Long-term follow-up of gonadal dysfunction in morbidly obese adolescent boys after bariatric surgery

Abstract Background Elevated body mass index (BMI) is associated with hypogonadism in men but this is not well described in adolescents. The aim is to evaluate gonadal dysfunction and the effects of weight loss after gastric banding in obese adolescent boys. Methods Thirty-seven of 54 boys (age 16.2±1.2 years, mean BMI 48.2 kg/m2) enrolled at the Center for Adolescent Bariatric Surgery at Columbia University Medical Center had low total testosterone for Tanner 5 <350 ng/dL. Sixteen had long-term hormonal data for analysis at baseline (T0), 1 year (T1) and 2 years (T2) post-surgery. T-tests, chi-squared (χ2) tests, correlation and linear mixed models were performed. Results At T0, the hypogonadal group had higher systolic blood pressure (SBP) (75th vs. 57th percentile, p=0.02), fasting insulin (19 vs. 9 μIU/mL, p=0.0008) and homeostatic index of insulin resistance (HOMA-IR) (4.2 vs. 1.9, p=0.009) compared to control group. Total testosterone was negatively correlated with fasting insulin and HOMA-IR. In the long-term analysis, BMI, weight, waist circumference (WC), and % excess weight decreased at T1 and T2 compared to T0. Mean total testosterone at T0, T1 and T2 were 268, 304 and 368 ng/dL, respectively (p=0.07). There was a statistically significant negative correlation between BMI and testosterone after 2 years (r=−0.81, p=0.003). Conclusions Low testosterone levels but unaltered gonadotropins are common in this group and associated with insulin resistance. While a significant increase in testosterone was not found over time, the negative relationship between BMI and testosterone persisted, suggesting there may be an optimal threshold for testosterone production with respect to BMI. Long-term studies are needed.

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Changes in Plasma Levels of N-Arachidonoyl Ethanolamine and N-Palmitoylethanolamine following Bariatric Surgery in Morbidly Obese Females with Impaired Glucose Homeostasis

Journal of Diabetes Research ◽

10.1155/2015/680867 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 13

Author(s):

Akhila Mallipedhi ◽

Sarah L. Prior ◽

Gareth Dunseath ◽

Richard M. Bracken ◽

Jonathan Barry ◽

...

Keyword(s):

Insulin Resistance ◽

Bariatric Surgery ◽

Glucose Homeostasis ◽

Fasting Glucose ◽

Morbidly Obese ◽

Fasting Insulin ◽

C Peptide ◽

Specific Analysis ◽

Obese Subjects ◽

Gender Specific

Aim. We examined endocannabinoids (ECs) in relation to bariatric surgery and the association between plasma ECs and markers of insulin resistance.Methods. A study of 20 participants undergoing bariatric surgery. Fasting and 2-hour plasma glucose, lipids, insulin, and C-peptide were recorded preoperatively and 6 months postoperatively with plasma ECs (AEA, 2-AG) and endocannabinoid-related lipids (PEA, OEA).Results. Gender-specific analysis showed differences in AEA, OEA, and PEA preoperatively with reductions in AEA and PEA in females postoperatively. Preoperatively, AEA was correlated with 2-hour glucose (r=0.55,P=0.01), HOMA-IR (r=0.61,P=0.009), and HOMA %S (r=-0.71,P=0.002). OEA was correlated with weight (r=0.49,P=0.03), waist circumference (r=0.52,P=0.02), fasting insulin (r=0.49,P=0.04), and HOMA-IR (r=0.48,P=0.05). PEA was correlated with fasting insulin (r=0.49,P=0.04). 2-AG had a negative correlation with fasting glucose (r=-0.59,P=0.04).Conclusion. Gender differences exist in circulating ECs in obese subjects. Females show changes in AEA and PEA after bariatric surgery. Specific correlations exist between different ECs and markers of obesity and insulin and glucose homeostasis.

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Obese patients with higher TSH levels had an obvious metabolic improvement after bariatric surgery

Endocrine Connections ◽

10.1530/ec-21-0360 ◽

2021 ◽

Vol 10 (10) ◽

pp. 1326-1336

Author(s):

Nannan Bian ◽

Xiaomeng Sun ◽

Biao Zhou ◽

Lin Zhang ◽

Qiu Wang ◽

...

Keyword(s):

Insulin Resistance ◽

Bariatric Surgery ◽

Thyroid Function ◽

Fasting Blood Glucose ◽

Thyroid Stimulating Hormone ◽

Morbidly Obese ◽

Obese Patients ◽

Free Triiodothyronine ◽

The Relationship ◽

Tsh Levels

Objective Bariatric surgery has become the most effective treatment for morbid obesity. Increasing evidence showed that bariatric surgery can alleviate insulin resistance and influence thyroid function. This study aimed to investigate the relationship between changes in thyroid function and adipose tissue insulin resistance (adipo-IR) after bariatric surgery. Methods A total of 287 non-diabetic participants with regular thyroid function were recruited and divided into the lean, overweight and obese groups. Among them, 50 morbidly obese patients submitted to bariatric surgery. Results The obese group had a higher level of adipo-IR, thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), FT3/free thyroxine (FT4) and metabolism disorders than the lean and overweight groups. BMI was correlated with TSH, FT3, FT3/FT4 and adipo-IR (r = 0.309, 0.315, 0.322 and 0.651, respectively, all P < 0.001). Adipo-IR was significantly correlated with TSH (r = 0.402, P < 0.001), FT3 (r = 0.309, P < 0.001), and FT3/FT4 (r = 0.228, P < 0.05). Bariatric surgery resulted in a sharp decline in BMI, adipo-IR, TSH, FT3 and FT3/FT4 levels, meanwhile, metabolic disorders improved. The decrease in BMI after bariatric surgery was significantly correlated with reductions in adipo-IR (r = 0.577, P < 0.001) and TSH (r = 0.401, P = 0.005). Interestingly, the fasting blood glucose, fasting insulin, adipo-IR and TSH in the higher TSH group decreased more remarkably than in the lower TSH group. Conclusion Obese individuals with higher TSH levels had an obvious metabolic improvement after bariatric surgery.

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Omentin-1 Changes following Biliopancreatic Diversion and Relationship with Cardiovascular Risk Factors

Annals of Nutrition and Metabolism ◽

10.1159/000491434 ◽

2018 ◽

Vol 73 (2) ◽

pp. 106-112 ◽

Cited By ~ 2

Author(s):

Daniel Antonio de Luis ◽

Susana García Calvo ◽

Juan Jose Lopez Gomez ◽

Olatz Izaola ◽

David Primo ◽

...

Keyword(s):

Insulin Resistance ◽

Blood Pressure ◽

Bariatric Surgery ◽

Weight Loss ◽

Biliopancreatic Diversion ◽

Fat Mass ◽

Fasting Blood Glucose ◽

Fasting Insulin ◽

Post Surgery ◽

Biliopancreatic Diversion Surgery

Introduction: Omentin-1 might play a role in the pathogenesis of insulin resistance and obesity. The aim of the present study was to evaluate the influence of weight loss after biliopancreatic diversion on serum omentin-1 concentrations. Material and Methods A Caucasian population of 24 morbid obese patients was analyzed before and after 12 months of a biliopancreatic diversion surgery. Biochemical and anthropometric evaluation were realized at basal visit and at 12 months. Body weight, fat mass, waist circumferences, blood pressure, fasting blood glucose, fasting insulin, insulin resistance (HOMA-IR), lipid concentrations and omentin-1 were measured. Results: After bariatric surgery and in both gender groups (males vs. females); BMI, weight, fat mass, waist circumference, blood pressure, glucose , total cholesterol, LDL cholesterol, triglycerides, HOMA-IR and fasting insulin decreased in a statistical manner from basal values. Omentin-1 levels increased after bariatric surgery and in both gender the improvement was similar (males vs. females); (delta: –87.1 ± 19.0 ng/dL; p = 0.02 vs. –93.8 ± 28.1 ng/dL; p = 0.03). In the multiple regression analysis adjusted by age and sex; BMI kg/m2 (Beta –0.32: 95% CI –3.98 to –0.12) and insulin UI/L (Beta –0.41: 95% CI –8.38 to –0.16) remained in the model with basal omentin-1 levels as dependent variable. The regression model with post-surgery omentin-1 levels as dependent variable showed as independent variables BMI kg/m2 (Beta –0.13: 95% CI –7.69 to –0.09) and insulin UI/L (Beta –0.24: 95% CI –5.69 to –0.08), too. Conclusion: This study showed a significant increase in omentin-1 levels after weight loss secondary biliopancreatic diversion surgery. A weak negative correlation with BMI and basal insulin levels was detected.

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MON-LB101 5-Year Data of an Aggressive Pharmacological Approach to Moderate and Morbid Obesity: Is Prevention of Bariatric Surgery Feasible in the Long Run?

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.2340 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Flavio Cadegiani

Keyword(s):

Bariatric Surgery ◽

Morbid Obesity ◽

Weight Loss ◽

Body Weight ◽

Weight Regain ◽

Morbidly Obese ◽

Biochemical Profile ◽

Initial Weight ◽

Initial Weight Loss

Abstract Background: Maintenance of weight loss in patients that undergo weight loss interventions is highly challenging, irrespective of the type of approach to obesity (whether surgical, pharmacological, or non-pharmacological). We proposed a protocol of an aggressive clinical treatment for obesity aiming to prevent the need of bariatric surgery, in patients unwilling to undergo this procedure, by proposing a protocol that included the combination of different anti-obesity medications and non-pharmacological modalities, for longer duration, and with an active approach to prevent weight regain. Our initial 2-year data showed that 93% (40 of 43 patients) with moderate and morbid obesity were able to avoid the need of bariatric surgery, with concomitant improvements of the biochemical profile. However, whether these patients would maintain their successful rates after five years was uncertain. Our objective is to describe the efficacy and safety of a long term (5-year data) pharmacological and multi-modal treatment for moderate and severe obesity. Methods: The 40 patients that were successful in the two-year approach in our obesity center (Corpometria Institute, Brasilia, DF, Brazil) were enrolled. A long-term anti-obesity protocol was employed, with continuous or intermittent use of anti-obesity drugs, trimestral body composition analysis, psychotherapy, visit to a nutritionist every four months, and both resistance and endurance exercises at least four times a week. Body weight (BW), total weight excess (TWE), body fat, markers of lipid and glucose metabolism, liver function, and inflammation were analyzed. Subjects that dropped out were considered as weight regain. Therapeutic success for the 5-year follow-up included as the maintenance of >20% loss of the initial BW loss, and no weight regain (or < 20% of the initial weight loss). Results: A total of 27 patients (67.5%) were able to maintain the body weight, seven dropped out, and six regained more than 20% of the initial weight loss. Of these, 21 (77.8%) had significant further increase of muscle mass and decrease of fat loss, while 17 (63.0%) had further weight loss (p < 0.05), compared to the 2-year data. Improvements on the biochemical profile persisted in all 27 patients, and had significant further improvements in 24 (88.9%) of these patients. Conclusion: The risk of weight regain five years after a weight loss treatment for obesity was significantly lower compared to previous literature, and comparable to the long-term outcomes of bariatric procedures. An aggressive, structured, and long-term clinical weight loss approach has been shown to be feasible, even for morbidly obese patients.

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Bariatric surgery in morbidly obese adolescents: long-term follow-up

International Journal of Pediatric Obesity ◽

10.3109/17477166.2011.606817 ◽

2011 ◽

Vol 6 (S1) ◽

pp. 65-69 ◽

Cited By ~ 18

Author(s):

Kurt Widhalm ◽

Maria Fritsch ◽

Harald Widhalm ◽

Gerd Silberhumer ◽

Sabine Dietrich ◽

...

Keyword(s):

Bariatric Surgery ◽

Morbidly Obese ◽

Obese Adolescents ◽

Long Term Follow Up

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Bariatric Surgery for Treatment of Sleep Apnea Syndrome in 15 Morbidly Obese Patients: Long-Term Results

Otolaryngology ◽

10.1067/mhn.2001.119139 ◽

2001 ◽

Vol 125 (4) ◽

pp. 299-302 ◽

Cited By ~ 52

Author(s):

Michael Scheuller ◽

Dudley Weider

Keyword(s):

Bariatric Surgery ◽

Sleep Apnea ◽

Sleep Apnea Syndrome ◽

Long Term Results ◽

Morbidly Obese ◽

Obese Patients ◽

Apnea Syndrome

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PSY3 Use Of A Discrete Event Simulation Model To Estimate Long Term Economic Outcomes Of Bariatric Surgery In Morbidly-Obese, Type-2 Diabetic Patients In Mexico

Value in Health ◽

10.1016/j.jval.2011.08.1712 ◽

2011 ◽

Vol 14 (7) ◽

pp. A568 ◽

Cited By ~ 1

Author(s):

O.O. Zanela ◽

H.A. Cabra ◽

P. Anaya ◽

S. Rodriguez ◽

G. Melendez ◽

...

Keyword(s):

Bariatric Surgery ◽

Discrete Event ◽

Morbidly Obese ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Event Simulation ◽

Discrete Event Simulation Model ◽

Type 2 Diabetic

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The Effect of Circuit Resistance Training on Plasma Levels of Amino acids, Alpha-hydroxybutyrate, Mannose, and Urinary Levels of Glycine Conjugated Adducts in Obese Adolescent Boys

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2020-0171 ◽

2020 ◽

Author(s):

Seyed Ali Rasooli ◽

Rozita Fathi ◽

Farhad Ahmadi-Kani Golzar ◽

Masoumeh Baghersalimi

Keyword(s):

Insulin Resistance ◽

Amino Acids ◽

Resistance Training ◽

Plasma Levels ◽

Control Group ◽

Adolescent Boys ◽

Obese Adolescent ◽

Urinary Levels ◽

Circuit Resistance Training ◽

Circuit Resistance

Few studies have examined the improving effects of exercise on the association between metabolites of impaired protein metabolism and insulin resistance in obese children. Therefore, this study aims to investigate the effect of circuit resistance training (CRT) on plasma levels of amino acids, alpha-hydroxybutyrate (α-HB), mannose, and urinary levels of glycine conjugated adducts in obese adolescent boys. Forty obese adolescent boys (BMI above the 95th percentile) with an age range of 14-17 were randomly divided into CRT group (n= 20) and control group (n= 20). The CRT program (3 times/week, 70-80% of 1 repetition maximum) was performed for 8 weeks. The results indicated that the body composition and plasma levels of glucose, insulin resistance, valine, mannose, lysine and the sum of branched-chain amino acids (BCAAs) were decreased due to CRT. The plasma levels of asparagine, glycine, serine, and urinary levels of glycine conjugated adduct also increased in the CRT group. Although α-HB level decreased during CRT, it had no significant difference from that of the control group. It can be concluded that the improvement in obesity complications including insulin resistance in obese adolescent boys after CRT may be due to decrease in plasma levels of mannose and BCAAs and increase urinary metabolites. Novelty Bullets: • CRT improves glucose metabolism and insulin resistance in obese adolescent boys. • CRT decreases plasma levels of mannose and BCAAs and normalizes other amino acids. • CRT increases urinary levels of glycine conjugated adducts.

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