scholarly journals Liver markers, prevalence of the metabolic syndrome abnormalities and effect of Roux-en-Y gastric bypass in morbidly obese subjects

2011 ◽  
Vol 9 (4) ◽  
pp. 429-435
Author(s):  
Ary Serpa Neto ◽  
Felipe Martin Bianco Rossi ◽  
Rodrigo Dal Moro Amarante ◽  
Marçal Rossi
Keyword(s):  
Metabolic Syndrome ◽  
Gastric Bypass ◽  
Heavy Drinking ◽  
University Hospital ◽  
Morbidly Obese ◽  
Metabolic Abnormalities ◽  
Glucose Levels ◽  
The Metabolic Syndrome ◽  
Obese Subjects ◽  
Liver Markers

ABSTRACT Objectives: To evaluate the relations between liver markers (GGT, ALT and AST) and the metabolic syndrome (and its components) in morbidly obese subjects, and to determine the response of these metabolic factors and hepatic enzymes after weight loss induced by Roux-en-Y gastric bypass. Methods: This study was carried out at a university hospital, in Santo André (SP), Brazil. We evaluated 140 morbidly obese subjects aged from 18 to 60 years submitted to a Roux-en-Y gastric bypass, who were followed for a mean period of 8 months. Patients with a history of heavy drinking, type 1 diabetes, and/or liver disease were excluded. Results: Liver markers, most notably GGT, were strongly associated with metabolic abnormalities, mainly hyperglycemia. The prevalence of type 2 diabetes significantly increased with increasing levels of GGT (highest versus lowest quartile GGT: odds ratio 3.89 [95%CI: 1.07-14.17]). Liver markers significantly decreased 8 months after the Roux-en-Y gastric bypass and the reduction of GGT levels were associated with the reduction of glucose levels (Pearson r = 0.286; p = 0.001). Conclusions: Elevated levels of liver markers, principally GGT, in morbidly obese subjects are associated with metabolic abnormalities. In addition to the well-known benefits of bariatric surgery, Roux-en-Y gastric bypass, reduced the levels of liver markers to the normal range.

scholarly journals Relation of uric acid with components of metabolic syndrome before and after Roux-en-Y gastric bypass in morbidly obese subjects

2011 ◽  
Vol 55 (1) ◽  
pp. 38-45 ◽  
Author(s):  
Ary Serpa Neto ◽  
Felipe Martin Bianco Rossi ◽  
Leonardo Guedes Moreira Valle ◽  
Gabriel Kushiyama Teixeira ◽  
Marçal Rossi
Keyword(s):  
Metabolic Syndrome ◽  
Gastric Bypass ◽  
Uric Acid ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Metabolic Abnormalities ◽  
Blood Samples ◽  
Glucose Levels ◽  
Before And After ◽  
Obese Subjects

OBJECTIVE: The purpose of the study was to investigate the prevalence of hyperuricemia in morbidly obese subjects before and after Roux-en-Y gastric bypass (RYGBP) and its relationship with metabolic syndrome abnormalities. SUBJECTS AND METHOD: We evaluated 420 morbidly obese patients. Pre and postoperative (8 months after RYGBP) blood samples were drawn. Obese patients underwent laparoscopic RYGBP and after eight months all the tests were repeated. RESULTS: The overall prevalence of hyperuricemia was 34.28%. Hyperuricemia was more common in men than in women (51.72 vs. 29.72%; p = 0.0002). Men with hyperuricemia were more likely to have diabetes (p = 0.034) and more elevated fasting plasma glucose levels (p = 0.027). Women with hyperuricemia were more likely to have hypertension (p = 0.003), metabolic syndrome (p = 0.001), elevated triglycerides (p = 0.001) and GGT (p = 0.009), and decreased HDL (p = 0.011). After surgery, uric acid levels decreased from 5.60 ± 1.28 to 4.23 ± 1.20 (p < 0.0001). The prevalence of hyperuricemia decreased from 33.6% to 6.4% (p < 0.0001), in men from 48.3% to 17.2% (p < 0.0001) and in women from 29.7% to 3.6% (p < 0.0001). CONCLUSION: Concentrations of uric acid were associated with the prevalence of metabolic abnormalities in this sample of morbidly obese patients. Also, weight loss after RYGBP can reduce uric acid levels and the prevalence of hyperuricemia.

scholarly journals Effect of Gastric Bypass and Gastric Banding on Proneurotensin Levels in Morbidly Obese Patients

2006 ◽  
Vol 91 (9) ◽  
pp. 3544-3547 ◽  
Author(s):  
Mirjam Christ-Crain ◽  
Rolf Stoeckli ◽  
Andrea Ernst ◽  
Nils G. Morgenthaler ◽  
Stefan Bilz ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Body Weight ◽  
Gastric Banding ◽  
University Hospital ◽  
Morbidly Obese ◽  
Gastrointestinal Hormone ◽  
Pronounced Increase ◽  
Long Term Follow Up ◽  
Overnight Fasting ◽  
Obese Subjects

Abstract Context: Neurotensin is produced mainly in the N cells of the ileum and has a role in appetite regulation; levels are decreased in obese subjects and increase after bariatric surgery. Mature neurotensin is very unstable, with a short half-life. Objective: The objective of this study was to compare baseline and postoperative levels of the more stable neurotensin precursor, proneurotensin/neuromedin (pro-NT/NMN), in patients after gastric banding, gastric bypass, and nonoperated controls, respectively, during long-term follow-up. Design and Setting: This was a prospective observational study in a university hospital. Participants and Main Outcome Measures: Overnight fasting plasma pro-NT/NMN concentrations were measured with a new sandwich immunoassay in morbidly obese subjects at baseline and 6, 12, and 24 months after gastric banding (n = 8), Roux-en-Y gastric bypass (n = 5), and in nonoperated controls (n = 7). Results: After gastric bypass and banding, body weight decreased by (mean ± sd) 29.5 ± 5.5 and 22.8 ± 5.9 kg, respectively. The decrease after 3 and 6 months was more pronounced after gastric bypass compared with gastric banding (P &lt; 0.05). Plasma pro-NT/NMN levels in patients after gastric bypass increased from 246.3 ± 174.3 pmol/liter on admission to 748.3 ± 429.6 pmol/liter after 24 months (P &lt; 0.01). In contrast, in patients with gastric banding, pro-NT/NMN concentrations remained stable (207.3 ± 60.5 pmol/liter at admission, 226.6 ± 116.8 pmol/liter after 24 months). Neither body weight nor plasma pro-NT/NMN levels changed in nonoperated controls. Conclusion: Plasma pro-NT/NMN levels show a more pronounced increase after gastric bypass compared with gastric banding, suggesting that specific bariatric surgical procedures result in distinct alterations of gastrointestinal hormone metabolism. The more stable precursor pro-NT/NMN provides a new tool to quantify neurotensin levels in clinical practice.

scholarly journals Insulin Resistance, Inflammation, and the Metabolic Syndrome Following Roux-en-Y Gastric Bypass Surgery in Severely Obese Subjects

Diabetes Care ◽  
2007 ◽  
Vol 30 (7) ◽  
pp. 1906-1908 ◽  
Author(s):  
R. Morinigo ◽  
R. Casamitjana ◽  
S. Delgado ◽  
A. Lacy ◽  
R. Deulofeu ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Gastric Bypass ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
The Metabolic Syndrome ◽  
Severely Obese ◽  
Obese Subjects

Percentage of excess BMI lost correlates better with improvement of metabolic syndrome after Roux-en-Y gastric bypass in morbidly obese subjects: anthropometric indexes and gastric bypass

2009 ◽  
Vol 5 (1) ◽  
pp. 11-18 ◽  
Author(s):  
Marçal Rossi ◽  
Ary Serpa Neto ◽  
Felipe Martin Bianco Rossi ◽  
Rodrigo Dal Moro Amarante ◽  
Geraldo Chaves Alcântara ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Gastric Bypass ◽  
Morbidly Obese ◽  
Obese Subjects ◽  
Anthropometric Indexes

scholarly journals Circulating nerve growth factor levels in relation to obesity and the metabolic syndrome in women

2007 ◽  
Vol 157 (3) ◽  
pp. 303-310 ◽  
Author(s):  
Mònica Bulló ◽  
Muhammad R Peeraully ◽  
Paul Trayhurn ◽  
J Folch ◽  
Jordi Salas-Salvadó
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Adipose Tissue ◽  
Nerve Growth Factor ◽  
Inflammatory Markers ◽  
Normal Weight ◽  
Morbidly Obese ◽  
The Metabolic Syndrome ◽  
Obese Subjects

Objective: Neurotrophins (NTs) could be involved in the development and progression of inflammatory and immune diseases. Because obesity and the metabolic syndrome (MetSyn) are related to a low-grade systemic inflammation, plasma NT levels (neurotrophinemia) could play an important role in the ethiopathogenic mechanisms underlying these metabolic derangements. This is the first study evaluating the plasma NT levels in a group of women with obesity and MetSyn, and also the adipose tissue nerve growth factor (NGF) expression in a small group of them. Methods: Included were 146 adult women with different degrees of adiposity, with or without MetSyn. Plasma NT levels were measured. NGF expression was analyzed in s.c. adipose tissue of a subgroup of morbidly obese and normal-weight females. Results: NGF plasma levels were 1.4-fold higher in overweight and obese subjects. Plasma NGF was, however, lower in a group of morbidly obese subjects than in overweight or obesity, but it remained elevated relative to the normal-weight group. Plasma NGF was significantly correlated with body mass index (BMI), percentage body fat, and waist circumference in non-morbidly obese subjects. NGF was positively related to inflammatory markers. NT3 and brain-derived neurotrophin factor seem to be more related to lipid profile than to BMI, adipose tissue distribution, or peripheral inflammatory markers. Subjects with type 2 diabetes, abdominal fat distribution, or the MetSyn showed significantly higher levels of NGF. The MetSyn was the only independent predictor of the variability observed in the NGF plasma values. Conclusion: NGF is upregulated in obesity, type 2 diabetes, and the MetSyn. Whether this NT may contribute to inflammation and the metabolic derangements associated with body weight gain remains to be elucidated.

Long-Term Effects of Sleeve Gastrectomy and Roux-en-Y Gastric Bypass Surgery on Type 2 Diabetes Mellitus in Morbidly Obese Subjects

2012 ◽  
Vol 256 (6) ◽  
pp. 1023-1029 ◽  
Author(s):  
Amanda Jiménez ◽  
Roser Casamitjana ◽  
Lílliam Flores ◽  
Judith Viaplana ◽  
Ricard Corcelles ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Gastric Bypass ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Morbidly Obese ◽  
Long Term Effects ◽  
Obese Subjects

scholarly journals GLP1 analogs as treatment of postprandial hypoglycemia following gastric bypass surgery: a potential new indication?

2013 ◽  
Vol 169 (6) ◽  
pp. 885-889 ◽  
Author(s):  
Niclas Abrahamsson ◽  
Britt Edén Engström ◽  
Magnus Sundbom ◽  
F Anders Karlsson
Keyword(s):  
Gastric Bypass ◽  
Gastric Bypass Surgery ◽  
Somatostatin Analogs ◽  
Medical Attention ◽  
Morbidly Obese ◽  
Channel Blockers ◽  
Partial Pancreatectomy ◽  
Glucose Levels ◽  
Open Treatment ◽  
New Treatment

ObjectiveThe number of morbidly obese subjects submitted to bariatric surgery is rising worldwide. In a fraction of patients undergoing gastric bypass (GBP), episodes with late postprandial hypoglycemia (PPHG) develop 1–3 years after surgery. The pathogenesis of this phenomenon is not fully understood; meal-induced rapid and exaggerated increases of circulating incretins and insulin appear to be at least partially responsible. Current treatments include low-carbohydrate diets, inhibition of glucose intestinal uptake, reduction of insulin secretion with calcium channel blockers, somatostatin analogs, or diazoxide, a KATP channel opener. Even partial pancreatectomy has been advocated. In type 2 diabetes, GLP1 analogs have a well-documented effect of stabilizing glucose levels without causing hypoglycemia.DesignWe explored GLP1 analogs as open treatment in five consecutive GBP cases seeking medical attention because of late postprandial hypoglycemic symptoms.ResultsGlucose measured in connection with the episodes in four of the cases had been 2.7, 2.5, 1.8, and 1.6 mmol/l respectively. The patients consistently described that the analogs eliminated their symptoms, which relapsed in four of the five patients when treatment was reduced/discontinued. The drug effect was further documented in one case by repeated 24-h continuous glucose measurements.ConclusionThese open, uncontrolled observations suggest that GLP1 analogs might provide a new treatment option in patients with problems of late PPHG.

scholarly journals Parameters of Glucose Homeostasis in the Recognition of the Metabolic Syndrome in Young Adults with Prader–Willi Syndrome

2021 ◽  
Vol 10 (23) ◽  
pp. 5635
Author(s):  
Graziano Grugni ◽  
Antonio Fanolla ◽  
Fiorenzo Lupi ◽  
Silvia Longhi ◽  
Antonella Saezza ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Glucose Homeostasis ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Prader Willi Syndrome ◽  
Insulinogenic Index ◽  
Glucose Levels ◽  
The Metabolic Syndrome ◽  
Diagnostic Threshold ◽  
Age Related

To verify the accuracy of different indices of glucose homeostasis in recognizing the metabolic syndrome in a group of adult patients with Prader–Willi syndrome (PWS), 102 PWS patients (53 females/49 males), age ±SD 26.9 ± 7.6 yrs, Body Mass Index (BMI) 35.7 ± 10.7, were studied. The following indices were assessed in each subject during an oral glucose tolerance test (OGTT): 1 h (>155 mg/dL) and 2 h (140–199 mg/dL) glucose levels, the oral disposition index (ODI), the insulinogenic index (IGI), the insulin resistance (HOMA-IR) were evaluated at baseline, 1 h and 2 h. Although minor differences among indices were found, according to the ROC analysis, no index performed better in recognizing MetS. Furthermore, the diagnostic threshold levels changed over the years and therefore the age-related thresholds were calculated. The easily calculated HOMA-IR at baseline may be used to accurately diagnose MetS, thus avoiding more complicated procedures.

scholarly journals Investigating Intestinal Glucagon After Roux-en-Y Gastric Bypass Surgery

2019 ◽  
Vol 104 (12) ◽  
pp. 6403-6416 ◽  
Author(s):  
Tina Jorsal ◽  
Nicolai J Wewer Albrechtsen ◽  
Marie M Christensen ◽  
Brynjulf Mortensen ◽  
Erik Wandall ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Small Intestine ◽  
Gastric Bypass Surgery ◽  
Plasma Concentrations ◽  
University Hospital ◽  
Morbidly Obese ◽  
Mucosal Biopsy ◽  
Cross Sectional ◽  
Biopsy Specimens ◽  
Before And After

Abstract Context After Roux-en-Y gastric bypass (RYGB) surgery, postprandial plasma glucagon concentrations have been reported to increase. This occurs despite concomitant improved glucose tolerance and increased circulating plasma concentrations of insulin and the glucagon-inhibiting hormone glucagon-like peptide 1 (GLP-1). Objective To investigate whether RYGB-induced hyperglucagonemia may be derived from the gut. Design and Setting Substudy of a prospective cross-sectional study at a university hospital in Copenhagen, Denmark. Participants Morbidly obese individuals undergoing RYGB (n = 8) with or without type 2 diabetes. Interventions Three months before and after RYGB, participants underwent upper enteroscopy with retrieval of gastrointestinal mucosal biopsy specimens. Mixed-meal tests were performed 1 week and 3 months before and after RYGB. Main Outcome Measures The 29–amino acid glucagon concentrations in plasma and in mucosal gastrointestinal biopsy specimens were assessed using mass spectrometry–validated immunoassays, and a new monoclonal antibody reacting with immunoreactive glucagon was used for immunohistochemistry. Results Postprandial plasma concentrations of glucagon after RYGB were increased. Expression of the glucagon gene in the small intestine increased after surgery. Glucagon was identified in the small-intestine biopsy specimens obtained after, but not before, RYGB. Immunohistochemically, mucosal biopsy specimens from the small intestine harbored cells costained for GLP-1 and immunoreactive glucagon. Conclusion Increased concentrations of glucagon were observed in small-intestine biopsy specimens and postprandially in plasma after RYGB. The small intestine harbored cells immunohistochemically costaining for GLP-1 and glucagon-like immunoreactivity after RYGB. Glucagon derived from small-intestine enteroendocrine l cells may contribute to postprandial plasma concentrations of glucagon after RYGB.

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