Zinc absorption and zinc status are reduced after either sleeve gastrectomy or Roux-en-Y gastric bypass in premenopausal women with severe obesity studied prospectively over 24 postoperative months

2021 ◽  
Author(s):  
Manuel Ruz ◽  
Fernando Carrasco ◽  
Pamela Rojas ◽  
Juana Codoceo ◽  
Jorge Inostroza ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Repeated Measures ◽  
Severe Obesity ◽  
Premenopausal Women ◽  
Absorption Capacity ◽  
Zinc Absorption ◽  
Zinc Status ◽  
Plasma Zinc ◽  
Hair Zinc

ABSTRACT Background Roux-en-Y gastric bypass (RYGBP) is known to reduce zinc absorption; the effects of vertical sleeve gastrectomy (SG) and its long-term implications on zinc absorption have not yet been studied. Objective The aim was to evaluate the effects of SG and RYGBP on zinc absorption and zinc status in premenopausal women with severe obesity up to 24 mo after surgery. Methods Twenty-six premenopausal women undergoing SG [BMI (in kg/m2): 37.3 ± 3.2] and 32 undergoing RYGBP (BMI: 42.0 ± 4.2) were studied. A series of anthropometric, dietary, and zinc status parameters (plasma and hair zinc), and the size of the exchangeable zinc pool (EZP), as well as percentage zinc absorption from a standardized dose using a stable isotope methodology were evaluated in the patients before the surgical procedure and at 12 and 24 mo after SG or RYGBP. SG patients received 15 mg and RYGBP received 25 mg of supplemental Zn/d. Results In premenopausal women, zinc absorption was decreased by 71.9% and 52.0% in SG and RYGBP, respectively, 24 mo postsurgery, compared with initial values. According to 2-factor repeated-measures ANOVA, time effect was significant (P = <0.0001), but not time × group interaction (P = 0.470). Plasma zinc below the cutoff point of 70 µg/dL increased from 0 to 15.4% and 38.1% in SG and RYGBP, respectively. Mean EZP was significantly reduced 24 mo after surgery, although no time × group interactions were observed. Hair zinc did not change across time or between groups. Conclusions Both SG and RYGBP have profound effects on zinc absorption capacity, which are not compensated for after 24 mo. Although zinc absorption reduction was similar in both types of surgeries, plasma zinc was more affected in RYGBP than SG, despite greater zinc supplementation in RYGBP. This trial was registered at http://www.isrctn.com as ISRCTN31937503.

scholarly journals A sympathetic gut connection drives the metabolic benefits of Roux-en-Y gastric bypass

Cell Stress ◽  
2020 ◽  
Vol 4 (12) ◽  
pp. 265-269
Author(s):  
Mohammed K. Hankir
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Body Weight ◽  
Sleeve Gastrectomy ◽  
Severe Obesity ◽  
Resting Metabolic Rate ◽  
Splanchnic Nerve ◽  
Negative Energy ◽  
Recent Issue ◽  
White Fat

Surgery is regarded by many as the go-to treatment option for severe obesity; yet how physically altering the gastrointestinal tract produces such striking results on body weight and overall metabolic health is poorly understood. In a recent issue of Cell Reports Ye et al. (2020) compare mouse models of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), the two most commonly performed weight loss surgeries in the clinic today, to show that the former reconfiguring procedure selectively increases resting metabolic rate through splanchnic nerve-mediated browning of mesenteric white fat. More significantly, they demonstrate that this effect for RYGB is required for the maintained negative energy balance and improved glycemic control that it confers.

Roux-en-Y Gastric Bypass versus Sleeve Gastrectomy: Nationwide data from the Danish quality registry for treatment of severe obesity

2021 ◽  
Author(s):  
Lotte Assing Winckelmann ◽  
Sigrid Bjerge Gribsholt ◽  
Lene Ring Madsen ◽  
Bjørn Richelsen ◽  
Elisabeth Svensson ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Severe Obesity ◽  
Quality Registry

Reduction in Long-term Mortality after Sleeve Gastrectomy and Gastric Bypass Compared to Non-surgical Patients with Severe Obesity

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Anita P. Courcoulas ◽  
Eric Johnson ◽  
David E. Arterburn ◽  
Sebastien Haneuse ◽  
Lisa J. Herrinton ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Severe Obesity ◽  
Surgical Patients ◽  
Long Term Mortality

scholarly journals First-Phase Insulin and Amylin after Bariatric Surgery: A Prospective Randomized Trial on Patients with Insulin Resistance or Diabetes after Gastric Bypass or Sleeve Gastrectomy

Obesity Facts ◽  
2020 ◽  
Vol 13 (6) ◽  
pp. 584-595
Author(s):  
Rahel Nussbaumer ◽  
Anne Christin Meyer-Gerspach ◽  
Ralph Peterli ◽  
Thomas Peters ◽  
Christoph Beglinger ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Gastric Bypass ◽  
Insulin Secretion ◽  
Sleeve Gastrectomy ◽  
Glycemic Control ◽  
Insulin Release ◽  
Severe Obesity ◽  
Intravenous Glucose ◽  
C Peptide ◽  
Postoperative Change

<b><i>Background:</i></b> Most patients with severe obesity show glucose intolerance. Early after sleeve gastrectomy (LSG) or gastric bypass (LRYGB), a marked amelioration in glycemic control occurs. The underlying mechanism is not yet clear. <b><i>Objective:</i></b> To determine whether the improvement in glycemic control on the level of endocrine pancreatic function is due to an increased first-phase insulin secretion comparing LRYGB to LSG. <b><i>Setting:</i></b> University of Basel Hospital and St. Clara Research Ltd., Basel, Switzerland. <b><i>Methods:</i></b> Sixteen morbidly obese patients with severe obesity and different degrees of insulin resistance were randomized to LSG or LRYGB, and islet cell functions were tested by intravenous glucose and intravenous arginine administration before and 4 weeks after surgery. <b><i>Results:</i></b> Fasting insulin and glucose levels and homeostasis model assessment insulin resistance were significantly lower in both groups after surgery compared to baseline, while no change was seen in fasting C-peptide, amylin, and glucagon. After intravenous glucose stimulation, no statistically significant pre- to postoperative change in area under the curve (AUC 0–60 min) was seen for insulin, glucagon, amylin, and C-peptide. No statistically significant pre- to postoperative change in incremental AUC for first-phase insulin release (AUC 0–10 min), second-phase insulin secretion (AUC 10–60 min), and insulin/glucose ratio could be shown in either group. Arginine-stimulated insulin and glucagon release showed no pre- to postoperative change. <b><i>Conclusion:</i></b> Intravenous glucose and arginine administrations show no pre- to postoperative changes of insulin release, amylin, glucagon, or C-peptide concentrations, and no differences between LRYGB and LSG were found. The postoperative improvement in glycemic control is not caused by changes in endocrine pancreatic hormone secretion.

scholarly journals Improvement of Lipid Profile after One-Anastomosis Gastric Bypass Compared to Sleeve Gastrectomy

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2770
Author(s):  
Silvia Bettini ◽  
Gianni Segato ◽  
Luca Prevedello ◽  
Roberto Fabris ◽  
Chiara Dal Prà ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Lipid Profile ◽  
Severe Obesity ◽  
Low Density Lipoprotein ◽  
Plasma Lipid ◽  
Density Lipoprotein ◽  
One Anastomosis Gastric Bypass ◽  
The Difference

Fewer studies compared the improvement of plasma lipid levels after different types of surgery, in particular compared to one-anastomosis gastric bypass (OAGB). The aim of our study was to investigate how laparoscopic sleeve gastrectomy (LSG) and OAGB impact on weight loss and lipid profile 18 months after surgery, in patients with severe obesity. Forty-six patients treated with OAGB were matched to eighty-eight patients submitted to LSG. Weight loss after OAGB (33.2%) was more evident than after LSG (29.6%) (p = 0.024). The difference in the prevalence of dyslipidemia showed a statistically significant reduction only after OAGB (61% versus 22%, p < 0.001). After adjustment for delta body mass index (BMI), age and sex, we demonstrated a statistically significant decrease of the differences between the changes before and after (delta Δ) the two surgery procedures: Δ total cholesterol values (p < 0.001), Δ low density lipoprotein-cholesterol values (p < 0.001) and Δ triglycerides values (p = 0.007). Patients with severe obesity undergoing to OAGB presented a better improvement of lipid plasma values than LSG patients. The reduction of lipid plasma levels was independent of the significant decrease of BMI after surgery, of age and of sex.

scholarly journals Mononuclear cell metallothionein mRNA levels in human subjects with poor zinc nutrition

2007 ◽  
Vol 97 (2) ◽  
pp. 247-254 ◽  
Author(s):  
Chong-Suk Kwon ◽  
Aggeliki M. Kountouri ◽  
Claus Mayer ◽  
Margaret-Jane Gordon ◽  
In-Sook Kwun ◽  
...  
Keyword(s):  
Phytic Acid ◽  
Mononuclear Cell ◽  
Human Subjects ◽  
Zinc Absorption ◽  
Mrna Levels ◽  
Zinc Status ◽  
Plasma Zinc ◽  
Zinc Intake ◽  
Transcript Levels ◽  
Zinc Nutrition

Human zinc deficiency is thought to be prevalent worldwide, particularly in populations with diets low in zinc and animal protein and high in inhibitors of zinc absorption, such as phytic acid. Confirmation of zinc deficiency is, however, difficult in the absence of a reliable and sensitive marker of zinc status. Under controlled conditions, T-lymphocyte metallothionein-2A (MT-2A) mRNA levels change in relation to zinc status and the objective of the present study was to investigate whether these transcript levels could be related to dietary zinc intake, plasma zinc or other biochemical parameters influenced by, or influencing, zinc metabolism in human subjects likely to be zinc deficient. Rural Koreans (n110, age 50–80 years) with a range of zinc and phytic acid dietary intake were recruited for the study and blood samples were analysed for plasma zinc, HDL, LDL, α-tocopherol and thiobarbituric acid reactive substances, mononuclear cell (MNC) MT-2A mRNA, serum protein and albumin, and blood haematocrit, Hb and glucose. Multiple correlation and principal component analysis showed a significant negative correlation between plasma zinc and MNC MT-2A mRNA levels. Female subjects had higher MT-2A transcript levels than males and MT-2A mRNA levels tended to increase with age. There was no significant association between dietary zinc intake or any index of zinc intake relating to dietary inhibitors of zinc absorption. It is concluded that MNC MT-2A mRNA levels cannot be used to predict poor zinc nutrition.

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