scholarly journals Sex-Specific Glucose Homeostasis and Anthropometric Responses to Sleeve Gastrectomy in Obese Patients

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2408
Author(s):  
Mark A. Taylor ◽  
Lukasz Szczerbinski ◽  
Anna Citko ◽  
Magdalena Niemira ◽  
Maria Gorska ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Sleeve Gastrectomy ◽  
Glucose Homeostasis ◽  
Cross Sections ◽  
Mixed Models ◽  
Human Populations ◽  
Obese Patients ◽  
Anthropometric Parameters ◽  
One Year

Bariatric surgery rapidly and effectively treats obesity and its comorbidities like dysregulated glucose homeostasis. Despite the sex-balanced incidence of obesity in most human populations, women have sought this intervention more frequently than men. However, as the number of bariatric surgeries rapidly rises, it is increasingly urgent to understand how sex-specific differences may emerge in metabolic and anthropometric parameters. Hundred fifty-four obese patients (47% men and 53% women) from the Bialystok Bariatric Surgery Study underwent sleeve gastrectomy and were measured for 25 parameters at baseline (immediately prior to surgery) and at four follow-up visits over one year. We used generalized linear mixed models to detect sex-specific differences in the time series of responses parameters. Unlike most previous studies with older cross-sections of men than women, our cohort was age-matched, and men were less healthy at baseline. Of parameters that showed a significant cohort-wide (across-sex) response, 14 (56%) also showed sex-specific responses with men improving more than women. In particular, men remitted in diabetes symptoms more strongly, rapidly, and durably than women. Taken together, our results indicate that men may benefit more from sleeve gastrectomy and that this difference in improvement may be related to more progressed morbidity prior to surgery independent of age.

scholarly journals Changes in Trimethylamine-N-oxide Levels in Obese Patients following Laparoscopic Roux-en-Y Gastric Bypass or Sleeve Gastrectomy in a Korean Obesity Surgical Treatment Study (KOBESS)

2021 ◽  
Vol 10 (21) ◽  
pp. 5091
Author(s):  
Soo Jin Lee ◽  
Young Suk Park ◽  
Yong-Jin Kim ◽  
Sang-Uk Han ◽  
Geum-Sook Hwang ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Controlled Trial ◽  
Serum Levels ◽  
Obese Patients ◽  
Korean Patients ◽  
Gut Microbe

Trimethylamine N-oxide (TMAO), a gut microbe-dependent metabolite, has been implicated as a novel risk factor for cardiovascular events related to obesity and type 2 diabetes mellitus (T2DM). The aim of the study was to test the hypothesis if TMAO is associated with the reduction of cardiovascular disease in the Korean obese patients who underwent bariatric surgery. From a subgroup of a multicenter, nonrandomized, controlled trial, titled KOBESS, 38 obese patients, 18 with and 20 without T2DM, who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) were investigated. Bariatric surgery is indicated for Korean patients with a body mass index (BMI) ≥ 35 kg/m2 or for Korean patients with a BMI ≥ 30 kg/m2 who have comorbidities. Serum levels of TMAO and its precursors, betaine, carnitine, and choline were measured before and six months after bariatric surgery. The levels of TMAO and its precursors did not differ between obese patients with T2DM and non-T2DM at baseline. However, TMAO increased more than twofold in patients with T2DM after RYGB surgery, but not in patients without T2DM. Choline levels were decreased by half in all patients after RYGB. In patients with T2DM who underwent SG, TMAO, betaine, and carnitine levels did not change after the surgery. Furthermore, in obese patients who underwent bariatric surgery, increased TMAO levels were associated with both T2DM and RYGB, while reduced choline levels were associated with RYGB. These associations need to be further elucidated in follow-up studies to gain further insights into the relationship between TMAO levels and bariatric surgery outcomes.

scholarly journals Hypogonadism as an additional indication for bariatric surgery in male morbid obesity?

2014 ◽  
Vol 171 (5) ◽  
pp. 555-560 ◽  
Author(s):  
Jinous Samavat ◽  
Enrico Facchiano ◽  
Marcello Lucchese ◽  
Gianni Forti ◽  
Edoardo Mannucci ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Complete Recovery ◽  
Free Testosterone ◽  
Sex Hormone Binding Globulin ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Anthropometric Parameters ◽  
Additional Indication ◽  
Beneficial Effects

ObjectiveMale obesity is often associated with reduced levels of circulating total (TT) and calculated free testosterone (cFT), with normal/reduced gonadotropins. Bariatric surgery often improves sex steroid and sex hormone-binding globulin (SHBG) levels. The aim of this study was to assess the effects of bariatric surgery on waist circumference (WC) and BMI, and on TT levels, in morbidly obese men, stratified, according to the gonadal state, in eugonadal and hypogonadal (TT<8 nmol/l) subjects.DesignA cohort of morbidly obese patients (29 with hypogonadism (HG) and 26 without) undergoing bariatric surgery (37, 10, 6, and 2, with Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding, biliopancreatic diversion and gastric sleeve, respectively) was studied at 6 and 12 months from the operation.MethodsAnthropometric parameters (weight, BMI, WC) and sex hormones (gonadotropins, TT, cFT, estradiol (E2), SHBG) were assessed.ResultsWC was the only parameter significantly correlated with androgens, but not with E2, SHBG, and gonadotropins, at baseline. After surgery, a significant increase in TT, cFT, and SHBG, accompanied by a decrease in E2, was evident in the two groups. However, both TT and cFT, but not E2, SHBG, and gonadotropin variations, were significantly higher in the hypogonadal group at follow-up, with an overall 93% complete recovery from HG. Reduction in WC, but not BMI, was significantly greater in hypogonadal men (ΔWC=−29.4±21.6 vs −14.4±17.4 at 12 months, P=0.047).ConclusionsRecovery from obesity-associated HG is one of the beneficial effects of bariatric surgery in morbidly obese men. The present findings suggest that the gonadal state is a predictor of WC decrease after bariatric surgery.

scholarly journals Effect of bariatric surgery on fatty liver disease in obese patients: A prospective one year follow-up study

2021 ◽  
Author(s):  
Daniel Toman ◽  
Petr Vavra ◽  
Petr Jelinek ◽  
Petr Ostruszka ◽  
Peter Ihnat ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Obese Patients ◽  
Follow Up Study ◽  
One Year

Improvement in Obstructive Sleep Apnea (OSA) in Super Morbidly Obese Patients After Bariatric Surgery

2020 ◽  
Vol 103 (8) ◽  
pp. 725-728
Keyword(s):  
Bariatric Surgery ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Lifestyle Modification ◽  
Apnea Hypopnea Index ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
Objective Evidence

Background: Lifestyle modification is the mainstay therapy for obese patients with obstructive sleep apnea (OSA). However, most of these patients are unable to lose the necessary weight, and bariatric surgery (BS) has been proven to be an effective modality in selected cases. Objective: To provide objective evidence that BS can improve OSA severity. Materials and Methods: A prospective study was conducted in super morbidly obese patients (body mass index [BMI] greater than 40 kg/m² or BMI greater than 35 kg/m² with uncontrolled comorbidities) scheduled for BS. Polysomnography (PSG) was performed for preoperative assessment and OSA was treated accordingly. After successful surgery, patients were invited to perform follow-up PSG at 3, 6, and 12 months. Results: Twenty-four patients with a mean age of 35.0±14.0 years were enrolled. After a mean follow-up period of 7.8±3.4 months, the mean BMI, Epworth sleepiness scale (ESS), and apnea-hypopnea index (AHI) significantly decreased from 51.6±8.7 to 38.2±6.8 kg/m² (p<0.001), from 8.7±5.9 to 4.7±3.5 (p=0.003), and from 87.6±38.9 to 28.5±21.5 events/hour (p<0.001), respectively. Conclusion: BS was shown to dramatically improve clinical and sleep parameters in super morbidly obese patients. Keywords: Morbid obesity, Bariatric surgery, Obstructive sleep apnea (OSA)

Diverted sleeve gastrectomy with ileal transposition in overweight, obese, and morbidly obese patients with type 2 diabetes: results of 1-year follow-up

2016 ◽  
Vol 12 (3) ◽  
pp. 541-549 ◽  
Author(s):  
Alper Celik ◽  
Eylem Cagiltay ◽  
Surendra Ugale ◽  
Muharrem Asci ◽  
Bahri Onur Celik ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Sleeve Gastrectomy ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Ileal Transposition

EP.WE.1048Weight Regain After Sleeve Gastrectomy More Common in Male and Less Common in Super-Obese Patients - Results of an 18-Month Follow-up Study

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ahmed Salman Bodla ◽  
Jenny Abraham ◽  
Neha Shah ◽  
Vinod Menon
Keyword(s):  
Sleeve Gastrectomy ◽  
Revisional Surgery ◽  
Patient Specific ◽  
Obese Patients ◽  
Inclusion Criteria ◽  
Super Obese ◽  
Burn Out ◽  
Single Centre Study ◽  
Male Patients

Abstract Aims Long-term success of Sleeve Gastrectomy (SG) is undermined by weight regain (WR). Several procedure- and patient-specific factors have been proposed in previous studies. Here we look at 18-month follow-up post-SG to investigate WR and patient-specific variables influencing this. Methods A single-centre study involving retrospective analysis of a prospectively-maintained database. Inclusion criteria: Primary non-revisional SG patients with adequate follow-up data to assess WL/WR trends. Patients were divided into two subgroups based on their %EWL between 6-to-12 and 12-to-18 months: weight regainers (WR) and weight losers/maintainers (WL/M). Results Out of 338 SG cases between 2012-2017, 180 met inclusion criteria of which 18.3% were men and 45% were super-obese. All patients lost weight during first 6 months (mean %EWL 52.3%, P &lt; 0.0001). Between 6-to-12 months, 87.6% patients continued WL with a further mean %EWL of 10.35% (P &lt; 0.0001). Between 12-to-18 months, a drastic deceleration/reversal of WL progress was observed with an average of only 0.76% EWL (P = 0.84), with 42% of patients regaining weight in this period (mean EWG 6.8%). Male patients encountered significantly higher WR rate (OR 3.27, P = 0.003), whereas it was much less frequent in pre-operatively super-obese patients (OR 0.48, P = 0.036). Moreover, there was no difference in the 6-month %EWL between WR and WL/M subgroups (P = 0.62), thus negating the possibility of WL burn-out phenomenon. Conclusions Different rates of WR in men and super-obese patients may indicate underlying behavioural and biological differences. More research is needed to investigate them in detail, having implications for revisional surgery and follow-up support.

scholarly journals A Very Rare Cause of Dilated Cardiomyopathy after Bariatric Surgery: Selenium Deficiency

2021 ◽  
pp. 1-3
Author(s):  
Gulay Kocak ◽  
Munevver Gul Avsar ◽  
Cansu Yazar ◽  
Aylia Yesilova ◽  
Gulcagri Yildiz ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Trace Elements ◽  
Sleeve Gastrectomy ◽  
Dilated Cardiomyopathy ◽  
Selenium Deficiency ◽  
Water Soluble ◽  
Nutritional Deficiencies ◽  
Reduced Ejection Fraction ◽  
Long Term Follow Up

Background: Sleeve gastrectomy for weight loss has increased significantly nowadays. Various complications may develop after this surgery that requires long-term follow-up of these patients. Nutrition is the most important aspect of the follow-up. The deficiency of trace elements, fat-soluble and water-soluble vitamins following bariatric surgeries have been well-described complications. Although nutritional supplementations are often initiated after bariatric surgery, the clinical outcomes related to the deficiency of trace elements have not been well known yet. Case Presentation: A 27-year-old woman who underwent a laparoscopic sleeve gastrectomy for surgical treatment of obesity 9 months ago presented to the emergency department with a signs of heart failure. Transthoracic echocardiography revealed dilated, poorly functioning left ventricle with reduced ejection fraction (28.9%) consistent with dilated cardiomyopathy. We assumed nutritional deficiencies secondary to sleeve gastrectomy as a cause of dilated cardiomyopathy, as the patient had inappropriate nutritional supplements after surgery. Laboratory tests revealed selenium and zinc deficiency that supported our hypothesis. Our patient completely recovered with adequate supplementation of selenium, zinc and thiamine. Conclusion: We highlighted that the early diagnosis of dilated cardiomyopathy due to selenium deficiency following bariatric surgery is of great importance since selenium deficiency is a cause of reversible cardiomyopathy.

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