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Abundis EM, Hernandez-Landero F, Escobar-Calderon G, Gomez-Crisostomo N, Contreras-Paredes A, de la Cruz-Hernandez E. Gene expression of cardiovascular risk markers in mononuclear cells of pregnant woman in relation to plasma leptin and homocysteine levels: A cross sectional study. Int J Gynaecol Obstet 2024; 165:350-360. [PMID: 38126620 DOI: 10.1002/ijgo.15302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/22/2023] [Accepted: 11/29/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To investigate the relationship between anthropometric, biochemical, and hematologic parameters and serum leptin and homocysteine (Hcy) levels. Also, to determine the effect of leptin and Hcy on expression of genes associated with cardiovascular disease susceptibility (APOA1, LRP1, COX-1, and COX-2) in mononuclear cells of healthy pregnant women. METHODS Between August 2018 and January 2020, a cross-sectional study was conducted on 161 healthy pregnant women in Tabasco, southeastern Mexico. The study population was classified by trimester, according to gestational pregnancy. Anthropometric, biochemical (leptin and homocysteine), and hematologic data were obtained under fasting conditions. APOA1, LRP1, COX-1, and COX-2 expression in mononuclear cells was evaluated using RT-qPCR. RESULTS Red cell indices (hemoglobin, hematocrit, and erythrocytes) were negatively and positively correlated with leptin and Hcy levels, respectively, in the first- and second-trimester groups. Increased leptin levels and low red cell indices were significantly associated with BMI <25.0 in the second-trimester group; however, no significant differences were observed in Hcy levels. Increased leptin and Hcy levels were significantly associated with high lipid indicators in the first- and third-trimester groups, respectively. High APOA1 and COX-2 expression was significantly associated with reduced leptin and increased Hcy levels in the second- and third-trimester groups. CONCLUSION Increased leptin and Hcy levels during pregnancy, mainly associated with modifications in erythrocytes and lipid indices, may lead to early modification of genes related to lipid metabolism (APOA1) and proinflammatory response (COX-2) and, thereby, increase cardiovascular disease risk.
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Affiliation(s)
- Eduardo Martínez Abundis
- Laboratorio de investigacion en Enfermedades Metabolicas e Infecciosas, Division Academica Multidisciplinaria de Comalcalco, Universidad Juarez Autonoma de Tabasco, Comalcalco, Tabasco, Mexico
| | - Fernanda Hernandez-Landero
- Laboratorio de investigacion en Enfermedades Metabolicas e Infecciosas, Division Academica Multidisciplinaria de Comalcalco, Universidad Juarez Autonoma de Tabasco, Comalcalco, Tabasco, Mexico
| | - Grecia Escobar-Calderon
- Laboratorio de investigacion en Enfermedades Metabolicas e Infecciosas, Division Academica Multidisciplinaria de Comalcalco, Universidad Juarez Autonoma de Tabasco, Comalcalco, Tabasco, Mexico
| | - Nancy Gomez-Crisostomo
- Laboratorio de investigacion en Enfermedades Metabolicas e Infecciosas, Division Academica Multidisciplinaria de Comalcalco, Universidad Juarez Autonoma de Tabasco, Comalcalco, Tabasco, Mexico
| | - Adriana Contreras-Paredes
- Unidad de Investigacion Biomedica en Cancer, Instituto Nacional de Cancerología-Universidad Nacional Autonoma de Mexico, Ciudad de Mexico, Mexico
| | - Erick de la Cruz-Hernandez
- Laboratorio de investigacion en Enfermedades Metabolicas e Infecciosas, Division Academica Multidisciplinaria de Comalcalco, Universidad Juarez Autonoma de Tabasco, Comalcalco, Tabasco, Mexico
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Nicol C, Jacquot J, Chebane L, Combret S, Pecquet PE, Massy N, Bagheri H. [Bariatric surgery and drugs: Review of the literature and Adverse Drug Reactions analysis in French National Pharmacovigilance Database]. Therapie 2024:S0040-5957(24)00033-7. [PMID: 38458944 DOI: 10.1016/j.therap.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/09/2024] [Accepted: 02/22/2024] [Indexed: 03/10/2024]
Abstract
INTRODUCTION Bariatric surgery is the only treatment for severe obesity (BMI>35kg/m2) currently recognized as effective both in achieving tangible and lasting weight loss, and in improving obesity-related comorbidities such as type 2 diabetes, hypertension, and cardiovascular complications. Bariatric surgery, like any other surgery of the digestive tract, can have an impact on nutrient absorption, as well as on drug absorption. The literature on drug management in bariatric surgery patients concerned mainly of case reports and retrospective studies involving a small number of patients. No official guidelines are available. METHODS We conducted a literature search on the consequences of bariatric surgery in terms of drug bioavailability and/or effect. The Medline® (PubMed) database was searched using the following keywords: "bariatric surgery", "bioavailability", "gastric bypass", and "obesity". We completed this review with an analysis of reports of adverse drug reactions (ADRs) in post-bariatric surgery patients for obesity registered in the National pharmacovigilance database (PVDB). We selected all cases with the mention of "bariatric surgery and/or gastrectomy" as "medical history". After reading the cases, we excluded those in which the patient had undergone surgery for an indication other than obesity, where the route of administration was other than oral, and cases in which ADRs resulted from voluntary overdose, attempted suicide, allergy, switch to Levothyrox® new formulation, meningioma under progestative drugs, inefficacy related to generic substitution and medication error. RESULTS The literature search identified mainly "case report" about the impact of bariatric surgery on so-called "narrow therapeutic window" drugs. We identified 66 informative cases out of a total of 565 cases selected (11%) in the PVDB. Nevertheless, the information does not allow a clear relationship between the occurrence of the ADR and the influence of bariatric surgery. CONCLUSION There is a lack of official information and/or recommendations on medication use in subjects who have undergone bariatric surgery. Apart from under-reporting, ADRs reports remain largely uninformative. Health professional and patients would be awareness for improving, quantitatively and qualitatively the reporting of ADRs in this population.
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Affiliation(s)
- Carole Nicol
- Service de pharmacologie médicale, centre de pharmacovigilance de Toulouse, CIC1436, faculté de médecine, CHU de Toulouse, 31000 Toulouse, France
| | - Julien Jacquot
- Service de pharmacologie médicale, centre de pharmacovigilance de Toulouse, CIC1436, faculté de médecine, CHU de Toulouse, 31000 Toulouse, France
| | - Leila Chebane
- Service de pharmacologie médicale, centre de pharmacovigilance de Toulouse, CIC1436, faculté de médecine, CHU de Toulouse, 31000 Toulouse, France
| | - Sandrine Combret
- Centre régional de pharmacovigilance de Bourgogne, CHU de Dijon, 21000 Dijon, France
| | - Pauline-Eva Pecquet
- Service de pharmacologie clinique, centre de pharmacovigilance d'Amiens, CHU d'Amiens, 80000 Amiens, France
| | - Nathalie Massy
- Centre régional de pharmacovigilance de Rouen, CHU de Rouen, 76000 Rouen, France
| | - Haleh Bagheri
- Service de pharmacologie médicale, centre de pharmacovigilance de Toulouse, CIC1436, faculté de médecine, CHU de Toulouse, 31000 Toulouse, France.
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Komorniak N, Kaczmarczyk M, Łoniewski I, Martynova-Van Kley A, Nalian A, Wroński M, Kaseja K, Kowalewski B, Folwarski M, Stachowska E. Analysis of the Efficacy of Diet and Short-Term Probiotic Intervention on Depressive Symptoms in Patients after Bariatric Surgery: A Randomized Double-Blind Placebo Controlled Pilot Study. Nutrients 2023; 15:4905. [PMID: 38068763 PMCID: PMC10707788 DOI: 10.3390/nu15234905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/04/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023] Open
Abstract
(1) Background: studies have shown that some patients experience mental deterioration after bariatric surgery. (2) Methods: We examined whether the use of probiotics and improved eating habits can improve the mental health of people who suffered from mood disorders after bariatric surgery. We also analyzed patients' mental states, eating habits and microbiota. (3) Results: Depressive symptoms were observed in 45% of 200 bariatric patients. After 5 weeks, we noted an improvement in patients' mental functioning (reduction in BDI and HRSD), but it was not related to the probiotic used. The consumption of vegetables and whole grain cereals increased (DQI-I adequacy), the consumption of simple sugars and SFA decreased (moderation DQI-I), and the consumption of monounsaturated fatty acids increased it. In the feces of patients after RYGB, there was a significantly higher abundance of two members of the Muribaculaceae family, namely Veillonella and Roseburia, while those after SG had more Christensenellaceae R-7 group, Subdoligranulum, Oscillibacter, and UCG-005. (4) Conclusions: the noted differences in the composition of the gut microbiota (RYGB vs. SG) may be one of the determinants of the proper functioning of the gut-brain microbiota axis, although there is currently a need for further research into this topic using a larger group of patients and different probiotic doses.
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Affiliation(s)
- Natalia Komorniak
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland;
| | - Mariusz Kaczmarczyk
- Sanprobi sp. z o.o. sp. k., Kurza Stopka 5/C, 70-535 Szczecin, Poland; (M.K.); (I.Ł.)
| | - Igor Łoniewski
- Sanprobi sp. z o.o. sp. k., Kurza Stopka 5/C, 70-535 Szczecin, Poland; (M.K.); (I.Ł.)
- Department of Biochemical Science, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland
| | | | - Armen Nalian
- Department of Biology, Stephen F. Austin State University, Nacogdoches, TX 75962, USA; (A.M.-V.K.); (A.N.)
| | - Michał Wroński
- Department of Psychiatry, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland;
| | - Krzysztof Kaseja
- Department of General Surgery and Transplantation, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
| | - Bartosz Kowalewski
- Independent Provincial Public Hospital Complex in Szczecin-Zdunowo, 70-891 Szczecin, Poland;
| | - Marcin Folwarski
- Division of Clinical Nutrition and Dietetics, Medical University of Gdańsk, 80-211 Gdańsk, Poland;
| | - Ewa Stachowska
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland;
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Madden C, Ferber M, Cantwell S, Xaverius P, Christopher KM. Maternal Malnutrition During Pregnancy Among Women with Metabolic and Bariatric Surgery. Obes Surg 2023; 33:2276-2281. [PMID: 37329409 DOI: 10.1007/s11695-023-06678-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 05/30/2023] [Accepted: 06/08/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION As the utilization of metabolic and bariatric surgery (MBS) continues to rise, it is important to address the nutritional needs of women who had MBS who become pregnant. Not meeting those nutritional needs could lead to complications associated with malnutrition. To better understand the relationship between MBS, pregnancy, and malnutrition, this study sought to determine whether differences exist in the presence of malnutrition during pregnancy in women with a history of MBS compared to women without a history of MBS. METHODS This cross-sectional study used the National Inpatient Sample (NIS) from 2012 to 2017, which samples 20% of hospital discharges in the USA. Multivariate logistic regression models were fitted, and odds rations and 95% confidence intervals were calculated with obesity and MBS as the independent variables and malnutrition during pregnancy as the dependent variable. Covariates included in the multivariate model were age, primary payer, hypertension, hyperlipidemia, and depression. RESULTS Compared to women who did not have MBS, women who had MBS had higher odds of malnutrition during pregnancy (aOR = 8.33, 95% CI 7.30-9.50), this result was moderated by racial category (aORBlack = 6.35, 95% CI 4.97-8.13; aORwhite = 8.25, 95% CI 7.00-9.73; aORLatina = 10.93, 95% CI 8.38-14.25). Women with obesity also had higher odds of malnutrition during pregnancy. CONCLUSIONS The increased odds of malnutrition among women with MBS suggests that it is important to consider tailoring nutrition recommendations to address the different nutritional needs of pregnant women who had MBS and may be at risk for malnutrition.
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Affiliation(s)
- Colleen Madden
- Marion County Public Health Department, 3838 N Rural St, Indianapolis, IN, 46205, USA
| | - Megan Ferber
- College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Avenue, St. Louis, MO, 63104, USA
| | - Sophia Cantwell
- Medical Family Therapy Program, Department of Family and Community Medicine, Saint Louis University, 3700 Lindell Blvd, Morrissey Hall Suite 1127, Saint Louis, MO, 63108, USA
| | - Pamela Xaverius
- University of Health Sciences and Pharmacy in St. Louis, 1 Pharmacy Place, Saint Louis, MO, 63110, USA
| | - Kara M Christopher
- Souers Stroke Institute, Department of Neurology, Saint Louis University, 1008 S. Spring Ave, 3rd Floor, Saint Louis, MO, 63110, USA.
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Wu F, Li Y, Liu W, Xiao R, Yao B, Gao M, Xu D, Wang J. Comparative Investigation of Raw and Processed Radix Polygoni Multiflori on the Treatment of Vascular Dementia by Liquid Chromatograph-Mass Spectrometry Based Metabolomic Approach. Metabolites 2022; 12:metabo12121297. [PMID: 36557335 PMCID: PMC9785642 DOI: 10.3390/metabo12121297] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/07/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Radix Polygoni Multiflori (PM) is a well-known nootropic used in traditional Chinese medicine (TCM). Considering the efficacy and application discrepancy between raw (RPM) and processed PM (PPM), the similarities and differences between them in the treatment of vascular dementia (VaD) is intriguing. In this study, a VaD rat model was constructed by 2-vessel occlusion (2-VO). During 28 days of treatment, plasma was collected on days 7, 14, 21, and 28 after the start of dosing and the metabolic profile was analyzed by HPLC-MS/MS-based metabolomics. The Morris Water Maze Test, hematoxylin-eosin and Nissl staining, and biochemical analysis were used to assess cognitive function, pathogenic alterations and oxidative stress, respectively. RPM and PPM effectivelyreducedthe 2VO-induced cognitive impairment and mitigated histological alterations in hippocampus tissue. The 2-VO model significantly elevated MDA level and decreased SOD activity and GSH level, indicating severe oxidative stress, which could also be attenuated by RPM and PPM treatment. RPM outperformed PPM in decreasing MDA levels while PPM outperformed RPM in increasing GSH levels. Differential metabolites were subjected to Metabolite Set Enrichment Analysis (MSEA) and genes corresponding to proteins having interactions with metabolites were further annotated with Gene Ontology (GO). Both RPM and PPM ameliorated VaD-relevant vitamin B6 metabolism, pentose phosphate pathways, and taurine and hypotaurine metabolism. In addition, the metabolism of cysteine and methionine was regulated only by RPM, and riboflavin metabolism was modulated only by PPM. The results suggested that raw and processed PM had comparable efficacy in the treatment of VaD but also with some mechanistic differenece.
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Moolenaar LR, de Waard NE, Heger M, de Haan LR, Slootmaekers CPJ, Nijboer WN, Tushuizen ME, van Golen RF. Liver Injury and Acute Liver Failure After Bariatric Surgery: An Overview of Potential Injury Mechanisms. J Clin Gastroenterol 2022; 56:311-323. [PMID: 35180151 DOI: 10.1097/mcg.0000000000001662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The obesity epidemic has caused a surge in the use of bariatric surgery. Although surgery-induced weight loss is an effective treatment of nonalcoholic fatty liver disease, it may precipitate severe hepatic complications under certain circumstances. Acute liver injury (ALI) and acute liver failure (ALF) following bariatric surgery have been reported in several case series. Although rare, ALI and ALF tend to emerge several months after bariatric surgery. If so, it can result in prolonged hospitalization, may necessitate liver transplantation, and in some cases prove fatal. However, little is known about the risk factors for developing ALI or ALF after bariatric surgery and the mechanisms of liver damage in this context are poorly defined. This review provides an account of the available data on ALI and ALF caused by bariatric surgery, with emphasis on potential injury mechanisms and the outcomes of liver transplantation for ALF after bariatric surgery.
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Affiliation(s)
- Laura R Moolenaar
- Departments of Gastroenterology and Hepatology
- Department of Pharmaceutics, College of Medicine, Jiaxing University, Jiaxing, Zhejiang Province, P.R. China
| | | | - Michal Heger
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht
- Department of Pharmaceutics, College of Medicine, Jiaxing University, Jiaxing, Zhejiang Province, P.R. China
| | - Lianne R de Haan
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht
- Department of Pharmaceutics, College of Medicine, Jiaxing University, Jiaxing, Zhejiang Province, P.R. China
| | - Caline P J Slootmaekers
- Department of Gastroenterology and Hepatology, Sint Franciscus Gasthuis, Rotterdam, The Netherlands
| | | | | | - Rowan F van Golen
- Departments of Gastroenterology and Hepatology
- Department of Pharmaceutics, College of Medicine, Jiaxing University, Jiaxing, Zhejiang Province, P.R. China
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Zhou LP, Zhang RJ, Jia CY, Kang L, Zhang ZG, Zhang HQ, Wang JQ, Zhang B, Shen CL. Ferroptosis: A potential target for the intervention of intervertebral disc degeneration. Front Endocrinol (Lausanne) 2022; 13:1042060. [PMID: 36339421 PMCID: PMC9630850 DOI: 10.3389/fendo.2022.1042060] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/04/2022] [Indexed: 12/05/2022] Open
Abstract
Ferroptosis, an iron-dependent form of programmed cell death marked by phospholipid peroxidation, is regulated by complex cellular metabolic pathways including lipid metabolism, iron balance, redox homeostasis, and mitochondrial activity. Initial research regarding the mechanism of ferroptosis mainly focused on the solute carrier family 7 member 11/glutathione/glutathione peroxidase 4 (GPX4) signal pathway. Recently, novel mechanisms of ferroptosis, independent of GPX4, have been discovered. Numerous pathologies associated with extensive lipid peroxidation, such as drug-resistant cancers, ischemic organ injuries, and neurodegenerative diseases, are driven by ferroptosis. Ferroptosis is a new therapeutic target for the intervention of IVDD. The role of ferroptosis in the modulation of intervertebral disc degeneration (IVDD) is a significant topic of interest. This is a novel research topic, and research on the mechanisms of IVDD and ferroptosis is ongoing. Herein, we aim to review and discuss the literature to explore the mechanisms of ferroptosis, the relationship between IVDD and ferroptosis, and the regulatory networks in the cells of the nucleus pulposus, annulus fibrosus, and cartilage endplate to provide references for future basic research and clinical translation for IVDD treatment.
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Pastore A, Panera N, Mosca A, Caccamo R, Camanni D, Crudele A, De Stefanis C, Alterio A, Di Giovamberardino G, De Vito R, Francalanci P, Battaglia S, Muda AO, De Peppo F, Alisi A. Changes in Total Homocysteine and Glutathione Levels After Laparoscopic Sleeve Gastrectomy in Children with Metabolic-Associated Fatty Liver Disease. Obes Surg 2022; 32:82-89. [PMID: 34546515 DOI: 10.1007/s11695-021-05701-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 12/30/2022]
Abstract
PURPOSE Paediatric obesity is a well-known risk factor for metabolic-associated fatty liver disease (MAFLD). The aim of this study was to evaluate the effects of laparoscopic sleeve gastrectomy (LSG) on the levels of total homocysteine (tHcy) and total glutathione (tGSH) plasma levels in children with MAFLD. MATERIAL AND METHODS Twenty-four children with severe obesity who underwent LSG were included in the study. The metabolic parameters, systemic inflammatory markers, one-carbon metabolism products, ultrasound and histological improvement were evaluated at baseline (T0M) and after 12 months from LSG (T12M). RESULTS The patients exhibited a significant amelioration of several metabolic parameters at T12M. A significant reduction of steatosis was observed at ultrasound (from 72.7% of moderate-severe grade to 0% severe steatosis), accompanied by a statistically significant improvement of ballooning, portal and lobular inflammation and fibrosis. A statistically significant decrease of tumour necrosis factor circulating levels was also observed (T0M median = 290.3, IQR = 281.0-317.0 pg/mL; T12M median = 260.4, IQR = 240.0-279.0 pg/mL; p < 0.0001). After 12 months from LSG, a significant increase of mean plasma levels of tHcy(T0M mean = 15.7 ± 4.1 μmol/L; T12M mean = 21.1 ± 9.3 μmol/L; p = 0.0146) was also observed. The increase of tHcy showed no causal link with the improvement of MAFLD-related inflammatory, metabolic and histological pattern. CONCLUSION LSG in children with obesity induces an improvement of MAFLD-related metabolic derangement and liver damage, but also a mild hyperhomocysteinemia that should be avoided to prevent cardiovascular risk.
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Affiliation(s)
- Anna Pastore
- Research Unit of Diagnostical and Management Innovations, Bambino Gesù Children's Hospital, IRCCS, Viale San Paolo 15, 00146, Rome, Italy.
| | - Nadia Panera
- Research Unit of Molecular Genetics of Complex Phenotypes, Bambino Gesù Children's Hospital, IRCCS, Viale San Paolo 15, 00146, Rome, Italy
| | - Antonella Mosca
- Hepatology, Gastroenterology and Nutrition Unit, Bambino Gesù Children's Hospital, IRCCS, Viale San Paolo 15, 00146, Rome, Italy
| | - Romina Caccamo
- Pediatric Surgery Unit, Bambino Gesù Children's Hospital, IRCCS, Viale San Paolo 15, 00146, Rome, Italy
| | - Daniela Camanni
- Pediatric Surgery Unit, Bambino Gesù Children's Hospital, IRCCS, Viale San Paolo 15, 00146, Rome, Italy
| | - Annalisa Crudele
- Research Unit of Molecular Genetics of Complex Phenotypes, Bambino Gesù Children's Hospital, IRCCS, Viale San Paolo 15, 00146, Rome, Italy
| | - Cristiano De Stefanis
- Research Unit of Molecular Genetics of Complex Phenotypes, Bambino Gesù Children's Hospital, IRCCS, Viale San Paolo 15, 00146, Rome, Italy
| | - Arianna Alterio
- Hepatology, Gastroenterology and Nutrition Unit, Bambino Gesù Children's Hospital, IRCCS, Viale San Paolo 15, 00146, Rome, Italy
| | | | - Rita De Vito
- Pathology Unit, Bambino Gesù Children's Hospital, IRCCS, Viale San Paolo 15, 00146, Rome, Italy
| | - Paola Francalanci
- Pathology Unit, Bambino Gesù Children's Hospital, IRCCS, Viale San Paolo 15, 00146, Rome, Italy
| | - Sonia Battaglia
- Pediatric Surgery Unit, Bambino Gesù Children's Hospital, IRCCS, Viale San Paolo 15, 00146, Rome, Italy
| | - Andrea Onetti Muda
- Research Unit of Diagnostical and Management Innovations, Bambino Gesù Children's Hospital, IRCCS, Viale San Paolo 15, 00146, Rome, Italy
| | - Francesco De Peppo
- Pediatric Surgery Unit, Bambino Gesù Children's Hospital, IRCCS, Viale San Paolo 15, 00146, Rome, Italy
| | - Anna Alisi
- Research Unit of Molecular Genetics of Complex Phenotypes, Bambino Gesù Children's Hospital, IRCCS, Viale San Paolo 15, 00146, Rome, Italy.
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Hernandez-Landero F, Sanchez-Garcia E, Gomez-Crisostomo N, Contreras-Paredes A, Eduardo MA, de la Cruz-Hernandez E. Anthropometric, biochemical, and haematological indicators associated with hyperhomocysteinemia and their relation to global DNA methylation in a young adult population. Epigenetics 2021; 17:1269-1280. [PMID: 34923898 DOI: 10.1080/15592294.2021.2013420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Increased homocysteine (Hcy) levels have been associated with a higher risk of cardiovascular and neurodegenerative diseases. Passive DNA demethylation has been suggested as one of the mechanisms implicated in the development of these conditions, and most studies have investigated this relationship in older adult populations. Therefore, this study aimed to evaluate the relationship between corporal composition and biochemical and haematological indicators with plasma homocysteine levels and genome-wide methylation (Alu, LINE-1, and SAT2) in a population of healthy young adults (median age, 18 years). We showed that the prevalence of hyperhomocysteinemia was significantly higher in men (18.5%) than in women (6.6%) (P = 0.034). Increased Hcy level was substantially associated with higher levels of body mass index and visceral fat in females, whereas in males, it was significantly associated with reduced red cell distribution width and high-density lipoprotein (HDL) cholesterol (HDL-C) levels and increased low-density lipoprotein/HDL ratio. Hypomethylation of Alu was significantly associated with reduced levels of HDL-C (<40.0 mg dL-1), whereas hypomethylation of LINE-1 and SAT2 was significantly associated with higher levels of skeletal muscle (<39.3%) in males. These results highlight the participation of hormonal factors in regulating Hcy metabolism, primarily in the female population, whereas changes in DNA methylation observed in males might be associated with the consumption of a protein diet with high levels of methionine, independent of increased Hcy levels.
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Affiliation(s)
- Fernanda Hernandez-Landero
- Laboratory of Research in Metabolic and Infectious Diseases. Multidisciplinary Academic Division of Comalcalco, Juarez Autonomous University of Tabasco, Comalcalco City, Mexico
| | - Erika Sanchez-Garcia
- Laboratory of Research in Metabolic and Infectious Diseases. Multidisciplinary Academic Division of Comalcalco, Juarez Autonomous University of Tabasco, Comalcalco City, Mexico
| | - Nancy Gomez-Crisostomo
- Laboratory of Research in Metabolic and Infectious Diseases. Multidisciplinary Academic Division of Comalcalco, Juarez Autonomous University of Tabasco, Comalcalco City, Mexico
| | - Adriana Contreras-Paredes
- Laboratory of Molecular Biology of Oncogenic Viruses, Unit of Biomedical Research in Cancer, National Cancer Institute - Biomedical Research Institute, National Autonomous University of Mexico, Mexico City, Mexico
| | - Martínez Abundis Eduardo
- Laboratory of Research in Metabolic and Infectious Diseases. Multidisciplinary Academic Division of Comalcalco, Juarez Autonomous University of Tabasco, Comalcalco City, Mexico
| | - Erick de la Cruz-Hernandez
- Laboratory of Research in Metabolic and Infectious Diseases. Multidisciplinary Academic Division of Comalcalco, Juarez Autonomous University of Tabasco, Comalcalco City, Mexico
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Kobylińska M, Antosik K, Decyk A, Kurowska K. Malnutrition in Obesity: Is It Possible? Obes Facts 2021; 15:19-25. [PMID: 34749356 PMCID: PMC8820192 DOI: 10.1159/000519503] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 09/03/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) classifies malnutrition as the biggest threat to public health worldwide, and this condition is observed in 20-60% of hospitalized patients. Malnutrition is a state of the body in which due to insufficient supply or incorrect absorption of essential nutrients, the body composition changes and the body's functions are impaired. Malnutrition is associated not only with reduced body mass index but also with obesity. SUMMARY Obesity is defined as a paradoxical state of malnutrition, which despite excessive energy consumption is associated with a shortage of individual microelements. Deficiency or lack of homeostasis of essential micronutrients can significantly affect daily performance, intellectual and emotional state, but also the physical state of the body. Food deficiency can also contribute to further weight gain or the development of other metabolic diseases. Micronutrient deficiency may include not only incorrect dietary choices and insufficient access to nutrient-rich foods but also changes in the absorption, distribution or excretion of nutrients, and altered micronutrient metabolism resulting from systemic inflammation caused by obesity. An effective therapy method recommended for people with morbid obesity is bariatric surgery aimed at both weight loss and improving quality of life. Unfortunately, the effects of these treatments are often medium- and long-term complications associated with micronutrient deficiency as a result of reduced consumption or absorption. Therefore, the use of bariatric surgery in patients with extreme obesity can affect the metabolism of microelements and increase the risk of nutritional deficiencies. Key Messages: Studies by many authors indicate a higher incidence of food deficiency among people with excessive body weight, than in people with normal body weight of the same age and same sex. Monitoring the concentration of minerals and vitamins in blood serum is a good practice in the treatment of obesity. The proper nutritional status of the body affects not only the state of health but also the effectiveness of therapy. The aim of the review was to present the issue of malnutrition in the context of obesity.
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Affiliation(s)
| | - Katarzyna Antosik
- Faculty of Medical and Health Sciences, Siedlce University of Natural Sciences and Humanities, Siedlce, Poland
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Association of Obesity with the Risk of Hyperhomocysteinemia among the Chinese Community Residents: A Prospective Cohort Study in Shanghai, China. Nutrients 2021; 13:nu13103648. [PMID: 34684648 PMCID: PMC8537264 DOI: 10.3390/nu13103648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/09/2021] [Accepted: 10/15/2021] [Indexed: 12/23/2022] Open
Abstract
A prospective community-based cohort study was conducted to investigate the effects of obesity on hyperhomocysteinemia (HHcy) in community residents from Shanghai, China, with a median follow-up period of 2.98 years. The exposures were high body mass index (BMI) (BMI ≥ 28.0 kg/m2) and high waist circumference (WC) (WC ≥ 85.0 cm for female and WC ≥ 90.0 for male) at baseline investigation, and the outcome was the incident of HHcy after the follow-up. A restricted cubic spline (RCS) was performed to assess the possible nonlinear relationship of BMI and WC with HHcy. A Cox proportional hazard regression model was used to evaluate the association between BMI and WC measured obesity and the risk of HHcy (Hcy level > 15 µmol/L). No significant non-linearity was found between BMI and WC with HHcy. Cox regression model showed that underweight measured by BMI was negatively associated with the risk of HHcy after controlling for confounder variables (adjusted HR = 0.64, 95% CI = 0.42 to 0.99). While abdominal obesity was positively associated with the risk of HHcy for those without CVD-related comorbidities (adjusted HR = 1.26, 95% CI = 1.05 to 1.51). Our results suggested that individuals could maintain a relatively low BMI and normal WC to lower the risk of HHcy.
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Bhattacharya S, Kalra S, Kapoor N, Singla R, Dutta D, Aggarwal S, Khandelwal D, Surana V, Dhingra A, Kantroo V, Chittawar S, Deka N, Bindal V, Dutta P. Expert opinion on the preoperative medical optimization of adults with diabetes undergoing metabolic surgery. World J Diabetes 2021; 12:1587-1621. [PMID: 34754367 PMCID: PMC8554368 DOI: 10.4239/wjd.v12.i10.1587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/18/2021] [Accepted: 08/25/2021] [Indexed: 02/06/2023] Open
Abstract
Diabetes mellitus (DM) and obesity are interrelated in a complex manner, and their coexistence predisposes patients to a plethora of medical problems. Metabolic surgery has evolved as a promising therapeutic option for both conditions. It is recommended that patients, particularly those of Asian origin, maintain a lower body mass index threshold in the presence of uncontrolled DM. However, several comorbidities often accompany these chronic diseases and need to be addressed for successful surgical outcome. Laparoscopic Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG) are the most commonly used bariatric procedures worldwide. The bariatric benefits of RYGB and LSG are similar, but emerging evidence indicates that RYGB is more effective than LSG in improving glycemic control and induces higher rates of long-term DM remission. Several scoring systems have been formulated that are utilized to predict the chances of remission. A glycemic target of glycated hemoglobin < 7% is a reasonable goal before surgery. Cardiovascular, pulmonary, gastrointestinal, hepatic, renal, endocrine, nutritional, and psychological optimization of surgical candidates improves perioperative and long-term outcomes. Various guidelines for preoperative care of individuals with obesity have been formulated, but very few specifically focus on the concerns arising from the presence of concomitant DM. It is hoped that this statement will lead to the standardization of presurgical management of individuals with DM undergoing metabolic surgery.
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Affiliation(s)
| | - Sanjay Kalra
- Endocrinology, Bharti Hospital, Karnal 132001, Haryana, India
| | - Nitin Kapoor
- Endocrinology, Christian Medical College, Vellore 632004, Tamil Nadu, India
| | - Rajiv Singla
- Endocrinology, Kalpavriksh Super Speciality Center, New Delhi 110075, India
| | - Deep Dutta
- Endocrinology, CEDAR Superspecialty Clinic, New Delhi 110075, India
| | - Sameer Aggarwal
- Endocrinology, Apex Plus Superspeciality Hospital, Rohtak 124001, Haryana, India
| | | | - Vineet Surana
- Endocrinology, Manipal Hospitals, New Delhi 110075, India
| | - Atul Dhingra
- Endocrinology, Gangaram Bansal Super Speciality Hospital, Sri Ganganagar 335001, Rajasthan, India
| | - Viny Kantroo
- Respiratory Medicine & Critical Care, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India
| | - Sachin Chittawar
- Endocrinology, Gandhi Medical College, Bhopal 462001, Madhya Pardesh, India
| | - Nilakshi Deka
- Endocrinology, Apollo Hospitals, Guwahati 781005, Assam, India
| | - Vivek Bindal
- Minimal Access, Metabolic and Bariatric surgery, Max Superspeciality Hospital, Patparganj, New Delhi 110092, India
| | - Puja Dutta
- Nutrition, Max Superspeciality Hospital, Patparganj, New Delhi 110092, India
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13
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Association between Plasma Homocysteine Concentrations and the First Ischemic Stroke in Hypertensive Patients with Obstructive Sleep Apnea: A 7-Year Retrospective Cohort Study from China. DISEASE MARKERS 2021; 2021:9953858. [PMID: 34621408 PMCID: PMC8492296 DOI: 10.1155/2021/9953858] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/16/2021] [Accepted: 09/21/2021] [Indexed: 12/16/2022]
Abstract
Purpose This study was aimed at investigating the association between baseline plasma homocysteine (Hcy) concentrations and the risk of the first ischemic stroke (IS) and at investigating any possible influential modifying factors in hypertensive patients with obstructive sleep apnea (OSA). Methods Cox proportional hazards regression was employed to investigate the relationship between plasma Hcy concentration and the first IS. A generalized additive model was applied to determine the nonlinear relationship. In addition, we conducted subgroup analysis. Results A total of 2350 hypertensive patients with OSA without a history of IS were enrolled in this study. At a median follow-up of 7.15 years, we identified 93 cases of the first IS. After adjusting for potential confounding, the findings revealed that plasma Hcy concentration was strongly and positively associated with the occurrence of the first IS (per SD increment; HR = 1.37, 95% CI: 1.30-1.44). A nonlinear relationship was found between plasma Hcy concentration and the risk of developing the first IS with inflection points for plasma Hcy of 5 μmol/L. In stratified analysis, a greater positive correlation was found between baseline plasma Hcy concentrations and new-onset IS in patients with DBP ≥ 90 mmHg (per SD increment; HR = 1.48, 95% CI: 1.33-1.65 vs. <90 mmHg: HR = 1.20, 95% CI: 1.02-1.42; P‐interaction = 0.04) and BMI ≥ 24 and <28 kg/m2 (per SD increment; HR = 1.46, 95% CI: 1.26-1.70 vs. <24 kg/m2: HR = 1.13, 95% CI: 0.95-1.33 vs. ≥28 kg/m2: HR = 1.46, 95% CI: 1.25-1.70; P‐interaction = 0.03). Conclusion Elevated plasma Hcy concentrations are independently associated with the risk of the first IS in hypertensive patients with OSA. Plasma Hcy concentrations ≥ 5 μmol/L surely increased the risk of the first IS in hypertensive patients with OSA.
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Tynes M, Hepprich M, Timper K. Regular intake of energy drinks and multivitamin supplements is associated with elevated plasma vitamin B6 levels in post-bariatric patients. Sci Rep 2021; 11:17830. [PMID: 34497284 PMCID: PMC8426371 DOI: 10.1038/s41598-021-97205-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 08/20/2021] [Indexed: 12/17/2022] Open
Abstract
The aim of the present survey was to analyze plasma vitamin B6 levels in post-bariatric patients and to elucidate the causal factors associated with elevated plasma vitamin B6 levels. This is a retrospective analysis of electronic patient data of all post-bariatric patients evaluated at the endocrine outpatient clinic of the University Hospital Basel in 2017, for which plasma vitamin B6 values were assessed during regular follow-up visits. In total, 205 patients were included in the study, whereof a minority of 43% had vitamin B6 levels in the normal range. 50% of the patients had vitamin B6 levels up to fourfold higher than the upper normal limit and 7% had levels more than fourfold above the upper normal limit. Vitamin B6 deficiency was not observed in any patient. While multivitamin supplementation in general was associated with elevated plasma vitamin B6 levels, the highest vitamin B6 levels were found after biliopancreatic diversion (BPD) and in patients who reported daily energy drink intake. Elevated plasma vitamin B6 levels up to fourfold above the upper normal limit are common in postbariatric patients and are associated with regular multivitamin supplementation, while highly elevated plasma vitamin B6 levels were seen primarily upon regular energy drink intake. Thus, a regular follow-up of vitamin B6 plasma levels and critical evaluation of vitamin B6 supplementation, either as part of the multivitamin preparation or related to regular energy drink intake, is highly warranted and should be an integral part of the routine post-bariatric follow-up.
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Affiliation(s)
- Martina Tynes
- Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056, Basel, Switzerland.,Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Matthias Hepprich
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.,Clinic of Endocrine and Metabolic Disorders, Cantonal Hospital Olten, Basler Strasse 150, 4600, Olten, Switzerland
| | - Katharina Timper
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland. .,Department of Biomedicine, University Basel, Hebelstrasse 20, 4031, Basel, Switzerland.
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15
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Çağlar TR, Seyit H, Çalışkan P, Vural M, Kural A. Serum Vitamin and Trace Element Levels of Patients Undergoing Laparoscopic Sleeve Gastrectomy. Bariatr Surg Pract Patient Care 2021. [DOI: 10.1089/bari.2020.0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Tuba Rana Çağlar
- Medical Biochemistry Department, Faculty of Medicine, University of Health Sciences, Istanbul, Turkey
| | - Hakan Seyit
- General Surgery Department, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Pinar Çalışkan
- Medical Biochemistry Department, Faculty of Medicine, University of Health Sciences, Istanbul, Turkey
| | - Meltem Vural
- Physical Medicine and Rehabilitation Department, Faculty of Medicine, University of Health Sciences, Istanbul, Turkey
| | - Alev Kural
- Medical Biochemistry Department, Faculty of Medicine, University of Health Sciences, Istanbul, Turkey
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Gasmi A, Bjørklund G, Mujawdiya PK, Semenova Y, Peana M, Dosa A, Piscopo S, Gasmi Benahmed A, Costea DO. Micronutrients deficiences in patients after bariatric surgery. Eur J Nutr 2021; 61:55-67. [PMID: 34302218 DOI: 10.1007/s00394-021-02619-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/09/2021] [Indexed: 12/14/2022]
Abstract
Bariatric surgery is an effective option for managing obesity and has gained general acceptance among patients in recent years. Generally, despite the high caloric intake, a bad nutritional habit of obese people results in the deficiency of several vitamins, minerals, and trace elements essential for body metabolism and normal physiological processes. Additionally, the current bariatric surgical approaches such as sleeve gastrectomy (SG), Roux-en-Y-gastric bypass (RYGB), laparoscopic adjustable gastric banding (LAGB), and jejunoileal bypass (JIB) can cause or exacerbate these deficiencies. Based on several reports, it appears that the various bariatric surgical procedures affect nutrient absorption differently. Being purely restrictive, LAGB and SG affect the absorption of iron, selenium, and vitamin B12, while RYGB, JIB, and biliopancreatic diversion have a more profound impact on the absorption of essential vitamins, minerals, and trace elements. Nutritional deficiencies in vitamins, minerals, and trace elements may follow bariatric surgery and are associated with clinical manifestations and diseases, including anemia, ataxia, hair loss, and Wernicke encephalopathy. The present review summarizes some of the major vitamin and micronutrient deficiencies associated with bariatric surgery, particularly those presented post-surgically. To avoid any adverse consequences of vitamin and trace element deficiency, proper monitoring and tests are recommended at any stage, from pre- to post-surgery (periodical check-up), followed by specific and individual nutritional supplementation treatments and a proper healthy diet.
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Affiliation(s)
- Amin Gasmi
- Société Francophone de Nutrithérapie et de Nutrigénétique Appliquée, Villeurbanne, France
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine (CONEM), Toften 24, 8610, Mo i Rana, Norway.
| | | | - Yuliya Semenova
- Semey Medical University, Semey, Kazakhstan
- CONEM Kazakhstan Environmental Health and Safety Research Group, Semey Medical University, Semey, Kazakhstan
| | - Massimiliano Peana
- Department of Chemistry and Pharmacy, University of Sassari, Sassari, Italy
| | - Alexandru Dosa
- Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania
| | - Salva Piscopo
- Société Francophone de Nutrithérapie et de Nutrigénétique Appliquée, Villeurbanne, France
- Department of Nutritional Research and Development, Nutri-Logics SA, Weiswampach, Luxembourg
| | - Asma Gasmi Benahmed
- Académie Internationale de Médecine Dentaire Intégrative, Paris, France
- Université Claude Bernard, Lyon 1, Villeurbanne, France
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Central retinal vein occlusion after laparoscopic sleeve gastrectomy in an 18-year-Old female. Am J Ophthalmol Case Rep 2021; 23:101165. [PMID: 34368493 PMCID: PMC8326183 DOI: 10.1016/j.ajoc.2021.101165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 07/20/2021] [Indexed: 12/30/2022] Open
Abstract
Purpose To describe a case of central retinal vein occlusion (CRVO) in a young adult found to have elevated homocysteine after bariatric surgery and to review risk factors for CRVO in younger patients. Observations An 18-year-old female presented with a CRVO and severe cystoid macular edema (CME). She was normotensive, not on medications, and without known heritable hypercoagulable disease. Her medical history was notable for bariatric surgery and subsequently she was found to have nutritional deficiency, anemia, and elevated homocysteine. Her elevated homocysteine may have induced a hypercoaguable state that predisposed her to developing a CRVO. Treatment with bevacizumab dramatically improved her macular edema and visual acuity. Nutritional supplementation was initiated. Conclusions Elevated homocysteine in the setting of nutritional deficiency from prior bariatric surgery may cause a hypercoaguable state and is a potential risk factor for CRVO. Importance With the increasing prevalence of obesity and bariatric surgery, it is important to consider associated nutrient deficiency as a potential cause of induced hypercoagulability and increased risk for CRVO. Identification of these at-risk patients is especially important given this condition is easily treatable and may be present in younger individuals. To the best of our knowledge, this is the first reported case of a CRVO with elevated homocysteine in the setting of nutrient deficiencies from laparoscopic sleeve gastrectomy.
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18
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Post-traumatic stress disorder may set the neurobiological stage for eating disorders: A focus on glutamatergic dysfunction. Appetite 2021; 167:105599. [PMID: 34271078 DOI: 10.1016/j.appet.2021.105599] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 06/23/2021] [Accepted: 07/12/2021] [Indexed: 12/30/2022]
Abstract
Post-traumatic stress disorder (PTSD) is a trauma and stress-related disorder which has been shown to be highly comorbid with, and commonly a precedent of, the eating disorders anorexia nervosa, bulimia nervosa, and binge eating disorder. The objective of this review is to discuss a potential overlapping neurobiological mechanism for this comorbidity. Alterations in glutamatergic neurotransmission have been observed in all four of the aforementioned disorders. Excessive excitation via glutamate contributes to excitotoxicity, and over-activation of the hypothalamic-pituitary-adrenal axis, both of which have implications for the deterioration of various brain structures. Prominent structures impacted include the hippocampus, hypothalamus, and prefrontal cortex, all of which are integral to the regulation of stress and eating. The current review suggests that altered glutamate function by trauma or extreme stress may facilitate PTSD and subsequent eating disorder onset, and that glutamatergic modulation may be a key treatment for individuals suffering from these conditions. This overlapping mechanism may help inform future research on individuals with comorbid PTSD and eating disorders, and it could also help inform ways to potentially prevent the onset of these conditions.
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Al Mansoori A, Shakoor H, Ali HI, Feehan J, Al Dhaheri AS, Cheikh Ismail L, Bosevski M, Apostolopoulos V, Stojanovska L. The Effects of Bariatric Surgery on Vitamin B Status and Mental Health. Nutrients 2021; 13:1383. [PMID: 33923999 PMCID: PMC8073305 DOI: 10.3390/nu13041383] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/16/2021] [Accepted: 04/16/2021] [Indexed: 02/06/2023] Open
Abstract
Diet is a modifiable factor that ensures optimal growth, biochemical performance, improved mood and mental functioning. Lack of nutrients, notably vitamin B, has an impact on human health and wellbeing. The United Arab Emirates is facing a serious problem of micronutrient deficiencies because of the growing trend for bariatric surgery, including Roux-en-Y gastric bypass and sleeve gastrectomy. People undergoing bariatric surgery are at high risk of developing neurological, cognitive, and mental disabilities and cardiovascular disease due to deficiency in vitamin B. Vitamin B is involved in neurotransmitter synthesis, including γ-aminobutyric acid, serotonin, dopamine, and noradrenaline. Deficiency of vitamin B increases the risk of depression, anxiety, dementia and Alzheimer's disease. In addition, vitamin B deficiency can disrupt the methylation of homocysteine, leading to hyperhomocysteinemia. Elevated homocysteine levels are detrimental to human health. Vitamin B deficiency also suppresses immune function, increases the production of pro-inflammatory cytokines and upregulates NF-κB. Considering the important functions of vitamin B and the severe consequences associated with its deficiency following bariatric surgery, proper dietary intervention and administration of adequate supplements should be considered to prevent negative clinical outcomes.
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Affiliation(s)
- Amna Al Mansoori
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 15551, United Arab Emirates; (A.A.M.); (H.S.); (H.I.A.); (A.S.A.D.)
| | - Hira Shakoor
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 15551, United Arab Emirates; (A.A.M.); (H.S.); (H.I.A.); (A.S.A.D.)
| | - Habiba I. Ali
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 15551, United Arab Emirates; (A.A.M.); (H.S.); (H.I.A.); (A.S.A.D.)
| | - Jack Feehan
- Institute for Health and Sport, Victoria University, Melbourne, VIC 8001, Australia; (J.F.); (V.A.)
- Department of Medicine-Western Health, The University of Melbourne, Melbourne, VIC 8001, Australia
| | - Ayesha S. Al Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 15551, United Arab Emirates; (A.A.M.); (H.S.); (H.I.A.); (A.S.A.D.)
| | - Leila Cheikh Ismail
- Clinical Nutrition and Dietetics Department, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates;
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford OX1 2JD, UK
| | - Marijan Bosevski
- Faculty of Medicine Skopje, University Clinic of Cardiology, University of Ss. Cyril and Methodius, 1010 Skopje, North Macedonia;
| | - Vasso Apostolopoulos
- Institute for Health and Sport, Victoria University, Melbourne, VIC 8001, Australia; (J.F.); (V.A.)
| | - Lily Stojanovska
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 15551, United Arab Emirates; (A.A.M.); (H.S.); (H.I.A.); (A.S.A.D.)
- Institute for Health and Sport, Victoria University, Melbourne, VIC 8001, Australia; (J.F.); (V.A.)
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Carabotti M, Annibale B, Lahner E. Common Pitfalls in the Management of Patients with Micronutrient Deficiency: Keep in Mind the Stomach. Nutrients 2021; 13:nu13010208. [PMID: 33450823 PMCID: PMC7828248 DOI: 10.3390/nu13010208] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 12/31/2020] [Accepted: 01/08/2021] [Indexed: 02/05/2023] Open
Abstract
Micronutrient deficiencies are relatively common, in particular iron and cobalamin deficiency, and may potentially lead to life-threatening clinical consequences when not promptly recognized and treated, especially in elderly patients. The stomach plays an important role in the homeostasis of some important hematopoietic micronutrients like iron and cobalamin, and probably in others equally important such as ascorbic acid, calcium, and magnesium. A key role is played by the corpus oxyntic mucosa composed of parietal cells whose main function is gastric acid secretion and intrinsic factor production. Gastric acid secretion is necessary for the digestion and absorption of cobalamin and the absorption of iron, calcium, and probably magnesium, and is also essential for the absorption, secretion, and activation of ascorbic acid. Several pathological conditions such as Helicobacter pylori-related gastritis, corpus atrophic gastritis, as well as antisecretory drugs, and gastric surgery may interfere with the normal functioning of gastric oxyntic mucosa and micronutrients homeostasis. Investigation of the stomach by gastroscopy plus biopsies should always be considered in the management of patients with micronutrient deficiencies. The current review focuses on the physiological and pathophysiological aspects of gastric acid secretion and the role of the stomach in iron, cobalamin, calcium, and magnesium deficiency and ascorbate homeostasis.
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21
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Zhang X, Huang Z, Xie Z, Chen Y, Zheng Z, Wei X, Huang B, Shan Z, Liu J, Fan S, Chen J, Zhao F. Homocysteine induces oxidative stress and ferroptosis of nucleus pulposus via enhancing methylation of GPX4. Free Radic Biol Med 2020; 160:552-565. [PMID: 32896601 DOI: 10.1016/j.freeradbiomed.2020.08.029] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/19/2020] [Accepted: 08/30/2020] [Indexed: 12/16/2022]
Abstract
Homocysteine (Hcy) is an amino acid involved in gene methylation. Plasma concentration of Hcy is elevated in the pathological condition hyperhomocysteinemia (HHcy), which increases the risk of disorders of the vascular, nervous and musculoskeletal systems, including chondrocyte dysfunction. The present study aimed to explore the role of Hcy in intervertebral disc degeneration (IVDD), using a range of techniques. A clinical epidemiological study showed that HHcy is an independent risk factor for human IVDD. Cell culture using rat nucleus pulposus cells showed that Hcy promotes a degenerative cell phenotype (involving increased oxidative stress and cell death by ferroptosis) which is mediated by upregulated methylation of GPX4. An in-vivo mouse 'puncture' model of IVDD showed that folic acid (which is used to treat HHcy in humans) reduced the ability of diet-induced HHcy to promote IVDD. We conclude that Hcy upregulates oxidative stress and ferroptosis in the nucleus pulposus via enhancing GPX4 methylation, and is a new contributing factor in IVDD.
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Affiliation(s)
- Xuyang Zhang
- Department of Orthopaedics, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, Qingchun Road East, Hangzhou, 310016, PR China; Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang Province, PR China.
| | - Zhaobo Huang
- Department of Orthopaedics, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, Qingchun Road East, Hangzhou, 310016, PR China; Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang Province, PR China.
| | - Ziang Xie
- Department of Orthopaedics, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, Qingchun Road East, Hangzhou, 310016, PR China; Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang Province, PR China.
| | - Yilei Chen
- Department of Orthopaedics, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, Qingchun Road East, Hangzhou, 310016, PR China; Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang Province, PR China.
| | - Zeyu Zheng
- Department of Orthopaedics, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, Qingchun Road East, Hangzhou, 310016, PR China; Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang Province, PR China.
| | - Xiao'an Wei
- Department of Orthopaedics, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, Qingchun Road East, Hangzhou, 310016, PR China; Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang Province, PR China.
| | - Bao Huang
- Department of Orthopaedics, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, Qingchun Road East, Hangzhou, 310016, PR China; Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang Province, PR China.
| | - Zhi Shan
- Department of Orthopaedics, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, Qingchun Road East, Hangzhou, 310016, PR China; Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang Province, PR China.
| | - Junhui Liu
- Department of Orthopaedics, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, Qingchun Road East, Hangzhou, 310016, PR China; Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang Province, PR China.
| | - Shunwu Fan
- Department of Orthopaedics, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, Qingchun Road East, Hangzhou, 310016, PR China; Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang Province, PR China.
| | - Jian Chen
- Department of Orthopaedics, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, Qingchun Road East, Hangzhou, 310016, PR China; Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang Province, PR China.
| | - Fengdong Zhao
- Department of Orthopaedics, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, Qingchun Road East, Hangzhou, 310016, PR China; Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang Province, PR China.
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Personalized Nutrition for Management of Micronutrient Deficiency-Literature Review in Non-bariatric Populations and Possible Utility in Bariatric Cohort. Obes Surg 2020; 30:3570-3582. [PMID: 32564308 PMCID: PMC7378102 DOI: 10.1007/s11695-020-04762-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 06/01/2020] [Accepted: 06/04/2020] [Indexed: 02/07/2023]
Abstract
Background Bariatric surgery can effectively treat morbid obesity; however, micronutrient deficiencies are common despite recommendations for high-dose supplements. Genetic predisposition to deficiencies underscores necessary identification of high-risk candidates. Personalized nutrition (PN) can be a tool to manage these deficiencies. Methods Medline, PubMed, and Google Scholar were searched. Articles involving genetic testing, micronutrient metabolism, and bariatric surgery were included. Results Studies show associations between genetic variants and micronutrient metabolism. Research demonstrates genetic testing to be a predictor for outcomes among obesity and bariatric surgery populations. There is limited research in bariatric surgery and micronutrient genetic variants. Conclusion Genotype-based PN is becoming feasible to provide an effective treatment of micronutrient deficiencies associated with bariatric surgery. The role of genomic technology in micronutrient recommendations needs further investigation.
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23
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Ciobârcă D, Cătoi AF, Copăescu C, Miere D, Crișan G. Bariatric Surgery in Obesity: Effects on Gut Microbiota and Micronutrient Status. Nutrients 2020; 12:E235. [PMID: 31963247 PMCID: PMC7019602 DOI: 10.3390/nu12010235] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 12/30/2019] [Accepted: 01/13/2020] [Indexed: 02/07/2023] Open
Abstract
Obesity is associated with reduced gut microbial diversity and a high rate of micronutrient deficiency. Bariatric surgery, the therapy of choice for severe obesity, produces sustained weight loss and improvements in obesity-related comorbidities. Also, it significantly alters the gut microbiota (GM) composition and function, which might have an important impact on the micronutrient status as GM is able to synthesize certain vitamins, such as riboflavin, folate, B12, or vitamin K2. However, recent data have reported that GM is not fully restored after bariatric surgery; therefore, manipulation of GM through probiotics represents a promising therapeutic approach in bariatric patients. In this review, we discuss the latest evidence concerning the relationship between obesity, GM and micronutrients, the impact of bariatric surgery on GM in relation with micronutrients equilibrium, and the importance of the probiotics' supplementation in obese patients submitted to surgical treatment.
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Affiliation(s)
- Daniela Ciobârcă
- Department of Bromatology, Hygiene, Nutrition, Faculty of Pharmacy, “Iuliu Hatieganu” University of Medicine and Pharmacy, 23 Gheorghe Marinescu Street, 400337 Cluj-Napoca, Romania
| | - Adriana Florinela Cătoi
- Department of Physiopathology, Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 3-4 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Cătălin Copăescu
- General Surgery Department, Ponderas Hospital, 85A Nicolae G. Caramfil Street, 014142 Bucharest, Romania;
| | - Doina Miere
- Department of Bromatology, Hygiene, Nutrition, Faculty of Pharmacy, “Iuliu Hatieganu” University of Medicine and Pharmacy, 23 Gheorghe Marinescu Street, 400337 Cluj-Napoca, Romania
| | - Gianina Crișan
- Department of Pharmaceutical Botany, Faculty of Pharmacy, “Iuliu Hatieganu” University of Medicine and Pharmacy, 23 Gheorghe Marinescu Street, 400337 Cluj-Napoca, Romania;
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24
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Paredes S, de Lurdes Fernandes Alves M, Ribeiro LVPT. Letter to the Editor Concerning Nutritional Deficiencies, Bariatric Surgery, and Serum Homocysteine Level: Review of Current Literature. Obes Surg 2019; 30:761-762. [PMID: 31760603 DOI: 10.1007/s11695-019-04263-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Sílvia Paredes
- Endocrinology Department, Hospital de Braga, Sete Fontes, São Victor, 4710-243, Braga, Portugal. .,Department of Public Health and Forensic Sciences, and Medical Education, Medical Education Unit, Faculty of Medicine of the University of Porto, 4200-319, Porto, Portugal.
| | | | - Laura Virgínia Pereira Teixeira Ribeiro
- Department of Public Health and Forensic Sciences, and Medical Education, Medical Education Unit, Faculty of Medicine of the University of Porto, 4200-319, Porto, Portugal.,I3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-319, Porto, Portugal
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