Alterations in the Common Pathway of Coagulation During Weight Loss Induced by Gastric Bypass in Severely Obese Patients

Objectives: The growing prevalence of obesity rates worldwide is associated with an upsurge in its comorbidities, particularly type 2 diabetes mellitus (T2DM). Bariatric surgery is a proven treatment modality for producing sustained weight loss and resolution of associated T2DM providing marked improvement in quality of life with rapid recovery. This study aims to investigate the effects of laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (RYGB), and mini-gastric bypass (MGB) on obese patients suffering from T2DM in the Indian population and their long-term association with regard to diabetes remission, resolution of comorbidities, and percentage EWL. Methods: Retrospective data of obese patients with T2DM (preoperative BMI 45.37 ± 8.1) who underwent bariatric surgery (RYGB, LSG, and MGB) were analyzed in this study over a period of 9 years. The mean follow-up period was 2.2 years. Following surgery, the clinical outcome on BMI, resolution of percentage weight loss, and T2DM were studied. The predictive factors of diabetic remission after surgery were determined. Student’s t test and ANOVA and McNemar’s test were applied. Results: Out of a total of 274 patients, complete remission of T2DM was achieved in 52.9% (n = 145) with mean fasting blood glucose and glycated hemoglobin values being 6.1 ± 0.769 (p = 0.00) at 1 year after surgery. The independent predictive factors of remission were age, gender, BMI, preoperative comorbidities, and % EWL. Gender had no correlation with the chance of achieving disease remission. Conclusion: Based on our results, bariatric surgery proves to be a successful treatment option resulting in sustained weight loss in obese patients suffering from T2DM. It is found to be beneficial for the long-term resolution of T2DM and improving comorbidities such as hypertension and dyslipidemia. The outcome of the different surgical methods is found to be similar for all patients irrespective of the independent predictors of complete remission.

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GLP-1 and Adiponectin: Effect of Weight Loss After Dietary Restriction and Gastric Bypass in Morbidly Obese Patients with Normal and Abnormal Glucose Metabolism

Obesity Surgery ◽

10.1007/s11695-008-9678-5 ◽

2008 ◽

Vol 19 (3) ◽

pp. 313-320 ◽

Cited By ~ 45

Author(s):

Camila Puzzi de Carvalho ◽

Daniela Miguel Marin ◽

Aglécio Luiz de Souza ◽

José Carlos Pareja ◽

Elintom Adami Chaim ◽

...

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Glucose Metabolism ◽

Dietary Restriction ◽

Morbidly Obese ◽

Obese Patients ◽

Abnormal Glucose Metabolism

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Characterization of one anastomosis gastric bypass and impact of biliary and common limbs on bile acid and postprandial glucose metabolism in a minipig model

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00356.2020 ◽

2021 ◽

Author(s):

Camille Marciniak ◽

Oscar Chávez-Talavera ◽

Robert Caiazzo ◽

Thomas Hubert ◽

Lorea Zubiaga ◽

...

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Body Weight ◽

Glucose Metabolism ◽

Glucose Homeostasis ◽

Body Weight Loss ◽

Metabolic Effects ◽

One Anastomosis Gastric Bypass ◽

Alimentary Limb ◽

The Common

Background/Objectives: The alimentary limb has been proposed to be a key driver of the weight-loss-independent metabolic improvements that occur upon bariatric surgery. However, the One Anastomosis Gastric Bypass (OAGB) procedure, consisting of one long biliary limb and a short common limb, induces stronger beneficial metabolic effects compared to Roux-en-Y Gastric Bypass (RYGB) in humans, despite the lack of an alimentary limb. The aim of this study was to assess the role of the biliary and common limbs in the weight-loss and metabolic effects that occur upon OAGB. Subjects/Methods: OAGB and sham surgery, with or without modifications of the length of either the biliary limb or the common limb, were performed in Gottingen-like minipigs. Weight loss, metabolic changes, and the effects on plasma and intestinal bile acids (BAs) were assessed 15 days after surgery. Results: OAGB significantly decreased body weight, improved glucose homeostasis, increased postprandial GLP-1 and fasting plasma BAs, and qualitatively changed the intestinal BA species composition. Resection of the biliary limb prevented the body weight loss effects of OAGB and attenuated the postprandial GLP-1 increase. Improvements in glucose homeostasis along with changes in plasma and intestinal BAs occurred after OAGB regardless of the biliary limb length. Resection of only the common limb reproduced the glucose homeostasis effects and the changes in intestinal BAs. Conclusions: Our results suggest that the changes in glucose metabolism and BAs after OAGB are mainly mediated by the length of the common limb, whereas the length of the biliary limb contributes to body weight loss.

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Gastric bypass achieves sustained weight loss in severely obese teenagers, studies show

BMJ ◽

10.1136/bmj.j83 ◽

2017 ◽

pp. j83

Author(s):

Susan Mayor

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Sustained Weight Loss ◽

Severely Obese

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Short- and Long-Term Effects of Weight Loss on the Complement Component C3 After Laparoscopic Gastric Bypass in Obese Patients

Obesity Surgery ◽

10.1007/s11695-016-2195-z ◽

2016 ◽

Vol 26 (11) ◽

pp. 2756-2763 ◽

Cited By ~ 5

Author(s):

Segundo Á. Gómez-Abril ◽

Carlos Morillas-Ariño ◽

Jose L. Ponce-Marco ◽

Teresa Torres-Sánchez ◽

Fernando Delgado-Gomis ◽

...

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Laparoscopic Gastric Bypass ◽

Complement Component ◽

Obese Patients ◽

Long Term Effects ◽

Complement Component C3 ◽

Short And Long Term

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Association of Circulating Irisin Concentrations with Weight Loss after Roux-en-Y Gastric Bypass Surgery

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16040660 ◽

2019 ◽

Vol 16 (4) ◽

pp. 660 ◽

Cited By ~ 3

Author(s):

Yeon Lee ◽

Yoonseok Heo ◽

Ji-Ho Choi ◽

Sunghyouk Park ◽

Kyoung Kim ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Gastric Bypass ◽

Bypass Surgery ◽

Excess Weight Loss ◽

Gastric Bypass Surgery ◽

Morbidly Obese ◽

Obese Patients ◽

Preoperative Serum ◽

One Year

Irisin is a myokine with potential anti-obesity properties that has been suggested to increase energy expenditure in obese patients. However, there is limited clinical information on the biology of irisin in humans, especially in morbidly obese patients undergoing bariatric surgery. We aimed to assess the association of circulating irisin concentrations with weight loss in obese patients undergoing bariatric surgery. This was a pilot, single-centre, longitudinal observational study. We recruited 25 morbidly obese subjects who underwent Roux-en-Y gastric bypass surgery (RYGBP), and blood samples from 12 patients were taken to measure serum irisin concentrations before, and one and nine months after surgery. Their clinical characteristics were measured for one year. The preoperative serum irisin concentration (mean 1.01 ± 0.23 μg/mL, range 0.73–1.49) changed bidirectionally one month after RYGBP. The mean concentration at nine months was 1.11 ± 0.15 μg/mL (range 0.92–1.35). Eight patients had elevated irisin levels compared with their preoperative values, but four did not. Elevations of irisin levels nine months, but not one month, after surgery, were associated with lower preoperative levels (p = 0.016) and worse weight reduction rates (p = 0.006 for the percentage excess weight loss and p = 0.032 for changes in body mass index). The preoperative serum irisin concentrations were significantly correlated with the percentage of excess weight loss for one year (R2 = 0.612; p = 0.04) in our study. Our results suggest that preoperative circulating irisin concentrations may be at least in part associated with a weight loss effect of bariatric surgery in morbidly obese patients. Further large-scale clinical studies are needed to ratify these findings.

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