The Impact of Rapid Weight Loss after Bariatric Surgery on the Systemic Inflammatory Response and Pulmonary Hemodynamics in Severely Obese Subjects with Pulmonary Hypertension

Objective. Obesity is linked with a state of increased oxidative stress, which plays an important role in the etiology of atherosclerosis and type 2 diabetes mellitus. The aim of our study was to evaluate the effect of rapid weight loss on oxidative stress markers in obese individuals with metabolic syndrome (MetS).Design and Methods. We measured oxidative stress markers in 40 obese subjects with metabolic syndrome (MetS+), 40 obese subjects without metabolic syndrome (MetS−), and 20 lean controls (LC) at baseline and after three months of very low caloric diet.Results. Oxidized low density lipoprotein (ox-LDL) levels decreased by 12% in MetS+ subjects, associated with a reduction in total cholesterol (TC), even after adjustment for age and sex. Lipoprotein associated phospholipase A2(Lp-PLA2) activity decreased by 4.7% in MetS+ subjects, associated with a drop in LDL-cholesterol (LDL-C), TC, and insulin levels. Multivariate logistic regression analysis showed that a model including ox-LDL, LpPLA2activity, and myeloperoxidase (MPO) improved prediction of MetS status among obese individuals compared to each oxidative stress marker alone.Conclusions. Oxidative stress markers were predictive of MetS in obese subjects, suggesting a higher oxidative stress. Rapid weight loss resulted in a decline in oxidative stress markers, especially in MetS+ patients.

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

Surgical Endoscopy ◽

10.1007/s00464-019-07094-1 ◽

2019 ◽

Vol 34 (7) ◽

pp. 3197-3203 ◽

Cited By ~ 1

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

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THE INFLUENCE OF BARIATRIC SURGERY ON THE COURSE OF CARDIOVASCULAR DISEASES

Fiziolohichnyĭ zhurnal ◽

10.15407/fz67.05.064 ◽

2021 ◽

Vol 67 (5) ◽

pp. 64-72

Author(s):

V.V. Gorbachova ◽

◽

I.M. Todurov ◽

O.I. Plegutsa ◽

K.M. Khorevina ◽

...

Keyword(s):

Heart Failure ◽

Bariatric Surgery ◽

Coronary Artery Disease ◽

Weight Loss ◽

Coronary Artery ◽

Cardiovascular Diseases ◽

Long Term Results ◽

Rapid Weight Loss ◽

Artery Disease ◽

The Impact

Obesity is an established risk factor for cardiovascular diseases (CVD) such as hypertension (HD), coronary artery disease (CAD), heart failure (HF), arrhythmias and venous thromboembolism. Lifestyle modifications to reduce weight have been shown to be successful in the short term, however their long-term results are still equivocal likely due to modest weight reduction and high recurrence rates. Bariatric surgery has been recognized as the most effective strategy in achieving substantial sustained weight loss, and can prevent the development or reverse CVD, metabolic syndrome, diabetes mellitus, obstructive sleep apnea syndrome, cancer, and COVID-associated complications. Bariatric surgery results in rapid weight loss over several months that lasts for at least 12-18 months. The surgery lowers all-cause mortality risks, risks of myocardial infarction and stroke. Furthermore, bariatric surgery contributes to the reduction of urgent hospitalizations for heart failure, coronary artery disease, and hypertension. The article shows modern view on the impact of bariatric surgery on the pathogenesis of the CVD in patients with obesity, indications and contraindications of the surgery, tactics of management of patients with existing cardiovascular pathology before the bariatric surgery.

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Reduction of Framingham BMI score after rapid weight loss in severely obese subjects undergoing sleeve gastrectomy: a single institution experience

Surgical Endoscopy ◽

10.1007/s00464-017-5799-z ◽

2017 ◽

Vol 32 (3) ◽

pp. 1248-1254 ◽

Cited By ~ 10

Author(s):

David Gutierrez-Blanco ◽

David Funes-Romero ◽

SriGita Madiraju ◽

Federico Perez-Quirante ◽

Emanuele Lo Menzo ◽

...

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Rapid Weight Loss ◽

Single Institution ◽

Severely Obese ◽

Obese Subjects

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Impact of rapid weight loss on risk reduction of developing arterial hypertension in severely obese patients undergoing bariatric surgery. A single-institution experience using the Framingham Hypertension Risk Score

Surgery for Obesity and Related Diseases ◽

10.1016/j.soard.2019.03.008 ◽

2019 ◽

Vol 15 (6) ◽

pp. 920-925 ◽

Cited By ~ 1

Author(s):

David Gutierrez Blanco ◽

David Romero Funes ◽

Giulio Giambartolomei ◽

Emanuele Lo Menzo ◽

Samuel Szomstein ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Arterial Hypertension ◽

Risk Reduction ◽

Risk Score ◽

Rapid Weight Loss ◽

Obese Patients ◽

Single Institution ◽

Hypertension Risk ◽

Severely Obese

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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 ◽

10.1161/circ.129.suppl_1.p084 ◽

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.

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Decrease of dipeptidyl peptidase 4 activity is associated with weight loss after bariatric surgery

Obesity Surgery ◽

10.1007/s11695-020-05200-0 ◽

2021 ◽

Author(s):

Carsten T. Herz ◽

Johanna M. Brix ◽

Bernhard Ludvik ◽

Guntram Schernthaner ◽

Gerit-Holger Schernthaner

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Hepatic Injury ◽

Dipeptidyl Peptidase ◽

Diabetic Patients ◽

Metabolic Dysfunction ◽

Dipeptidyl Peptidase 4 ◽

Cholesterol Levels ◽

Glucagon Like Peptide 1 ◽

The Impact

Abstract Purpose Dipeptidyl peptidase 4 (DPP4) is expressed and secreted by adipocytes. DPP4 induces insulin resistance independently of its effect on glucagon-like peptide 1, thus it is conceivable that DPP4 directly contributes to metabolic dysfunction in patients with morbid obesity. The aim of this study was to investigate the impact of weight loss induced by bariatric surgery on DPP4 activity, and whether these changes are associated with improvements in markers of metabolic dysfunction and fatty liver disease. Materials and Methods We included 68 non-diabetic patients who underwent bariatric surgery. Serum DPP4 activity was measured using a fluorogenic substrate before and after surgery. Results Results: After a median follow-up period of 12 (IQR 11-17) months, median serum DPP4 activity decreased from 230 (IQR: 194-273) to 193 (164-252) pmol/min (p=0.012). The decrease in DPP4 activity was significantly correlated with decreases in BMI, improved cholesterol levels, reduced hepatic injury markers as well as improved post-prandial insulin sensitivity. After multivariable adjustment, ΔDPP4 activity remained significantly associated with Δcholesterol (beta=0.341, p=0.025), ΔLDL cholesterol (beta=0.350, p=0.019), Δgamma-glutamyltransferase (beta=0.323, p=0.040) and ΔMatsuda index (beta=-0.386, p=0.045). Conclusion We demonstrated that weight loss induced by bariatric surgery results in decreased circulating DPP4 activity beyond the initial phase of weight loss. The associations between decreased DPP4 activity and improved cholesterol levels as well as hepatic injury markers point towards pleiotropic effects of DPP4 beyond glucose metabolism which warrant further investigation.

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