease, Cancer and Mortality: Results from the Swedish Obese Subjects Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Christian Herder ◽  
Markku Peltonen ◽  
Per-Arne Svensson ◽  
Maren Carstensen ◽  
Peter Jacobson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Control Group ◽  
Incident Type ◽  
Surgery Group ◽  
Obese Subjects

Introduction: Adiponectin has anti-inflammatory, insulin-sensitising and atheroprotective effects in rodents. Although serum adiponectin is uniformly downregulated in obesity, its clinical relevance in humans seems more complex. It is not known whether changes in circulating adiponectin predict type 2 diabetes, cardiovascular disease, cancer and mortality in an obese population. Hypothesis: We hypothesised that adiponectin levels are upregulated substantially after weight loss following bariatric surgery and that pronounced increases of adiponectin should offer better protection for individuals against type 2 diabetes. In addition, findings for type 2 diabetes should be compared to associations with cardiovascular disease, myocardial infarction, stroke, cancer and mortality. Methods: Serum concentrations of total adiponectin were measured in 3,223 participants of the Swedish Obese Subjects (SOS) Study (1,533 in the bariatric surgery group: 229 with gastric bypass, 1056 with vertical banded gastroplasty, 248 with adjustable gastric banding; 1,690 in the control group without surgery) at study baseline and after 2 years. Hazard ratios (HR) and 95% confidence intervals (CI) per 1 standard deviation (SD) of 2-year changes (concentration at year 2 - concentration at baseline) in adiponectin were calculated for incident type 2 diabetes, cardiovascular disease, myocardial infarction, stroke, cancer and mortality in the combined surgery group. Numbers of cases were 93, 122, 78, 55, 82 and 179, respectively. Median follow-up times ranged from 10 years for diabetes up to 16 years for mortality. Results: Mean (SD) levels of adiponectin at baseline were 7,453 (4,150) ng/ml in the combined surgery group and 8,247 (4,846) ng/ml in the control group. During the first 2 years of follow-up, adiponectin levels increased in the surgery group by 4,850 (5,387) ng/ml (parallel to a loss of 24% of body weight) and decreased slightly by 270 (2,650) ng/ml in the control group (parallel to a slight gain of 0.1% body weight). The degree of correlation between changes in adiponectin and weight loss in kg was more pronounced in the surgery groups compared with the control group (p=0.001 for interaction). Two-year increases in adiponectin in the surgery group were associated with decreased risk of type 2 diabetes (HR [95% CI] 0.61 [0.38-0.98], adjusted for baseline data for age, sex, BMI, lipids, blood pressure, alcohol consumption, smoking, anti-hypertensive drugs, glucose, insulin), but not with cardiovascular disease, myocardial infarction, stroke, cancer and mortality (adjusted HR between 0.89 and 1.05). Conclusions: Weight loss after bariatric surgery is paralleled by a substantial increase in circulating adiponectin. The degree of upregulation of adiponectin is associated with protection against future type 2 diabetes, but not with the incidence of cardiovascular outcomes, cancer or mortality.

scholarly journals Weight and Glycemic Control Outcomes of Bariatric Surgery and Pharmacotherapy in Patients With Melanocortin-4 Receptor Deficiency

2022 ◽  
Vol 12 ◽  
Author(s):  
Esphie Grace Fodra Fojas ◽  
Saradalekshmi Koramannil Radha ◽  
Tomader Ali ◽  
Evan P. Nadler ◽  
Nader Lessan
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Glycemic Control ◽  
Therapeutic Interventions ◽  
Control Group ◽  
Short Term ◽  
Melanocortin 4 Receptor ◽  
Significant Difference

BackgroundMelanocortin-4 receptor (MC4R) mutations are the most common of the rare monogenic forms of obesity. However, the efficacy of bariatric surgery (BS) and pharmacotherapy on weight and glycemic control in individuals with MC4R deficiency (MC4R-d) is not well-established. We investigated and compared the outcomes of BS and pharmacotherapy in patients with and without MC4R-d.MethodsPertinent details were derived from the electronic database among identified patients who had BS with MC4R-d (study group, SG) and wild-type controls (age- and sex-matched control group, CG). Short- and long-term outcomes were reported for the SG. Short-term outcomes were compared between the two groups.ResultsSeventy patients were screened for MC4R-d. The SG [six individuals (four females, two males); 18 (10–27) years old at BS; 50.3 (41.8–61.9) kg/m2 at BS, three patients with homozygous T162I mutations, two patients with heterozygous T162I mutations, and one patient with heterozygous I170V mutation] had a follow-up duration of up to 10 years. Weight loss, which varied depending on mutation type [17.99 (6.10–22.54) %] was stable for 6 months; heterogeneity of results was observed thereafter. BS was found superior to liraglutide on weight and glycemic control outcomes. At a median follow-up of 6 months, no significant difference was observed on weight loss (20.8% vs. 23.0%, p = 0.65) between the SG and the CG [eight individuals (four females, four males); 19.0 (17.8–36.8) years old at BS, 46.2 (42.0–48.3) kg/m2 at BS or phamacotherapeutic intervention]. Glycemic control in patients with MC4R-d and Type 2 diabetes improved post-BS.ConclusionOur data indicate efficacious short-term but varied long-term weight loss and glycemic control outcomes of BS on patients with MC4R-d, suggesting the importance of ongoing monitoring and complementary therapeutic interventions.

scholarly journals 9p21.3 Coronary Artery Disease Locus Identifies Patients With Treatment Benefit From Bariatric Surgery in the Nonrandomized Prospective Controlled Swedish Obese Subjects Study

2020 ◽  
Vol 13 (5) ◽  
pp. 460-465
Author(s):  
Peter Jacobson ◽  
Markku Peltonen ◽  
Per-Arne Svensson ◽  
Magdalena Taube ◽  
Johanna C. Andersson-Assarsson ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Risk Allele ◽  
Hazard Ratio ◽  
Control Group ◽  
Fasting Insulin ◽  
Unique Identifier ◽  
Treatment Benefit ◽  
Obese Subjects ◽  
Traditional Risk Factors

Background: Sequence variation at chromosome 9p21.3 accounts for 20% of myocardial infarctions (MIs) in several populations. Whereas the risk conferred by the 9p21.3 locus appears to act independently of traditional risk factors, studies suggest that the association between 9p21.3 and MI is modified by glucose homeostasis and lifestyle. We examined if the 9p21.3 variant rs1333049, along with the previously identified predictor fasting insulin, modifies the preventive effect of bariatric surgery on MI incidence. Methods: rs1333049 was genotyped in 1852 patients treated by bariatric surgery and 1803 controls given usual care in the SOS study (Swedish Obese Subjects). MI incidence was determined using national registers. Median follow-up was 21 years (interquartile range 18–24 years). Results: Overall, 366 MIs occurred during follow-up. Among rs1333049 risk-allele carriers (CC+GC), the incidence of MI was reduced in the surgery group compared with the control group (hazard ratio=0.72 [95% CI, 0.57–0.92], P =0.008). By contrast, noncarriers (GG) showed no significant differences in MI incidence between the treatment groups (hazard ratio=1.28 [0.86–1.90], P =0.227; interaction between treatment and the risk-allele P =0.016). In addition, carriers with higher fasting insulin (above the median [17 mmol/L]) experienced significantly higher MI incidence than carriers with lower fasting insulin (hazard ratio=0.58 [0.42–0.78], P <0.001, interaction P =0.031). Conclusions: In the SOS cohort, patients with the chromosome 9p21.3 rs1333049 risk allele together with high fasting insulin levels benefitted from bariatric surgery in terms of reduced incidence of MI. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT01479452.

scholarly journals Bariatric Surgery and Brain Health—A Longitudinal Observational Study Investigating the Effect of Surgery on Cognitive Function and Gray Matter Volume

Nutrients ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 127 ◽  
Author(s):  
Kristin Prehn ◽  
Thorge Profitlich ◽  
Ida Rangus ◽  
Sebastian Heßler ◽  
A. Veronica Witte ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gray Matter ◽  
Gray Matter Volume ◽  
Neuropsychological Test ◽  
Control Group ◽  
Rapid Weight Loss ◽  
Brain Health ◽  
Matter Volume

Dietary modifications leading to weight loss have been suggested as a means to improve brain health. In morbid obesity, bariatric surgery (BARS)—including different procedures, such as vertical sleeve gastrectomy (VSG), gastric banding (GB), or Roux-en-Y gastric bypass (RYGB) surgery—is performed to induce rapid weight loss. Combining reduced food intake and malabsorption of nutrients, RYGB might be most effective, but requires life-long follow-up treatment. Here, we tested 40 patients before and six months after surgery (BARS group) using a neuropsychological test battery and compared them with a waiting list control group. Subsamples of both groups underwent structural MRI and were examined for differences between surgical procedures. No substantial differences between BARS and control group emerged with regard to cognition. However, larger gray matter volume in fronto-temporal brain areas accompanied by smaller volume in the ventral striatum was seen in the BARS group compared to controls. RYGB patients compared to patients with restrictive treatment alone (VSG/GB) had higher weight loss, but did not benefit more in cognitive outcomes. In sum, the data of our study suggest that BARS might lead to brain structure reorganization at long-term follow-up, while the type of surgical procedure does not differentially modulate cognitive performance.

scholarly journals Outcomes of Bariatric Surgery in Morbidly Obese Patients with Multiple Sclerosis

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Kalman Bencsath ◽  
Adham Jammoul ◽  
Ali Aminian ◽  
Hideharu Shimizu ◽  
Carolyn J. Fisher ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Excess Weight ◽  
Control Group ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Percent Excess Weight Loss ◽  
Severely Obese

Obesity is common in patients with multiple sclerosis (MS); however, safety and efficacy of bariatric surgery in this population remain unclear. A database of 2,918 was retrospectively reviewed, yielding 22 (0.75%) severely obese patients with MS who underwent bariatric surgery. Sixteen surgical patients with complete follow-up data were matched to a nonsurgical control group of MS patients, based on age, BMI, MS subtype, and length of follow-up. MS relapse rates and trends in the timed twenty-five foot walk test (T25FW) were compared. In the surgical group (gastric bypass n=19, sleeve gastrectomy n=3), preoperative BMI was 46.5 ± 7.2 Kg/m2 and average excess weight was 60.4 kg. Follow-up data was collected at 59.0 ± 29.8 months. There were two major and four minor complications. Five patients required readmission and there were no mortalities. Percent excess weight loss was 75.5 ± 27.0%. In the 16 patients with follow-up data, patients who underwent bariatric surgery were significantly faster on the T25FW compared to the nonsurgical population. In conclusion, bariatric surgery is relatively safe and effective in achieving weight loss in patients with MS. In addition, surgery may help patients maintain ambulation. Findings support the need for further studies on bariatric surgery and disease-specific outcomes in this population.

scholarly journals Long-term incidence of colorectal cancer after bariatric surgery or usual care in the Swedish Obese Subjects study

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248550
Author(s):  
Magdalena Taube ◽  
Markku Peltonen ◽  
Kajsa Sjöholm ◽  
Richard Palmqvist ◽  
Johanna C. Andersson-Assarsson ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Bariatric Surgery ◽  
Rectal Cancer ◽  
Cancer Risk ◽  
Colorectal Cancer Risk ◽  
Control Group ◽  
Surgery Group ◽  
Obese Subjects

Bariatric surgery in patients with obesity is generally considered to reduce cancer risk in patients with obesity. However, for colorectal cancer some studies report an increased risk with bariatric surgery, whereas others report a decreased risk. These conflicting results demonstrate the need of more long-term studies analyzing the effect of bariatric surgery on colorectal cancer risk. Therefore, data from the Swedish Obese Subjects (SOS) study, ClinicalTrials.gov identifier: NCT01479452, was used to examine the impact of bariatric surgery on long-term incidence of colorectal cancer. The SOS study includes 2007 patients who underwent bariatric surgery and 2040 contemporaneously matched controls who received conventional obesity treatment. Patients in the surgery group underwent gastric bypass (n = 266), banding (n = 376) or vertical banded gastroplasty (n = 1365). Information on colorectal cancer events was obtained from the Swedish National Cancer Registry. Median follow-up was 22.2 years (inter-quartile range 18.3–25.2). During follow up there were 58 colorectal cancer events in the surgery group and 67 colorectal cancer events in the matched control group with a hazard ratio (HR) of 0.79 (95% CI:0.55–1.12; p = 0.183). After adjusting for age, body mass index, alcohol intake, smoking status, and diabetes, the adjusted HR was 0.89 (95% CI:0.62–1.29; p = 0.551). When analyzing rectal cancer events separately- 19 events in the surgery group and 31 events in the control group-a decreased risk of rectal cancer with surgery was observed (HR = 0.56; 95% CI:0.32–0.99; p = 0.045, adjusted HR = 0.61 (95% CI:0.34–1.10; p = 0.099), while the risk of colon cancer was unchanged. To conclude- in this long-term, prospective study, bariatric surgery was not associated with altered colorectal cancer risk.

scholarly journals Bariatric Surgery in Super-Superobese Patients Maintains Metabolic Improvement Beyond The Failure in Expected Weight Loss.

2021 ◽  
Author(s):  
Sergio Susmallian ◽  
Asnat Raziel ◽  
Irena Babis ◽  
Royi Barnea
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Perioperative Complications ◽  
Metabolic Effects ◽  
Revisional Bariatric Surgery ◽  
Super Obesity ◽  
The Mean

Abstract Background Extreme obesity leads to increased health risks and perioperative complications. The results of bariatric surgery in patients with super-super obesity (SSO) are presented in this study. Methods From April 2008 to August 2019, 60 patients with SSO underwent bariatric surgery. Their weight loss and surgical outcome were analyzed. The mean follow-up time was 7.2 years. Results At baseline, the mean age was 41.5 years old, the mean BMI was 63.8 kg/m2, 80% of the patients suffered from co-morbidities, and 23.33% were revisional surgeries. Weight loss continued for up to two years after surgery. The percentage of EBW lost at two years was 62.27%, from two to five years: 61.48%, from five to 10 years: 36.82% and after ten years it was 31.89%, the differences in weight change over the time is significative (P<.001). The mean BMI at last visit (Mean 7.2 years) was 45.1 kg/m2 and 48.33% of the patients failed to lose at least 50% of EBW. Patients with fatty liver, diabetes, sleep apnea and hyperlipidemia had a remission or improvement in more than 70% of the cases. There were 5% perioperative complications, one perioperative death (1.67%) and other patient died in a motor vehicle accident, overall mortality 3.33%. Conclusion In the long term, almost half of the patients failed to lose 50% of their EBW. However, the metabolic effects of bariatric surgery were maintained during the follow-up time with a high remission of comorbidities. Revisional bariatric surgery increased the risk of mortality.

scholarly journals Bariatric surgery and the incidence of rheumatoid arthritis – a Swedish Obese Subjects study

Rheumatology ◽  
2019 ◽  
Vol 59 (2) ◽  
pp. 303-309 ◽  
Author(s):  
Cristina Maglio ◽  
Yuan Zhang ◽  
Markku Peltonen ◽  
Johanna Andersson-Assarsson ◽  
Per-Arne Svensson ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Protocol Analysis ◽  
International Classification Of Diseases ◽  
Control Group ◽  
Intention To Treat ◽  
Classification Of Diseases ◽  
National Patient ◽  
Obese Subjects ◽  
Serum Crp

Abstract Objective The aim of this study was to determine the effect of bariatric surgery on the incidence of RA in participants of the Swedish Obese Subjects (SOS) study. Methods The SOS is a longitudinal study aiming to assess the effect of bariatric surgery on mortality and obesity-related diseases. This report includes 2002 subjects with obesity who underwent bariatric surgery and 2034 matched controls; none of them had RA at baseline. Cases of incident RA were identified through the Swedish National Patient Register by searching for International Classification of Diseases codes. Both intention-to-treat analyses and per-protocol analyses are reported. In the per-protocol analysis, participants from the control group who underwent bariatric surgery later on during follow-up were censored at the time of surgery. Results During follow-up, 92 study participants developed RA. The median follow-up was 21 years (range 0–29). Bariatric surgery was neither associated with the incidence of RA in the intention-to-treat analysis [hazard ratio (HR) 0.92 (95% CI 0.59, 1.46), P = 0.74], nor in the per-protocol analysis [HR 0.86 (95% CI 0.54, 1.38), P = 0.53]. Weight change at the 2 year follow-up, expressed as the change in BMI compared with baseline, did not associate with the development of RA. Higher serum CRP levels and smoking associated with the future development of RA independent of other factors. Conclusions We did not detect any association between bariatric surgery and the incidence of RA in subjects affected by obesity followed up for up to 29 years. ClinicalTrials.gov (http://clinicaltrials.gov): NCT01479452.

scholarly journals The safety and efficacy of bariatric surgery for obese, wheelchair bound patients

2014 ◽  
Vol 96 (5) ◽  
pp. 373-376 ◽  
Author(s):  
GJ Williams ◽  
PA Georgiou ◽  
DM Cocker ◽  
G Bonanomi ◽  
J Smellie ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Excess Weight Loss ◽  
Length Of Hospital Stay ◽  
Mobility Limitations ◽  
Mobility Impairment ◽  
The Mean ◽  
Lost To Follow Up

Introduction The aim of this study was to evaluate outcomes of bariatric surgery performed in order to improve mobility in patients with severe mobility limitations. Methods Patients with severe mobility impairment (wheelchair bound) who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic adjustable gastric banding (LAGB) surgery to improve their mobility were included in this study. Patients were identified between July 2009 and October 2011 using an electronic prospective bariatric database. Mobility was assessed by questionnaire during clinic follow-up appointments. Results Fifteen patients (11 female, 4 male) with a mean age of 48 years (range: 26–71 years) and a mean body mass index of 46kg/m2 (range: 33–54kg/m2) were included. Seven patients (47%) underwent LAGB and eight (53%) LRYGB. The aetiologies of mobility impairment included advanced osteoarthritis (n=6), spinal conditions (n=4), severe bilateral leg oedema and ulceration (n=2), advanced rheumatoid arthritis (n=2) and traumatic paraplegia (n=1). The mean length of hospital stay was 3.8 days. There was no mortality. One patient was lost to follow-up. Of the remaining 14 patients, the mean excess weight loss percentage at a mean of 18.5 months postoperatively was 48% (68% for LRYGB, 20 months; 29% for LAGB, 17 months). Ten patients reported improved mobility. Reduced pain, improved independence and ability to transfer were most commonly cited. Four patients reported no improvement in mobility (three LAGB patients, one LRYGB patient). Conclusions Bariatric surgery can safely improve mobility and quality of life in obese patients with severe mobility impairment. Our paper supports the idea that severe mobility impairment should be considered an indication for bariatric surgery in selected patients. LRYGB demonstrated better weight loss and mobility improvement than LAGB. Larger studies are required to establish robust selection criteria for surgery in this group.

scholarly journals Changes in the Composition and Function of Lipoproteins after Bariatric Surgery in Patients with Severe Obesity

2021 ◽  
Vol 10 (8) ◽  
pp. 1716
Author(s):  
Idoia Genua ◽  
Núria Puig ◽  
Inka Miñambres ◽  
Sonia Benítez ◽  
Pedro Gil ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Lipid Profile ◽  
Healthy Subjects ◽  
Control Group ◽  
Morbidly Obese ◽  
Qualitative Properties ◽  
Ldl Particles ◽  
Obese Subjects ◽  
Lipoprotein Composition ◽  
Qualitative Characteristics

The effect of bariatric surgery on lipid profile and the qualitative characteristics of lipoproteins was analyzed in morbidly obese subjects. Thirteen obese patients underwent bariatric surgery. Plasma samples were obtained before surgery and at 6 and 12 months after the intervention. Thirteen healthy subjects comprised the control group. Lipid profile, hsCRP, and the composition and functional characteristics of VLDL, LDL, and HDL were assessed. At baseline, plasma from subjects with obesity had more triglycerides, VLDLc, and hsCRP, and less HDLc than the control group. These levels progressively normalized after surgery, although triglyceride and hsCRP levels remained higher than those in the controls. The main differences in lipoprotein composition between the obese subjects and the controls were increased apoE in VLDL, and decreased cholesterol and apoJ and increased apoC-III content in HDL. The pro-/anti-atherogenic properties of LDL and HDL were altered in the subjects with obesity at baseline compared with the controls, presenting smaller LDL particles that are more susceptible to modification and smaller HDL particles with decreased antioxidant capacity. Bariatric surgery normalized the composition of lipoproteins and improved the qualitative characteristics of LDL and HDL. In summary, patients with obesity present multiple alterations in the qualitative properties of lipoproteins compared with healthy subjects. Bariatric surgery reverted most of these alterations.

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