scholarly journals Thiamine deficiency after sleeve gastrectomy

2021 ◽  
pp. 52-59
Author(s):  
I. M. Todurov ◽  
O. O. Kalashnikov ◽  
O. V. Perekhrestenko ◽  
S. V. Kosiukhno ◽  
G. C. Chervyts ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Sleeve Gastrectomy ◽  
Thiamine Deficiency ◽  
Clinical Case ◽  
De Novo ◽  
Vitamin B1 ◽  
Micronutrient Deficiencies ◽  
Correct Treatment ◽  
Restrictive Procedure ◽  
Short Period

The prevalence of morbid obesity has risen to global epidemic proportions. Bariatric surgery has been proven to be a safe and effective treatment for obesity with weight reduction, resolution of obesity-related co-morbidities, improved quality of life and an increased life expectancy. Sleeve gastrectomy (SG) is the most commonly performed bariatric procedure worldwide. Obesity is associated with micronutrient deficiencies that results in the high prevalence of deficient vitamins status prior to bariatric surgery. After bariatric surgery, these micronutrient and vitamins deficiencies increase or occur de novo, and they may be threatening when left unattended. This presented clinical case demonstrates the clinical features of thiamine deficiency as well as the principles of laboratory and instrumental diagnostics. Electromyo­graphy is an informative method for diagnostic of muscle weakness. The lower serum thiamine level, neurological symptoms and electromyography results are the most important for the diagnosis of thiamine deficiency. Pathogenetic treatment can improve the patient’s condition in a short period of time. Although the SG is a purely restrictive procedure with no malabsorptive component, microelement or vitamin deficiency can occur in patients after procedure. The presented clinical case demonstrates the importance of timely thorough diagnosis and correct treatment of thiamine deficiency in patients after SG. Thus, patients after the LRS in deficiency of vitamin B1 may cause the development of neurological comp­lica­tions of varying severity, in particular dysmetabolic polyneuropathy. This condition is reversed and administration of an adequate and timely substitution therapy in patients with thiamine insufficiency allows be avoided the development of fatal complications.

scholarly journals Thiamine Deficiency in People with Obesity (P18-060-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Elizabeth Costello ◽  
Jennifer Kerns
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Thiamine Deficiency ◽  
Type Ii Diabetes ◽  
Medical Center ◽  
Vitamin B1 ◽  
Type Ii ◽  
Micronutrient Deficiencies ◽  
Diabetes Status ◽  
Increased Risk

Abstract Objectives Thiamine (vitamin B1) and other micronutrient deficiencies are commonly observed after bariatric surgery. However, there is evidence that patients with obesity may be deficient in thiamine even before surgery, possibly due to metabolic changes following recent weight loss or decreased intake through dietary restriction. Type II diabetes may also adversely affect thiamine absorption and increase urinary thiamine losses, placing patients with this condition at increased risk of deficiency. The purpose of this research is to (1) determine the prevalence of thiamine deficiency in patients at a bariatric surgery clinic and compare this across type II diabetes status, race, and gender; and (2) determine the relationship between recent weight loss and thiamine deficiency. Methods This is a retrospective observational study of patients with obesity who were evaluated at the preoperative bariatric surgery clinic at the Washington, DC VA Medical Center between January 1, 2012 and April 1, 2018. Patients who had prior bariatric surgery, current or recent history of alcohol abuse, current use of diuretics or vitamin supplements, or for whom no thiamine test was ordered were excluded. All patients had a BMI of 31.7–49.0 kg/m2. Thiamine deficiency was defined as a test value below the reference range. Weight data were collected at the initial evaluation and up to four months prior. Results Of 155 clinic patients, 107 met all inclusion criteria. Thiamine deficiency was found in 36 (33.6%) patients. Chi-square tests did not show any differences in prevalence between patients with type II diabetes and those without, or by gender or race. Preliminary logistic regression analyses indicated that the odds of thiamine deficiency were 14% higher per % increase in recent weight loss (OR = 1.14, 95% CI: 1.01–1.29). Conclusions Approximately one third of those evaluated at the bariatric surgery clinic were found to have a test result indicating thiamine deficiency. This suggests that people with obesity, especially those engaging in weight loss efforts, may benefit from additional nutritional screening. Funding Sources None.

scholarly journals Pathophysiology, prevention, and treatment of beriberi after gastric surgery

2020 ◽  
Vol 78 (12) ◽  
pp. 1015-1029
Author(s):  
Robert Beaumont Wilson
Keyword(s):  
Bariatric Surgery ◽  
Thiamine Deficiency ◽  
Gastrointestinal Surgery ◽  
Vitamin B1 ◽  
Gastric Surgery ◽  
Nutritional Deficiencies ◽  
National Guidelines ◽  
Post Surgery ◽  
Long Term Follow Up

Abstract Beriberi is a nutritional complication of gastric surgery, caused by deficiency of vitamin B1, or thiamine. Thiamine deficiency leads to impaired glucose metabolism, decreased delivery of oxygen by red blood cells, cardiac dysfunction, failure of neurotransmission, and neuronal death. This review describes the history and pathophysiology of beriberi as well as the relationship between beriberi and nutritional deficiencies after gastric surgery. A literature review of the history and pathophysiology of beriberi and the risk factors for thiamine deficiency, particularly after gastric resection or bariatric surgery, was performed. Recommendations for nutritional follow-up post gastric surgery are based on current national guidelines. Patients may have subclinical thiamine deficiency after upper gastrointestinal surgery, and thus beriberi may be precipitated by acute illness such as sepsis or poor dietary intake. This may occur very soon or many years after gastrectomy or bariatric surgery, even in apparently well-nourished patients. Prompt recognition and administration of supplemental thiamine can decrease morbidity and mortality in patients with beriberi. Dietary education post surgery and long-term follow-up to determine nutritional status, including vitamin and mineral assessment, is recommended for patients who undergo gastric surgery.

HIF1-α-Mediated Gene Expression Induced by Vitamin B1 Deficiency

2013 ◽  
Vol 83 (3) ◽  
pp. 188-197 ◽  
Author(s):  
Rebecca L. Sweet ◽  
Jason A. Zastre
Keyword(s):  
Gene Expression ◽  
Thiamine Deficiency ◽  
Glucose Transporter ◽  
Neuroblastoma Cell ◽  
Hypoxia Inducible Factor ◽  
Clinical Manifestations ◽  
Vitamin B1 ◽  
Low Oxygen ◽  
Glucose Transporter 1 ◽  
Metabolic Intermediates

It is well established that thiamine deficiency results in an excess of metabolic intermediates such as lactate and pyruvate, which is likely due to insufficient levels of cofactor for the function of thiamine-dependent enzymes. When in excess, both pyruvate and lactate can increase the stabilization of the hypoxia-inducible factor 1-alpha (HIF-1α) transcription factor, resulting in the trans-activation of HIF-1α regulated genes independent of low oxygen, termed pseudo-hypoxia. Therefore, the resulting dysfunction in cellular metabolism and accumulation of pyruvate and lactate during thiamine deficiency may facilitate a pseudo-hypoxic state. In order to investigate the possibility of a transcriptional relationship between hypoxia and thiamine deficiency, we measured alterations in metabolic intermediates, HIF-1α stabilization, and gene expression. We found an increase in intracellular pyruvate and extracellular lactate levels after thiamine deficiency exposure to the neuroblastoma cell line SK-N-BE. Similar to cells exposed to hypoxia, there was a corresponding increase in HIF-1α stabilization and activation of target gene expression during thiamine deficiency, including glucose transporter-1 (GLUT1), vascular endothelial growth factor (VEGF), and aldolase A. Both hypoxia and thiamine deficiency exposure resulted in an increase in the expression of the thiamine transporter SLC19A3. These results indicate thiamine deficiency induces HIF-1α-mediated gene expression similar to that observed in hypoxic stress, and may provide evidence for a central transcriptional response associated with the clinical manifestations of thiamine deficiency.

2315-PUB: High Serum Ferritin Predicts Inferior Diabetes-Related Outcomes after Gastric Bypass but Not Sleeve Gastrectomy Bariatric Surgery

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 2315-PUB
Author(s):  
JENNY TONG ◽  
RAFAEL ALVAREZ ◽  
GREGORY B. RUSSELL ◽  
ALEXANDER N. KHOURI ◽  
RANDY J. SEELEY ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Serum Ferritin ◽  
High Serum

scholarly journals Efficacy of laparoscopic sleeve gastrectomy for patient with morbid obesity and type 1 diabetes mellitus: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hidetaka Ichikawa ◽  
Hirofumi Imoto ◽  
Naoki Tanaka ◽  
Hiroaki Musha ◽  
Shojiro Sawada ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Body Weight ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Hba1c Level ◽  
Insulin Dose ◽  
Body Weight Loss

Abstract Background Bariatric surgery is effective for the treatment of patients with morbid obesity and type 2 diabetes mellitus (T2DM), for body weight loss and glycemic control. However, in Japan, there has been no previous report of the effectiveness bariatric surgery in a case of morbid obesity associated with acute onset type 1 diabetes mellitus (T1DM), in which pancreatic β-cells were destroyed and endogenous insulin was depleted. Case presentation A 36-year-old woman with morbid obesity and T1DM, diagnosed when she was 6 years, was admitted for bariatric surgery. At her first consultation, she had a body weight of 106.7 kg and a body mass index of 42.2 kg/m2. Her HbA1c level was 9.0%, with a required daily insulin dose of 75 units. She underwent laparoscopic sleeve gastrectomy. At 1 year after surgery, her body weight had decreased to 81.0 kg and her body mass index to 32.2 kg/m2. In addition, her daily required dose of insulin had decreased to 24 units, with an improvement in her HbA1c level to 7.7%. Conclusions Although further evidence needs to be accumulated, including long-term outcomes, laparoscopic sleeve gastrectomy may provide an effective treatment for patients with morbid obesity and T1DM for body weight loss, improvement in HbA1c level, and insulin dose reduction.

scholarly journals Orosensory Perception of Fat/Sweet Stimuli and Appetite-Regulating Peptides before and after Sleeve Gastrectomy or Gastric Bypass in Adult Women with Obesity

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 878
Author(s):  
Arnaud Bernard ◽  
Johanne Le Beyec-Le Bihan ◽  
Loredana Radoi ◽  
Muriel Coupaye ◽  
Ouidad Sami ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Gut Hormones ◽  
Sweet Taste ◽  
Taste Perception ◽  
Taste Sensitivity ◽  
Adult Women ◽  
Before And After ◽  
The Impact

The aim of this study was to explore the impact of bariatric surgery on fat and sweet taste perceptions and to determine the possible correlations with gut appetite-regulating peptides and subjective food sensations. Women suffering from severe obesity (BMI > 35 kg/m2) were studied 2 weeks before and 6 months after a vertical sleeve gastrectomy (VSG, n = 32) or a Roux-en-Y gastric bypass (RYGB, n = 12). Linoleic acid (LA) and sucrose perception thresholds were determined using the three-alternative forced-choice procedure, gut hormones were assayed before and after a test meal and subjective changes in oral food sensations were self-reported using a standardized questionnaire. Despite a global positive effect of both surgeries on the reported gustatory sensations, a change in the taste sensitivity was only found after RYGB for LA. However, the fat and sweet taste perceptions were not homogenous between patients who underwent the same surgery procedure, suggesting the existence of two subgroups: patients with and without taste improvement. These gustatory changes were not correlated to the surgery-mediated modifications of the main gut appetite-regulating hormones. Collectively these data highlight the complexity of relationships between bariatric surgery and taste sensitivity and suggest that VSG and RYGB might impact the fatty taste perception differently.

scholarly journals Single Anastomosis Duodenoileal Bypass or Roux-en-Y Gastric Bypass After Failed Sleeve Gastrectomy: Medium-Term Outcomes

2021 ◽  
Author(s):  
Phillip J. Dijkhorst ◽  
May Al Nawas ◽  
Laura Heusschen ◽  
Eric J. Hazebroek ◽  
Dingeman J. Swank ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Revisional Surgery ◽  
Complication Rates ◽  
Total Weight Loss ◽  
Micronutrient Deficiencies ◽  
Single Anastomosis

Abstract Background Although the sleeve gastrectomy (SG) has good short-term results, it comes with a significant number of patients requiring revisional surgery because of insufficient weight loss or functional complications. Objective To investigate the effectiveness of the single anastomosis duodenoileal bypass (SADI-S) versus the Roux-en-Y gastric bypass (RYGB) on health outcomes in (morbidly) obese patients who had previously undergone SG, with up to 5 years of follow-up. Methods Data from patients who underwent revisional SADI-S or RYGB after SG were retrospectively compared on indication of surgery, weight loss, quality of life, micronutrient deficiencies, and complications. Results From 2007 to 2017, 141 patients received revisional laparoscopic surgery after SG in three specialized Dutch bariatric hospitals (SADI-S n=63, RYGB n=78). Percentage total weight loss following revisional surgery at 1, 2, 3, 4, and 5 years was 22%, 24%, 22%, 18%, and 15% for SADI-S and 10%, 9%, 7%, 8%, and 2% for RYGB (P<.05 for 1–4 years). Patients who underwent RYGB surgery for functional complications experienced no persistent symptoms of GERD or dysphagia in 88% of cases. No statistical difference was found in longitudinal analysis of change in quality of life scores or cross-sectional analysis of complication rates and micronutrient deficiencies. Conclusion Conversion of SG to SADI-S leads to significantly more total weight loss compared to RYGB surgery with no difference in quality of life scores, complication rates, or micronutrient deficiencies. When GERD in sleeve patients has to be resolved, RYGB provides adequate outcomes. Graphical abstract

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