scholarly journals EFFECT OF SIZE OF INTESTINAL DIVERSIONS IN OBESE PATIENTS WITH METABOLIC SYNDROME SUBMITTED TO GASTRIC BYPASS

2016 ◽  
Vol 29 (suppl 1) ◽  
pp. 15-19 ◽  
Author(s):  
Rafael Jacques RAMOS ◽  
Cláudio Corá MOTTIN ◽  
Letícia Biscaino ALVES ◽  
Daniela BENZANO ◽  
Alexandre Vontobel PADOIN
Keyword(s):  
Metabolic Syndrome ◽  
Gastric Bypass ◽  
Loop Group ◽  
Intestinal Loop ◽  
Obese Patients ◽  
Alimentary Limb ◽  
Biliopancreatic Limb ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

ABSTRACT Background: There is no consensus on the ideal size of intestinal loops in gastric bypass of bariatric surgeries. Aim: To evaluate the metabolic outcome of patients submitted to gastric bypass with alimentary and biliopancreatic loops of different sizes. Methods: Was conducted a retrospective cohort study in diabetic obese patients (BMI≥35 kg/m2) with metabolic syndrome submitted to gastric bypass. The patients were divided into three groups according to the size of the intestinal loop: group 1, biliopancreatic limb 50 cm length and alimentary limb 100 cm length; group 2 , biliopancreatic limb 50 cm length and alimentary limb 150 cm length; and group 3, biliopancreatic limb 100 cm length and alimentary limb 150 cm length. The effect of gastric bypass with different sizes of intestinal loops in relation to the parameters that define metabolic syndrome was determined. Results: Sixty-three patients were evaluated, and they had a mean age of 44.7±9.4 years. All were diabetics, with 62 (98.4%) being hypertensive and 51 (82.2%) dyslipidemic. The three groups were homogeneous in relation to the variables. In 24 months, there was a remission of systemic arterial hypertension in 65% of patients in group 1, 62.5% in group 2 and 68.4% in group 3. Remission of diabetes occurred in 85% of patients in group 1, 83% in group 2 and 84% in group 3. There was no statistical difference in %LEW between the groups, and waist measurements decreased in a homogeneous way in all groups. The size of loops also had no influence on the improvement in dyslipidemia. Conclusion: Variation in size of intestinal loops does not appear to influence improvement in metabolic syndrome in this group of patients.

scholarly journals M86. CAN WEIGHT GAIN CAUSE METABOLIC SYNDROME A DECADE LATER IN PATIENTS WITH SCHIZOPHRENIA SPECTRUM DISORDER?

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S167-S167
Author(s):  
Moradi Hawar ◽  
Lars Helldin ◽  
Anna-Karin Olsson ◽  
Pontén Anna
Keyword(s):  
Metabolic Syndrome ◽  
Weight Gain ◽  
Life Time ◽  
Spectrum Disorder ◽  
Schizophrenia Spectrum Disorder ◽  
Group 4 ◽  
Schizophrenia Spectrum ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background Patients with schizophrenia spectrum disorder have a reduced life time expectancy with up to 20 years. Obesity and metabolic syndrome is highly prevalent and cardio vascular disease, CVD, remain the most common cause of the excess mortality. Despite studies showing the reduced life time expectancy and its causes the patients with schizophrenia spectrum disorder yet remain to benefit of the development of the healthcare. In this study we aim to focus on how the weight changes in different age groups and when do the cluster of conditions of metabolic syndrome start to occur. Methods In this naturalistic study we follow 71 patients, 47 man and 24 women diagnosed with schizophrenia spectrum disorder. We divided the patients into 5 different groups based on age. Group 1 aged 20–30 years, Group 2 aged 31–40 years, Group 3 aged 41–50 years, group 4 aged 51–60 years and Group 5 aged 61 years and elder. The longest time of observation was 18 years. Data on weight (kg) and disorders such as diabetes, hypertension and dyslipidemia were collected at baseline and then yearly thereafter. Data from baseline and the last yearly follow up were included in this study. Weight and the presence of the cluster of conditions that make up metabolic syndrome in the above-mentioned groups were analyzed. Results Patients in group 1 make the highest gain of weight with 0, 9 kg per year and group 2 with the least gain of weight only 0, 01 kg per year. Patients in group 3 have a weight loss of 0, 2 kg per year. At endpoint 9 out 19 patients in group 3 and 11 out of 21 patients in group 4 were treated for one, two or three conditions of the metabolic syndrome. Discussion In our study we show that weight gain appears at least 10 years before the development of metabolic syndrome. Despite the loss of weight that appear in group 3 the negative effects of the weight gained a decade earlier may be a factor that make patients aged 41 years and older to be at risk of developing metabolic syndrome.

scholarly journals Cough hypersensitivity in patients with metabolic syndrome: a clinical finding and its possible mechanisms

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiafen Cheng ◽  
Zhuangli Xie ◽  
Shengyuan Wang ◽  
Siwan Wen ◽  
Shanshan Niu ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Gastroesophageal Reflux ◽  
Induced Sputum ◽  
Minimum Concentration ◽  
Calcitonin Gene ◽  
Routine Physical Examination ◽  
Group 3 ◽  
Group 2 ◽  
Capsaicin Cough ◽  
Group 1

Abstract Purpose To investigate the changes of cough sensitivity in patients with metabolic syndrome and its possible mechanisms. Method A total of 29 metabolic syndrome (MetS) patients with OSAHS (group-1), 22 MetS patients without OSAHS (group-2), and 25 healthy controls (group-3) were included. All participants underwent a routine physical examination and completed the gastroesophageal reflux disease questionnaire (GerdQ), and the inflammatory mediator profile were determined. The cough threshold for capsaicin, induced sputum cell count and cell classification, and inflammatory mediators in induced sputum supernatants were compared. The correlation between capsaicin cough sensitivity and various indicators in the MetS population was analyzed. Results The minimum concentration of inhaled capsaicin needed to induce ≥ 5 coughs (C5) was significantly different among three groups (H = 14.393, P = 0.001) and lower for group-1 and group-2 than it for group-3 (P = 0.002, P = 0.005). The percentage of neutrophils in induced sputum and the concentrations of calcitonin gene-related peptide (CGRP), substance P (SP), and interleukin 8 (IL-8) in the sputum supernatant of group-1 and group-2 were significantly higher than those of group-3. Besides, the pepsin concentrations were significantly different among the 3 groups (F = 129.362, P < 0.001), which significantly was highest in group-1 (P < 0.001) and lowest in group-3 (P < 0.001). Triglycerides, AHI, pepsin concentration and BMI were risk factors of increased capsaicin cough sensitivity. Conclusion Increased capsaicin cough sensitivity in MetS patients is closely related to sleep apnea and gastroesophageal reflux. For patients in MetS patients without OSAHS, gastroesophageal reflux is an important factor for increased capsaicin cough sensitivity. Airway inflammation, especially airway neurogenic inflammation, may also play a role in the pathogenesis of increased capsaicin cough sensitivity. Trial registration The protocol was registered in the Chinese Clinical Trials Register (http://www.chictr.org.cn/) (ChiCTR1800014768). Written informed consent was obtained from all participants before enrollment.

The levels of leptin, adiponectin, and free fatty acids in the patients of different body weight presenting with myocardial infarction and elevated ST segment

2013 ◽  
Vol 59 (3) ◽  
pp. 8-12
Author(s):  
L V Kvitkova ◽  
D A Borodkina ◽  
O V Gruzdeva ◽  
O L Barbarash ◽  
A A Silonova ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Body Mass Index ◽  
Fatty Acids ◽  
Waist Circumference ◽  
Free Fatty Acids ◽  
Reference Values ◽  
Obese Patients ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The present study involed the patients (n=100) presenting with myocardial infarction (MI). Based on the body mass index, they were allocated to three groups: those with normal body mass index (BMI) (18.5≤BMI< 25 kg/m2; n=32; group 1), overweight patients (25≤BMI <30 kg/m2; n=42; group 2), and obese patients (BMI≤30 kg/m2; n=27; group 3). The laboratory studies included the measurement of serum adipocytokine levels (leptin, adiponectin, and free fatty acids (FFA)) in conjunction with the evaluation of insulin resistance (IR). All the patients regardless of BMI had the waist circumference in excess of the upper limit of the normal gender-specific values. Deviations from the reference values of leptin, adiponectin, and FFA levels were observed in 65.6% of the patients with normal BWI, in 69.0% of the overweight patients, and in 70.3% of the obese patients. In the patients of all the three groups, significant correlation was documented between waist circumference and the levels of leptin (group 1: r=0.3100, p=0.00; group 2: r=0.32, p=0.00; group 3: r=0.37, p=0.03) and adiponectin (group 1: r=-0.43, p=0.00; group 2: r=-0.35, p=0.04; group 3: r=-0.18, p=0.01). Moreover, the waist circumference significantly correlated with the occurrence of IR (group 1: r=0.11, p=0.04; group 2: r=0.45, p=0.00, group 3: r=0.34, p=0.03). It is concluded that the observed deviations of the parameters of interest from the respective reference values suggest disturbances in the metabolic and secretory functions of the visceral adipose tissue associated with the enlargement of its volume).

Evaluating Time to In-Hospital Venous Thromboembolism in Obese Patients

2019 ◽  
pp. 089719001984700
Author(s):  
B. Tate Cutshall ◽  
Alexandra W. Tatara ◽  
Navneet Upadhyay ◽  
Mobolaji Adeola ◽  
David Putney ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Surgical Patients ◽  
Obese Patients ◽  
Consensus Approach ◽  
Vte Prophylaxis ◽  
Pharmacologic Prophylaxis ◽  
Group 3 ◽  
Group 2 ◽  
Insight Into ◽  
Group 1

Background: Currently, no consensus approach exists for optimal venous thromboembolism (VTE) prophylaxis in obese (BMI ≥30 kg/m2) patients. Time to development of in-hospital VTE is not well studied. Objective: This study evaluates time to in-hospital VTE in obese patients. Methods: A single-center, retrospective study evaluated obese patients that developed an in-hospital VTE. Patients were categorized into 3 BMI groups: 30 to 34.9 (group 1), 35 to 39.9 (group 2), and ≥40 (group 3) kg/m2. The primary end point compared time to VTE between the groups. Results: A total of 246 patients were included, and time to VTE was similar between the groups, 8 (group 1) versus 8 (group 2) versus 9 days (group 3); P = .38. Secondary outcomes showed time to VTE was shorter in acute care versus ICU patients (7.5 vs 10 days; P = .01), nonsurgical versus surgical patients (6 vs 9 days; P = .004), and no prophylaxis versus mechanical plus pharmacologic prophylaxis (4.5 vs 9 days; P < .001). Conclusions: BMI category did not significantly impact time to in-hospital VTE. This study provides insight into the timing of in-hospital VTE in obese patients. The differences in prophylactic strategies highlight the importance of optimized prophylaxis.

scholarly journals ROLE OF METFORMIN ON CLOZAPINE INDUCED DYSLIPIDAEMIA IN WISTAR RATS

2018 ◽  
pp. 1-5
Author(s):  
Syed Shoib Md Hussaini ◽  
Akram A Naikwadi ◽  
Narsapur VU
Keyword(s):  
Diabetes Mellitus ◽  
Metabolic Syndrome ◽  
Type Ii Diabetes ◽  
Wistar Rats ◽  
Type Ii Diabetes Mellitus ◽  
Type Ii ◽  
Metabolic Derangement ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background: The clinical research in past decade has reported that most second-generation antipsychotics (SGAs) can cause serious metabolic derangement, which substantially increases the risk for type II diabetes mellitus. Several retrospective studies have shown increased in serum triglyceride in patients treated with Clozapine. SGAs induced metabolic syndrome is characterized by weight gain, hyperglycaemia, hypertension, hyperlipidaemia, glucose intolerance and insulin resistance. Metformin is currently used to treat metabolic syndrome and type II diabetes mellitus. It is therefore important to determine whether Metformin is efficacious in treating Clozapine-induced metabolic derangement like dyslipidaemia. Objectives: To evaluate the effect of Metformin in minimizing Clozapine induced metabolic derangement like dyslipidaemia. Methodology: Wistar rats weighing 180-240g either sex were divided into 3 groups of 6 rats each. Group 1 served as control, Group 2 Treated with Clozapine 25mg/kg body weight and Group 3 Treated with Clozapine 25mg + Metformin 100mg/kg body weight for 28 days P.O. Group 2 and group 3 were treated for 28 days. Biochemical investigations: Retro-orbital blood was collected for Lipid profile. Result: Lipid profile of group 2 rats treated with Clozapine showed dyslipidaemia (TG 103.3 ±1.7mg/dl, Tc 113.7 ±1.6mg/dl). Whereas group 3 rats treated with Clozapine 25mg + Metformin showed normal lipid levels (TG 94.7±1.7mg/dl, TC 102.8 ±0.8 mg/dl) comparable to group 1(TG 93.0 ±2.6mg/dl, TC 103.7 ±1.5mg/dl). Conclusion: This study exploring the use of Metformin to prevent metabolic derangement like dyslipidaemias in patients of schizophrenia treated with Clozapine. KEYWORDS: Clozapine; Metformin; Dyslipidaemia.

scholarly journals GENERATION OF IL-17 IMMUNE RESPONSE IN OBESE PATIENTS WITH ASTHMA

2017 ◽  
Vol 2 (2) ◽  
pp. 30-33
Author(s):  
MS S Nurdina ◽  
VI I Kupaev ◽  
OV V Sazonova
Keyword(s):  
Body Mass Index ◽  
Immune Response ◽  
Clinical Characteristics ◽  
Elisa Assay ◽  
Obese Patients ◽  
Asthma Treatment ◽  
Group 3 ◽  
Group 2 ◽  
Important Therapeutic Target ◽  
Group 1

Aim - to investigate the influence of IL-17, IL-10 on the level of asthma control among obese patients. Materials and methods. 79 patients with asthma aged from 18 to 65 years were enrolled in our study and categorized into three groups according to their body mass index (BMI): group 1 - normal BMI (27 (34,2%) patients, age 50±13,8), group 2 - overweight (28 (35,4%) patients, age 44±16,5) and group 3 - obese (24 patients (30,4%), age 57,3±8,2). These patients underwent spirometry and were compared for clinical characteristics, plasma level of IL-17 and IL-10 using ELISA assay. Results. IL-17 concentrations were higher in the obese and uncontrolled asthmatics. Statistically significant correlation between the level of IL-10 and BMI was not found. Conclusions. Our study shows that cytokines IL-17 play an important role in the immune response of asthma in obese patients, and represent an important therapeutic target for the asthma treatment.

Comparison of bursting pressure on sleeve gastrectomy staple lines between stapling, buttressing, and oversewing

2020 ◽  
pp. 155335062096900
Author(s):  
Salvatore Tolone ◽  
Claudio Gambardella ◽  
Gianmattia del Genio ◽  
Luigi Brusciano ◽  
Roberto Ruggiero ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Staple Line ◽  
Barbed Suture ◽  
Burst Pressure ◽  
Obese Patients ◽  
Staple Line Reinforcement ◽  
Bursting Pressures ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Backgrounds. One of the major complications after laparoscopic sleeve gastrectomy (LSG) is represented by leaks along the staple line. Several reinforcement techniques have been proposed, but scarce data about the real strengthening offered are present. Thus, we aimed to evaluate if different reinforcements produced different bursting pressures after LSG, and then to verify if the clinical application of the stronger reinforcement produced a reduction in leakage rate. Methods. We prospectively enrolled all consecutive obese patients that underwent LSG. We tested 3 different types of staple lines, as follows: group 1, no reinforcement; group 2, bioabsorbable buttress reinforcement; group 3, invaginating overrunning barbed suture. A burst pressure test was applied to the gastric specimen by means of high-resolution manometric catheter. After burst pressure tests, a subsequent consecutive series of patients were treated with the most effective reinforcement, and rate of leaks was recorded. Results. We enrolled in total 110 obese patients; 20 patients for each group of staple line reinforcement and then other 50 consecutive patients underwent LSG with the higher burst pressure staple line reinforcement. Median burst pressures were similar in group 1 and group 2; group 3 showed a statistically significant pressure increase ( P < .0001) than group 1 and group 2, with a 5.2-fold value. Other consecutive 50 obese patients underwent LSG with overrunning reinforcement. In none of them a leak was detected. Conclusions. Reinforcement of the SG staple line, with overrunning suture, seems to drastically increase bursting pressures in an ex vivo model and it is promising when reproduced in vivo.

Coronary Collaterals in Obese Patients: Impact of Metabolic Syndrome

Angiology ◽  
2008 ◽  
Vol 60 (2) ◽  
pp. 164-168 ◽  
Author(s):  
Hatice Sasmaz ◽  
Yilmaz Mehmet Birhan
Keyword(s):  
Metabolic Syndrome ◽  
Body Mass Index ◽  
Coronary Artery ◽  
Angina Pectoris ◽  
Body Mass ◽  
Symptom Duration ◽  
Obese Patients ◽  
Coronary Collaterals ◽  
Group 2 ◽  
Group 1

Obesity is a growing pandemic. Among obese patients with significant coronary artery stenosis, development of coronary collaterals was investigated. Consecutive 104 obese patients with stable angina pectoris were enrolled. Coronary collaterals were assessed according to the Cohen and Rentrop grading system and classified into 2 as those with poor collaterals (grade 0–1, Group 1) and those with good collaterals (grade 2–3, Group 2). Group 1 had higher body mass index, shorter duration of angina pectoris than Group 2. Poor collaterals were present in 82.3% and 59.5% of patients with and without ( P = .019) metabolic syndrome, respectively. Metabolic syndrome score (sum of each component) was found to be negatively correlated with Rentrop score ( r = −691; P < .001). After controlling for symptom duration and body mass index, metabolic syndrome kept independent association with poor collaterals among obese patients ( P = .043, B = 1.8). Metabolic syndrome appears to influence the development of coronary collaterals among obese patients with stable coronary artery disease.

MO698IS PERITONEAL DIALYSIS SUITABLE METHOD FOR OBESE PATIENTS?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Tatjana Damjanovic ◽  
Jelena Bjedov ◽  
Vesna Maslarevic Radovic ◽  
Bojan Stopić ◽  
Tatjana Rajcic ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Statistical Significance ◽  
Normal Weight ◽  
Prospective Clinical Study ◽  
Obese Patients ◽  
Adequate Treatment ◽  
Technique Survival ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background and Aims In recent years, obesity has reached epidemic proportions, and it's a great challenge to choose an adequate treatment for obese ESRD patients. The aim of the study was to analyze the outcome in patients with peritoneal dialysis with different degrees of nutrition expressed through body mass index at the beginning of treatment. Method The prospective clinical study included 53 incidental patients, who started peritoneal dialysis between June 2006 and August 2015. According to BMI on the beginning of treatment, patients were divided into three groups: normal weight: BMI of 18.5 - 24.9 kg/m2, n=17, overweight: BMI of 25 - 29.9 kg/m2, n=25, obese: BMI&gt; 30.0 kg/m2. n=11. Mechanical and infective complications, technique survival and patients survival were analyzed over 48 - months period. Results In terms of mechanical complications, there was no difference between the groups- malposition of the catheter (p = 0.769), leakage of dialysate (p = 0.462), hernia (p = 0.381). Exit sitе infection were most prevalent in group 3 - 1 episode/22 patient months vs 1 episode/30 patient months in groups 1 and 2, but without statistical significance (p = 0.272). However, the lowest incidence of peritonitis was in the group 3 - 1 episode/40 patient months vs 1 episode/30 patient months in group 2, and 1 episode/33 patient months in group 1, but even here the difference did not reach statistical significance (p = 0.624). Cardiovascular events – myocardial infarction, stroke and peripheral vascular disease were rare in all groups, with no statistical significance between groups. The incidence of hospitalizations was highest in the obese group – 1 episode/22 patient months vs 1 episode/27 patient months in group 2, and 1 episode/25 patient months in group 1 (p = 0.735). Kaplan Meier's analysis showed the worst, but not significant, survival of the technique in a group of obese patients (group 1 vs. group 2; p = 0.536; group 1 vs. group 3 - p= 0.662; group 2 vs. group 3 - p = 0.357). Also, overall patient survival was not differed between the groups (group 1 vs group 2 - p = 0.387; group 1 vs group 3 - p= 0.885; group 2 vs group 3 - p = 0.375). According to Cox's analysis, only values of total cholesterol at the end of the follow-up period (p = 0.027) and diastolic blood pressure (p = 0.013) were significantly associated with overall survival obese patients. Conclusion In the present study the degree of nutrition at the beginning of treatment had no significant effect on the outcome of peritoneal dialysis treatment. Therefore, patients should not be discouraged for peritoneal dialysis on the basis of BMI.

scholarly journals Predictive Factors of Secondary Normocalcemic Hyperparathyroidism after Roux-en-Y Gastric Bypass

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Claudio Casella ◽  
Sarah Molfino ◽  
Francesco Mittempergher ◽  
Carlo Cappelli ◽  
Nazario Portolani
Keyword(s):  
Bariatric Surgery ◽  
Vitamin D ◽  
Gastric Bypass ◽  
Vertical Banded Gastroplasty ◽  
Elapsed Time ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Normocalcemic Hyperparathyroidism ◽  
Group 1

Objective. Aim of this study is to evaluate determinants of secondary normocalcemic hyperparathyroidism (SNHPT) persistence in patients who have undergone Roux-en-Y gastric bypass on vertical-banded gastroplasty.Methods. 226 consecutive patients submitted to bariatric surgery were prospectively enrolled and divided in two groups on the basis of preoperative presence of SNHPT. For each patient, we evaluated anthropometric and laboratory parameters. Calcium metabolism (calcemia, PTH, and 25-hydroxy vitamin D serum levels) was studied before surgery and at 6-month intervals (6, 12, and 18 months) as surgical follow-up.Results. Based on presurgical SNHPT presence or absence, we definedgroup 1—201 patients andgroup 2—25 patients, respectively. Among thegroup 1, 153 (76%) recovered from this endocrinopathy within 6 months after surgery (group 3), while the remaining 48 patients (24%) had persistent SNHPT (group 4). Comparing the anthropometric and laboratory data ofgroup 3withgroup 2, the only statistically significant factor was the elapsed time since a prior effective medically controlled diet that led to a steady and substantial weight loss. We found also a statistically significant difference (p<0.05) betweengroup 3andgroup 4in term of % of weight loss and PTH levels.Conclusions. Patients suitable for bariatric surgery must have history of at least one efficient medically controlled diet, not dating back more than 5 years before surgery. This elapsed time represent the cut-off time within which it is possible to recover from SNHPT in the first semester after Roux-en-Y gastric bypass on vertical-banded gastroplasty. The treatment of vitamin D insufficiency and the evaluation of SNHPT before bariatric surgery should be recommended. The clinical significance of preoperative SNHPT and in particular SNHPT after bariatric surgery remains undefined and further studies are required.

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