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

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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Erratum to: ESR1, FTO, and UCP2 Genes Interact with Bariatric Surgery Affecting Weight Loss and Glycemic Control in Severely Obese Patients

Obesity Surgery ◽

10.1007/s11695-011-0564-1 ◽

2011 ◽

Vol 22 (1) ◽

pp. 194-194

Author(s):

Tsan-Hon Liou ◽

Hsin-Hung Chen ◽

Weu Wang ◽

Shu-Fen Wu ◽

Yi-Chih Lee ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Glycemic Control ◽

Obese Patients ◽

Severely Obese

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Outcomes of Bariatric Surgery in Morbidly Obese Patients with Multiple Sclerosis

Journal of Obesity ◽

10.1155/2017/1935204 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 3

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.

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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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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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Efficacy of a liquid low-energy formula diet in achieving preoperative target weight loss before bariatric surgery

Journal of Nutritional Science ◽

10.1017/jns.2016.13 ◽

2016 ◽

Vol 5 ◽

Cited By ~ 14

Author(s):

Lone V. Nielsen ◽

Mette S. Nielsen ◽

Julie B. Schmidt ◽

Sue D. Pedersen ◽

Anders Sjödin

Keyword(s):

Blood Pressure ◽

Bariatric Surgery ◽

Weight Loss ◽

Fat Mass ◽

Blood Parameters ◽

Low Energy ◽

Fat Free Mass ◽

Obese Patients ◽

Target Weight ◽

Severely Obese

AbstractA preoperative weight loss of 8 % is a prerequisite to undergo bariatric surgery (BS) in Denmark. The aim of the present study was to evaluate the efficacy of a 7- or an 11-week low-energy diet (LCD) for achieving preoperative target weight before BS. A total of thirty obese patients (BMI 46·0 (sd 4·4) kg/m2) followed an LCD (Cambridge Weight Plan®, 4184 kJ/d (1000 kcal/d)) for 7 or 11 weeks as preparation for BS. Anthropometric measurements including body composition (dual-energy X-ray absorptiometry), blood parameters and blood pressure were assessed at weeks 0, 7 and 11. At week 7, the majority of patients (77 %) had reached their target weight, and this was achieved after 5·4 (sem 0·3) weeks. Mean weight loss was 9·3 (sem 0·5) % (P < 0·01) and consisted of 41·6 % fat-free mass (FFM) and 58·4 % fat mass. The weight loss was accompanied by a decrease in systolic and diastolic blood pressure (7·1 (sem 2·3) and 7·3 (sem 1·8) mmHg, respectively, all P < 0·01) as well as an improved metabolic profile (8·2 (sem 1·8) % decrease in fasting glucose (P < 0·01), 28·6 (sem 6·4) % decrease in fasting insulin (P < 0·01), 23·1 (sem 2·2) % decrease in LDL (P < 0·01), and 9·7 (sem 4·7) % decrease in TAG (P < 0·05)). Weight, FFM and fat mass continued to decrease from week 7 to 11 (all P < 0·01), whereas no additional improvements was observed in the metabolic parameters. Severely obese patients can safely achieve preoperative target weight on an LCD within 7 weeks as part of preparation for BS. However, the considerable reduction in FFM in severely obese subjects needs further investigation.

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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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ESR1, FTO, and UCP2 Genes Interact with Bariatric Surgery Affecting Weight Loss and Glycemic Control in Severely Obese Patients

Obesity Surgery ◽

10.1007/s11695-011-0457-3 ◽

2011 ◽

Vol 21 (11) ◽

pp. 1758-1765 ◽

Cited By ~ 26

Author(s):

Tsan-Hon Liou ◽

Hsin-Hung Chen ◽

Weu Wang ◽

Shu-Fen Wu ◽

Yi-Chih Lee ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Glycemic Control ◽

Obese Patients ◽

Severely Obese

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Improved blood pressure, nitric oxide and asymmetric dimethylarginine are independent after bariatric surgery

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1258/acb.2012.012069 ◽

2012 ◽

Vol 49 (6) ◽

pp. 589-594 ◽

Cited By ~ 4

Author(s):

R Patle ◽

S Dubb ◽

J Alaghband-Zadeh ◽

R A Sherwood ◽

F Tam ◽

...

Keyword(s):

Nitric Oxide ◽

Blood Pressure ◽

Bariatric Surgery ◽

Weight Loss ◽

Asymmetric Dimethylarginine ◽

Obese Patients ◽

Endogenous Inhibitor ◽

Nitrite Concentration ◽

Plasma Adma ◽

Adma Concentration

Background Obesity is associated with hypertension, but the exact mechanism is not fully understood. Bariatric surgery significantly decreases weight and blood pressure (BP). Low plasma nitric oxide (NO) and raised asymmetric dimethylarginine (ADMA), an endogenous inhibitor of NO, concentrations are associated with both obesity and hypertension. Correlations between the changes in these parameters were studied after bariatric surgery. Methods Weight, BP, plasma ADMA and NO were measured in 29 obese patients (24 female, 5 male) before and six weeks after bariatric surgery. Results Patients were 39.2 ± 1.2 (mean ± SEM) years old and weighed 126 ± 3 kg. Six weeks after the surgery, patients had lost 10 ± 0.7 kg ( P < 0.0001) and mean arterial pressure (MAP) decreased by 11 ± 1.0 mmHg ( P < 0.0001). The plasma ADMA concentration decreased by 24 ± 2% from 5 ± 0.4 to 4.0 ± 0.3 μmol/L ( P < 0.0001). The plasma total nitrite concentration increased by 15 ± 1% from 51.4 ± 2.6 to 60 ± 3 μmol/L ( P < 0.0001). The correlation between the decrease of ADMA and increase of NO subsequent to weight loss was significant ( P < 0.0001). However, MAP was not correlated to the changes in ADMA or NO. Conclusions After bariatric surgery, beneficial changes in BP, NO and ADMA occur, but our findings suggest that these BP changes are independent of changes in the NO–ADMA axis. Other causes for the changes in BP should therefore be considered.

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