The impact of Bariatric Surgery on the Absorption of Micronutrients: Animal study

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.

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The impact of patient-reported outcomes on loss to follow-up care after bariatric surgery

Surgical Endoscopy ◽

10.1007/s00464-021-08352-x ◽

2021 ◽

Author(s):

Alexandra Jacobs ◽

Paige Martinez ◽

Ellen Morrow ◽

Anna Ibele

Keyword(s):

Bariatric Surgery ◽

Patient Reported Outcomes ◽

Loss To Follow Up ◽

Patient Reported ◽

Follow Up Care ◽

The Impact

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Decrease of dipeptidyl peptidase 4 activity is associated with weight loss after bariatric surgery

Obesity Surgery ◽

10.1007/s11695-020-05200-0 ◽

2021 ◽

Author(s):

Carsten T. Herz ◽

Johanna M. Brix ◽

Bernhard Ludvik ◽

Guntram Schernthaner ◽

Gerit-Holger Schernthaner

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Hepatic Injury ◽

Dipeptidyl Peptidase ◽

Diabetic Patients ◽

Metabolic Dysfunction ◽

Dipeptidyl Peptidase 4 ◽

Cholesterol Levels ◽

Glucagon Like Peptide 1 ◽

The Impact

Abstract Purpose Dipeptidyl peptidase 4 (DPP4) is expressed and secreted by adipocytes. DPP4 induces insulin resistance independently of its effect on glucagon-like peptide 1, thus it is conceivable that DPP4 directly contributes to metabolic dysfunction in patients with morbid obesity. The aim of this study was to investigate the impact of weight loss induced by bariatric surgery on DPP4 activity, and whether these changes are associated with improvements in markers of metabolic dysfunction and fatty liver disease. Materials and Methods We included 68 non-diabetic patients who underwent bariatric surgery. Serum DPP4 activity was measured using a fluorogenic substrate before and after surgery. Results Results: After a median follow-up period of 12 (IQR 11-17) months, median serum DPP4 activity decreased from 230 (IQR: 194-273) to 193 (164-252) pmol/min (p=0.012). The decrease in DPP4 activity was significantly correlated with decreases in BMI, improved cholesterol levels, reduced hepatic injury markers as well as improved post-prandial insulin sensitivity. After multivariable adjustment, ΔDPP4 activity remained significantly associated with Δcholesterol (beta=0.341, p=0.025), ΔLDL cholesterol (beta=0.350, p=0.019), Δgamma-glutamyltransferase (beta=0.323, p=0.040) and ΔMatsuda index (beta=-0.386, p=0.045). Conclusion We demonstrated that weight loss induced by bariatric surgery results in decreased circulating DPP4 activity beyond the initial phase of weight loss. The associations between decreased DPP4 activity and improved cholesterol levels as well as hepatic injury markers point towards pleiotropic effects of DPP4 beyond glucose metabolism which warrant further investigation.

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The Impact of Bariatric Surgery Compared to Metformin Therapy on Pregnancy Outcomes in Patients with Polycystic Ovarian Syndrome: a Systematic Review and Meta-analysis

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-020-04900-3 ◽

2021 ◽

Vol 25 (2) ◽

pp. 378-386

Author(s):

Catherine Chang ◽

Steven Chang ◽

Jillian Poles ◽

Violeta Popov

Keyword(s):

Systematic Review ◽

Bariatric Surgery ◽

Pregnancy Outcomes ◽

Polycystic Ovarian Syndrome ◽

Meta Analysis ◽

Metformin Therapy ◽

The Impact ◽

Ovarian Syndrome

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Serum concentrations of antidepressants, antipsychotics, and antiepileptics over the bariatric surgery procedure

European Journal of Clinical Pharmacology ◽

10.1007/s00228-021-03182-1 ◽

2021 ◽

Author(s):

Susanna M. Wallerstedt ◽

Karin Nylén ◽

Magnus A. B. Axelsson

Keyword(s):

Bariatric Surgery ◽

Antiepileptic Drugs ◽

Therapeutic Drug ◽

Serum Concentrations ◽

Consistent Finding ◽

Low Calorie ◽

Post Surgery ◽

Low Calorie Diet ◽

Calorie Diet ◽

The Impact

Abstract Purpose As a substantial proportion of bariatric surgery patients use psychotropic/antiepileptic drugs, we investigated the impact of this procedure on serum concentrations. Methods In a naturalistic, longitudinal, prospective case series, we compared dose-adjusted trough concentrations of antidepressants, antipsychotics, or antiepileptics in consecutive patients before and after bariatric surgery. Adherence to treatment over 2 weeks preceding each sampling was considered. Results In all, 85 participants were included (86% female, median age 45 years, median body mass index 42 kg/m2). They were being treated with 18 different psychotropic/antiepileptic drugs (7 substances: 6–17 individuals, 11 substances: 1–4 individuals) and contributed 237 samples over a median of 379 days after surgery. For four out of seven substances with pre-/post-surgery samples available from six or more individuals, the dose-adjusted concentration was reduced (sertraline: 51%, mirtazapine: 41%, duloxetine: 35%, citalopram: 19%). For sertraline and mirtazapine, the low-calorie-diet before surgery entirely explained this reduction. A consistent finding, irrespective of drug, was the association between the mean ratio of the post-/pre-diet dose-adjusted concentration and the lipophilicity of the drug (logD; correlation coefficient: −0.69, P = 0.0005), the low-calorie diet often affecting serum concentration more than the surgery itself. Conclusions Serum concentrations of psychotropic/antiepileptic drugs vary after bariatric surgery and can be hard to predict in individual patients, suggesting that therapeutic drug monitoring is of value. Conversely, effects of the pre-surgery, low-calorie diet appear generalizable, with decreased concentrations of highly lipophilic drugs and increased concentrations of highly hydrophilic drugs. Interaction effects (surgery/dose/concentration) were not evident but cannot be excluded.

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