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Bariatric Surgery in Rats Upregulates FSP27 Expression in Fat Tissue to Affect Fat Hydrolysis and Metabolism. BIOMED RESEARCH INTERNATIONAL 2019; 2019:6415732. [PMID: 31205943 PMCID: PMC6530210 DOI: 10.1155/2019/6415732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/21/2019] [Accepted: 04/16/2019] [Indexed: 12/23/2022]
Abstract
Purpose To explore the changes in FSP27 expression and fat metabolism in adipose tissue and their relationship after bariatric surgery in rats. Method Food intake, body weight, triglyceride content, fat distribution, and fat cell morphology were evaluated in rats grouped into control, sham, sleeve gastrectomy (SG), and Roux-en-Y gastric bypass (RYGB) groups. Immunohistochemistry and western blotting were used to detect protein expression and real-time PCR was used to detect mRNA expression. Mouse 3T3-L1 preadipocytes were used to assess the effects of different energy levels and nutrient factors on FSP27 in adipocytes. Result Food intake, body weight, and triglyceride levels were reduced in RYGB and SG rats within 28 days after surgery, with a more pronounced effect in the RYGB group. Weight loss was mainly due to loss of fat mass rather than loss of lean mass, with the most pronounced decrease in trunk fat. FSP27 expression increased in lean rat adipocytes accompanied by increased lipid droplets (LDs). In SG and RYGB rats, the FSP27 protein concentration gradually increased in white adipose tissue (WAT) after operation. Hormone-sensitive lipase (HSL), p-HSL/HSL, Adipose Triglyceride Lipase (ATGL), and Comparative Gene Identification-58 (CGI-58) gradually decreased in SG and RYGB rats, but they were always higher than in control and sham animals. FSP27 was also decreased in 3T3-L1 adipocytes of animals with a high-energy diet. Conclusion FSP27 is associated with rat lipid metabolism and its expression varies with energy and nutrient supply. It can inhibit excessive hydrolysis and fat accumulation by regulating HSL and ATGL expression and by mediating LDs formation.
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Browning MG, Franco RL, Cyrus JC, Celi F, Evans RK. Changes in Resting Energy Expenditure in Relation to Body Weight and Composition Following Gastric Restriction: A Systematic Review. Obes Surg 2017; 26:1607-15. [PMID: 27103027 DOI: 10.1007/s11695-016-2184-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
In comparison to gastric bypass surgery, gastric restriction without malabsorption more closely simulates dietary adherence while still producing durable weight loss. The latter is achieved despite considerable reductions in resting energy expenditure (REE), and whether REE is adjusted for body weight/composition using ratio- or regression-based methods could influence understanding of how these procedures affect energy balance. This systematic review identified studies that reported REE before and after gastric restriction in order to compare changes using each method. Ratio assessments revealed increases and decreases when REE was expressed per kilogram of body weight and per kilogram of fat-free mass, respectively. In comparison, measured REE tended to be less than predicted from linear regression after surgery. Explanations for these seemingly disparate findings and future directions are discussed.
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Affiliation(s)
- Matthew G Browning
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, 500 Academic Centre, 1020 West Grace St, Richmond, VA, 23284, USA.
| | - Robert L Franco
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, 500 Academic Centre, 1020 West Grace St, Richmond, VA, 23284, USA
| | - John C Cyrus
- Tompkins-McCaw Library for the Health Sciences, Virginia Commonwealth University, Richmond, VA, 23298, USA
| | - Francesco Celi
- Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Ronald K Evans
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, 500 Academic Centre, 1020 West Grace St, Richmond, VA, 23284, USA
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Castagneto Gissey L, Casella Mariolo JR, Mingrone G. How to Choose the Best Metabolic Procedure? Curr Atheroscler Rep 2017; 18:43. [PMID: 27229936 DOI: 10.1007/s11883-016-0590-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Bariatric/metabolic surgery has proven to be effective in inducing and maintaining diabetes remission-although with a percentage of patients undergoing hyperglycemia relapse-weight loss, and improvement of the cardiovascular risk. It is, however, associated with mortality, although low, and early and late complications. In particular, metabolic complications are related to vitamin deficiency due to the erratic absorption of the supplemented vitamins and to the unpredictable compliance of patients to vitamin and trace element supplementation. In addition, often, the general practitioners and even the specialists are unaware of the clinical effects of metabolic dysfunction following malabsorptive surgery. The choice of the surgical procedure should be the balance between benefits and risks. Our review addresses this important question trying to give some suggestions.
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Affiliation(s)
- Lidia Castagneto Gissey
- Department of General Surgery, University of Rome "La Sapienza", Rome, Italy. .,James Black Centre, King's College Hospital, Denmark Hill, SE5 9RS, London, UK.
| | - James Rossario Casella Mariolo
- Department of General Surgery, University of Rome "La Sapienza", Rome, Italy.,James Black Centre, King's College Hospital, Denmark Hill, SE5 9RS, London, UK
| | - Geltrude Mingrone
- Department of Internal Medicine, Catholic University, Rome, Italy.,Department of Diabetes, King's College London, London, UK
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Kim DJ, Kim W. Gastric necrosis due to adhesive band formed by lap-band fixation suture managed by laparoscopy-assisted LES preserving proximal gastrectomy. Surg Obes Relat Dis 2016; 12:e77-e79. [PMID: 27989524 DOI: 10.1016/j.soard.2016.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 09/11/2016] [Accepted: 09/15/2016] [Indexed: 01/03/2023]
Affiliation(s)
- Dong Jin Kim
- Department of Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Wook Kim
- Department of Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Liu XZ, Fan J, Zhang YQ, Xu MJ, Zhao DB. Single-incision or conventional laparoscopic adjustable gastric banding: A systematic review. MINIM INVASIV THER 2015; 25:62-9. [PMID: 26471295 DOI: 10.3109/13645706.2015.1096288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Single-incision laparoscopic surgery (SILS) in gastric banding (SI-LAGB) has been reported to be a safe and technically feasible procedure among various operating methods. However, there is little evidence with regard to the question whether SI-LAGB has more advantages and should be recommended compared with conventional LAGB (CLAGB). Thus, this study was performed to assess the safety and efficacy of SI-LAGB. MATERIAL AND METHODS A computerized search of the electronic databases PubMed and EMBASE was performed. Data regarding operative parameters, postoperative recovery parameters, follow-up time, percentage of excess weight loss, and postoperative complication were pooled and analyzed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. RESULTS Ten comparative studies including 2,073 patients (1,038 patients who received SI-LAGB and 1,035 patients who received CLAGB) were included and analyzed. Compared with CLAGB, a similar weight loss could be obtained using SI-LAGB. The postoperative complications of SI-LAGB were within the acceptable range, but one study reported one perioperative death. SI-LAGB required a longer operative time. Other outcome variables, such as blood loss, days of hospitalization, pain score, and hospitalization costs, were not significantly different between the two groups. CONCLUSIONS SI-LAGB might be a safe and effective alternative to C-LAGB when performed by experienced surgeons, but available data do not allow to give a definitive answer and randomized controlled trials are needed.
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Affiliation(s)
- Xing-Zhen Liu
- a The First Department of Recovery , Hangzhou Sanatorium of Nanjing Military Command Region , Hangzhou , China.,c Department of Rheumatology , Changhai Hospital, The Second Military Medical University , Shanghai , China
| | - Jie Fan
- a The First Department of Recovery , Hangzhou Sanatorium of Nanjing Military Command Region , Hangzhou , China
| | - You-Qin Zhang
- a The First Department of Recovery , Hangzhou Sanatorium of Nanjing Military Command Region , Hangzhou , China
| | - Mao Jin Xu
- b Department of Endocrinology , Changhai Hospital, The Second Military Medical University , Shanghai , China
| | - Dong-Bao Zhao
- c Department of Rheumatology , Changhai Hospital, The Second Military Medical University , Shanghai , China
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Ahluwalia JS, Chang PC, Tai CM, Tsai CC, Sun PL, Huang CK. Comparative Study Between Laparoscopic Adjustable Gastric Banded Plication and Sleeve Gastrectomy in Moderate Obesity—2 Year Results. Obes Surg 2015; 26:552-7. [DOI: 10.1007/s11695-015-1791-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Busetto L, Dixon J, De Luca M, Shikora S, Pories W, Angrisani L. Bariatric surgery in class I obesity : a Position Statement from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). Obes Surg 2015; 24:487-519. [PMID: 24638958 DOI: 10.1007/s11695-014-1214-1] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Class I obesity conveys an increased risk of comorbidities, impairs physical and mental health-related quality of life, and it is associated to an increased psychosocial burden, particularly in women. The need for effective and safe therapies for class I obesity is great and not yet met by nonsurgical approaches. Eligibility to bariatric surgery has been largely based on body mass index (BMI) cut points and limited to patients with more severe obesity levels. However, obese patients belonging to the same BMI class may have very different levels of health, risk, and impact of obesity on quality of life. Individual patients in class I obesity may have a comorbidity burden similar to, or greater than, patients with more severe obesity. Therefore, the denial of bariatric surgery to a patient with class I obesity suffering from a significant obesity-related health burden and not achieving weight control with nonsurgical therapy simply on the basis of the BMI level does not appear to be clinically justified. A clinical decision should be based on a more comprehensive evaluation of the patient's current global health and on a more reliable prediction of future morbidity and mortality. After a careful review of available data about safety and efficacy of bariatric surgery in patients with class I obesity, this panel reached a consensus on ten clinical recommendations.
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Affiliation(s)
- Luca Busetto
- Department of Medicine, University of Padua, Padua, Italy,
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Pedroso FE, Gander J, Oh PS, Zitsman JL. Laparoscopic vertical sleeve gastrectomy significantly improves short term weight loss as compared to laparoscopic adjustable gastric band placement in morbidly obese adolescent patients. J Pediatr Surg 2015; 50:115-22. [PMID: 25598106 DOI: 10.1016/j.jpedsurg.2014.10.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 10/06/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Bariatric surgery has shown to be an effective weight loss treatment in morbidly obese adolescents. We compared outcomes of laparoscopic adjustable gastric band (LAGB) to laparoscopic vertical sleeve gastrectomy (VSG). METHODS A single institution, retrospective evaluation of a prospectively collected database of LAGB and VSG patients. RESULTS 174 morbidly obese patients underwent bariatric surgery at our institution between 2006 and 2013. 137 patients underwent LAGB and 37 underwent VSG. There were no significant differences between LAGB vs. VSG groups on day of surgery for age, gender, ethnicity, weight, and BMI. At 24-month follow up, patients who underwent VSG vs. LAGB displayed significantly greater percent excess weight loss (70.9±20.7 vs. 35.5±28.6, P=0.004) and percent preoperative BMI loss (32.3±11.0 vs. 16.4±12.7, P=0.004). Both VSG and LAGB significantly improved levels of HDL, HgA1c, and fasting glucose. LAGB patients had more complications than VSG patients. CONCLUSION Bariatric surgery is an effective treatment strategy in morbidly obese adolescents who have failed medical management. VSG results in greater short term weight and BMI loss when compared to LAGB. Longer follow up with more patients will be required to confirm the long term safety and efficacy of VSG in adolescent patients.
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Affiliation(s)
- Felipe E Pedroso
- New York Presbyterian Morgan Stanley Children's Hospital, Columbia University Medical Center, Department of General Surgery, Division of Pediatric Surgery, Center for Adolescent Bariatric Surgery
| | - Jeffery Gander
- New York Presbyterian Morgan Stanley Children's Hospital, Columbia University Medical Center, Department of General Surgery, Division of Pediatric Surgery, Center for Adolescent Bariatric Surgery; University of Virginia Health System, Department of Surgery, Division of Pediatric Surgery
| | - Pilyung Stephen Oh
- New York Presbyterian Morgan Stanley Children's Hospital, Columbia University Medical Center, Department of General Surgery, Division of Pediatric Surgery, Center for Adolescent Bariatric Surgery
| | - Jeffrey L Zitsman
- New York Presbyterian Morgan Stanley Children's Hospital, Columbia University Medical Center, Department of General Surgery, Division of Pediatric Surgery, Center for Adolescent Bariatric Surgery.
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Liu XZ, Yin K, Fan J, Shen XJ, Xu MJ, Wang WH, Zhang YG, Zheng CZ, Zou DJ. Long-Term outcomes and experience of laparoscopic adjustable gastric banding: one center's results in China. Surg Obes Relat Dis 2014; 11:855-9. [PMID: 25862180 DOI: 10.1016/j.soard.2014.09.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 09/11/2014] [Accepted: 09/21/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Laparoscopic adjustable gastric banding (LAGB), as one major bariatric surgery for treatment of obesity, results in ineffective long-term weight loss and a high reoperation rate. The objective of this study was to evaluate the long-term effects of LAGB on the weight loss outcomes and reoperation rates of obese patients with different body mass index (BMI) levels in China. METHODS A retrospective study was performed to review the follow-up data of obese patients who underwent LAGB at Shanghai Changhai Hospital between November 2003 and May 2013. The main outcomes included weight loss, percentage excess weight loss (%EWL), reoperation rate, and reasons for reoperation. RESULTS A total of 254 LAGB procedures were performed in our hospital. By the end of May 2013, 145 Chinese patients (57.8%) were followed up, 99 patients with BMI ≥ 35 kg/m(2) (high BMI group) and 46 patients with BMI < 35 kg/m(2) (low BMI group). In the high BMI group, the mean %EWL was > 25% within 5 years postoperatively, but it decreased to less than 25% after 5 years. However, in the low BMI group, the mean %EWL at each time point was over 50%. The reoperation rate was 33.1%; it was 17.4% in the low BMI group and 34.3% in the high BMI group. CONCLUSION LAGB is more effective with a lower reoperation rate for obese patients with a BMI < 35 kg/m(2) compared to BMI ≥ 35 kg/m(2) in our population.
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Affiliation(s)
- Xing Zhen Liu
- The First Department of Recovery, Hangzhou Sanatorium of Nanjing Military Command Region, Hangzhou 310007, China; Department of Endocrinology, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China
| | - Kai Yin
- Department of General Surgery, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China
| | - Jie Fan
- The First Department of Recovery, Hangzhou Sanatorium of Nanjing Military Command Region, Hangzhou 310007, China
| | - Xiao Jun Shen
- Department of General Surgery, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China
| | - Mao Jin Xu
- Department of Endocrinology, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China
| | - Wen Hui Wang
- Department of Pathology, The 117 Hospital of PLA, Hangzhou 310007, China
| | - Yan Gao Zhang
- The First Department of Recovery, Hangzhou Sanatorium of Nanjing Military Command Region, Hangzhou 310007, China
| | - Cheng Zhu Zheng
- Department of General Surgery, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China.
| | - Da Jin Zou
- Department of Endocrinology, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China.
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Fan J, Xu JH, Wang J, Wang GZ, Zhang YQ, Liu XZ. Effects of Laparoscopic Adjustable Gastric Banding on Weight Loss, Metabolism, and Obesity-Related Comorbidities: 5-year Results in China. Obes Surg 2014; 24:891-6. [DOI: 10.1007/s11695-013-1173-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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