scholarly journals Holter-Derived Autonomic Function, Arrhythmias and Carbohydrate Metabolism in Patients with Class III Obesity Treated with Laparoscopic Sleeve Gastrectomy

2021 ◽  
Vol 10 (10) ◽  
pp. 2140
Author(s):  
Piotr Bienias ◽  
Zuzanna Rymarczyk ◽  
Justyna Domienik-Karłowicz ◽  
Wojciech Lisik ◽  
Piotr Sobieraj ◽  
...  

The effects of weight loss following bariatric surgery on autonomic balance, arrhythmias and insulin resistance are still of interest. We prospectively investigated 50 patients with BMI > 40 kg/m2, aged 36.5 (18–56) years who underwent laparoscopic sleeve gastrectomy. Among other examinations, all subjects had 24-h Holter monitoring with heart rate variability (HRV) and heart rate turbulence (HRT) evaluation. After a median of 15 months, BMI decreased from 43.9 to 29.7 kg/m2, the incidence of hypertension decreased from 54 to 32% (p = 0.04) and any carbohydrate disorders decreased from 24 to 6% (p = 0.02). Fasting insulin concentration and insulin resistance index improved significantly (p < 0.001). Improvements in HRV parameters related to the sympathetic autonomic division were also observed (p < 0.001), while HRT evaluation was not conclusive. The enhancement of autonomic tone indices was correlated with reduction of BMI (SDNN-I r = 0.281 p = 0.04; SDNN r = 0.267 p = 0.05), but not with reduction of waist circumference, and it was also associated with decrease of mean heart rate (OR 0.02, 95%CI 0.0–0.1, p < 0.001). The incidence of arrhythmias was low and similar before and after follow-up. In conclusion, improvement of homeostasis of carbohydrate metabolism and autonomic function is observed in relatively young patients after weight loss due to laparoscopic sleeve gastrectomy.

2017 ◽  
Vol 68 (7) ◽  
pp. 1622-1627 ◽  
Author(s):  
Diana Simona Stefan ◽  
Andrada Mihai ◽  
Daiana Bajko ◽  
Daniela Lixandru ◽  
Laura Petcu ◽  
...  

Metabolic surgery is the most efficacious method for the treatment of morbid obesity and was recently included among the antidiabetes treatments recommended in obese type 2 diabetes (T2D) patients. The aim of this study was to compare in a randomized controlled trial the effect of sleeve gastrectomy (SG) to that of intensive lifestyle intervention plus pharmacologic treatment on some markers of insulin resistance and beta cell function as well as some appetite controlling hormones in a group of male obese T2D subjects. The study groups comprised 20 subjects for SG and 21 control subjects. Fasting blood glucose, insulin, proinsulin, adiponectin, leptin, ghrelin, HOMA-IR, HOMA-%B, proinsulin-to-insulin ratio and proinsulin-to-adiponectin ratio were evaluated at baseline and after one year follow-up. Overall, patients in the SG group lost 78.98% of excess weight loss (%EWL) in comparison with 9.45% in the control group. This was accompanied by a significant improvement of insulin resistance markers, including increase of adiponectin and decrease of HOMA-IR, while no changes were recorded in the control group. Weight loss was also associated with a significant improvement of proinsulin-to-insulin and proinsulin-to-adiponectin ratio, both surrogate markers of beta cell dysfunction. These also improved in the control group, but were only marginally significant. Our findings suggest that improved insulin resistance and decreased beta cell dysfunction after sleeve gastrectomy might explain diabetes remission associated with metabolic surgery.


Nutrition ◽  
2019 ◽  
Vol 65 ◽  
pp. 4-5
Author(s):  
E. Cava ◽  
F. Butera ◽  
A. Collo ◽  
G. D"Aloisio ◽  
S. Gentilli ◽  
...  

2020 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
FaisalA Alsaif ◽  
FahadS Alabdullatif ◽  
MohammedK Aldegaither ◽  
KhalidA Alnaeem ◽  
AbdulrahmanF Alzamil ◽  
...  

2021 ◽  
Vol 8 ◽  
Author(s):  
Taha Anbara

Introduction: Laparoscopic sleeve gastrectomy is a primary treatment of obesity among older adults and its satisfactory outcomes would be the main reason behind the popularity of this procedure. We aim to evaluate the impact of age on excess weight loss in adult morbidly obese subjects older than 60 years old following LSG.Methods: In this retrospective survey, 3,072 subjects were included in the study that underwent LSG in Erfan Hospital. Screening follow-up period was 12 months. The level of statistical significance was set at P < 0.05. We hired comorbid conditions to avoid bias results including hypertension, diabetes mellitus and dyslipidemia. Results: Of 3072 patients, 1879 cases were females (61.2%) and 1193 subjects were males (38.8 %). Mean %EBMIL of the group 12 months after surgery was 78.9 %. In younger than 60 years old group, mean %EBMIL 12 months postoperative 83 % and patients  over 60 years demonstrated mean %EBMIL 74.9 %. There was an obvious difference among age groups in presence of diabetes mellitus and hypertension in the older group which was more frequent. Conclusion: To sum up, laparoscopic sleeve gastrectomy is safe procedure for older groups. Albeit, %EBMIL was significantly lower in older group compared to younger subjects, but resolution in comorbidities was satisfactory.


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