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Genua I, Miñambres I, Puig R, Sardà H, Fernández-Ananin S, Sánchez-Quesada JL, Pérez A. Weight loss benefits on HDL cholesterol persist even after weight regaining. Surg Endosc 2024; 38:3320-3328. [PMID: 38684527 DOI: 10.1007/s00464-024-10826-7] [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: 11/09/2023] [Accepted: 03/23/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Obesity-related comorbidities may relapse in patients with weight regain after bariatric surgery. However, HDL cholesterol (HDLc) levels increase after surgery and seem to remain stable despite a gradual increase in BMI. The aim of this study is to analyze the effects of weight regain after bariatric surgery on HDL cholesterol. MATERIALS AND METHODS This is a retrospective, observational, cohort study in patients who underwent bariatric surgery in the Hospital de la Santa Creu i Sant Pau (Barcelona) between 2007 and 2015. Patients without at least 5 years of follow-up after surgery, under fibrate treatment, and those who required revisional surgery were excluded from the analysis. Data were collected at baseline, 3 and 6 months after surgery, and then annually until 5 years post-surgery. RESULTS One hundred fifty patients were analyzed. 93.3% of patients reached > 20% of total weight loss after surgery. At 5th year, 37% of patients had regained > 15% of nadir weight, 60% had regained > 10%, and 22% had regained < 5% of nadir weight. No differences were found in HDLc levels between the different groups of weight regain, nor in the % of change in HDLc levels between nadir weight and 5 years, or in the proportion of patients with normal HDLc concentrations either. CONCLUSION HDLc remains stable regardless of weight regain after bariatric surgery.
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Affiliation(s)
- Idoia Genua
- Department of Endocrinology and Nutrition, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, C/Sant Quintí 89, 08025, Barcelona, Spain
- Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Inka Miñambres
- Department of Endocrinology and Nutrition, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, C/Sant Quintí 89, 08025, Barcelona, Spain.
- Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain.
- CIBER of Diabetes and Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - Rocío Puig
- Department of Endocrinology and Nutrition, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, C/Sant Quintí 89, 08025, Barcelona, Spain
| | - Helena Sardà
- Department of Endocrinology and Nutrition, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, C/Sant Quintí 89, 08025, Barcelona, Spain
- Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Sonia Fernández-Ananin
- Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
- Unit of Esophagogastric and Bariatric and Metabolic Surgery, Department of General and Digestive Surgery, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - José Luis Sánchez-Quesada
- CIBER of Diabetes and Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Cardiovascular Biochemistry Group, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Antonio Pérez
- Department of Endocrinology and Nutrition, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, C/Sant Quintí 89, 08025, Barcelona, Spain.
- Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain.
- CIBER of Diabetes and Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
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2
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Torrego-Ellacuría M, Barabash A, Matía-Martín P, Sánchez-Pernaute A, Torres AJ, Calle-Pascual AL, Rubio-Herrera MA. Combined Effect of Genetic Variants on Long-Term Weight Response after Bariatric Surgery. J Clin Med 2023; 12:4288. [PMID: 37445323 DOI: 10.3390/jcm12134288] [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: 05/16/2023] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
The pathophysiology of body weight control involves complex interactions between hormonal, environmental, behavioral and genetic factors. The purpose of this study was to analyze the association between single nucleotide polymorphisms (SNPs) of 13 genes encoding gastrointestinal peptides, their receptors or the proteins involved in their expression, with long-term weight response in a cohort of 375 patients undergoing bariatric surgery (BS). To evaluate weight response, we combined several variables to define specific response phenotypes six years after surgery. The study protocol was registered in ISRCTN (ID80961259). The analysis of the selected SNPs was performed via allelic discrimination using Taqman® probes (Applied Biosystems, Foster City, CA, USA). The genotype association study was performed using the SNPstat program, with comparisons adjusted for sex, age, initial body mass index, type 2 diabetes, hypertension diagnosis and the type of surgery. We identified eight genetic variants associated with the weight response to BS, independently of the presurgery patient profile and the type of surgical technique, from which we calculated the unweighted risk score (RS) for each phenotype. The highest scoring category in each RS was significantly associated with lower weight loss (p = 0.0001) and greater weight regain (p = 0.0012) at the end of the follow-up.
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Affiliation(s)
| | - Ana Barabash
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain
- Faculty of Medicine, Department of Medicine, Universidad Complutense, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28040 Madrid, Spain
| | - Pilar Matía-Martín
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain
- Faculty of Medicine, Department of Medicine, Universidad Complutense, 28040 Madrid, Spain
| | - Andrés Sánchez-Pernaute
- Faculty of Medicine, Department of Medicine, Universidad Complutense, 28040 Madrid, Spain
- Department of Surgery, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain
| | - Antonio J Torres
- Faculty of Medicine, Department of Medicine, Universidad Complutense, 28040 Madrid, Spain
- Department of Surgery, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain
| | - Alfonso L Calle-Pascual
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain
- Faculty of Medicine, Department of Medicine, Universidad Complutense, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28040 Madrid, Spain
| | - Miguel A Rubio-Herrera
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain
- Faculty of Medicine, Department of Medicine, Universidad Complutense, 28040 Madrid, Spain
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3
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Elhag W, El Ansari W. Effectiveness and Safety of Liraglutide in Managing Inadequate Weight Loss and Weight Regain after Primary and Revisional Bariatric Surgery: Anthropometric and Cardiometabolic Outcomes. Obes Surg 2022; 32:1005-1015. [DOI: 10.1007/s11695-021-05884-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/30/2021] [Accepted: 12/30/2021] [Indexed: 11/24/2022]
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4
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Ruiz-Tovar J, Zubiaga L, Llavero C. Mammary Volume-to-Body Mass Index Ratio: Preoperative Predictor of Cardiovascular Risk Factor and Indicator of Long-term Postoperative Remission of Comorbidities in Premenopausal Women Undergoing Sleeve Gastrectomy. Obes Surg 2021; 31:5189-5195. [PMID: 32789551 DOI: 10.1007/s11695-020-04887-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/26/2020] [Accepted: 07/28/2020] [Indexed: 01/28/2023]
Abstract
PURPOSE A correct preoperative selection of candidates to undergo a sleeve gastrectomy (SG) is advisable. However, there is a dearth of available literature addressing outcome predictors after SG, besides surgical factors. To assess the accuracy of the mammary volume-to-body mass index (MV-BMI) ratio as an indicator of cardiovascular disease (CVD) risk in morbidly obese patients and as a preoperative predictor of long-term outcomes after SG. MATERIALS AND METHODS A prospective observational study of 100 consecutive females under 40 years old and planned to undergo a SG was performed. Mammary volume was calculated based on a geometry of the breast model. Correlation of the preoperative MV-BMI ratio with preoperative Framingham risk score (FRS) and triglyceride/HDL-cholesterol ratio was investigated. The correlation of preoperative MV-BMI with 5-year postoperative remission of comorbidities was also assessed. RESULTS Preoperative MV-BMI showed an inverse correlation with preoperative FRS and triglyceride/high-density lipoprotein-cholesterol ratio. It also showed a direct correlation with long-term T2D, hypertension, and dyslipidemia remission after SG. A cutoff point of MV-BMI 60 has been established as the most accurate predictive value. CONCLUSION MV-BMI can be used as a predictive factor of long-term outcome after SG in premenopausal women.
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Affiliation(s)
- Jaime Ruiz-Tovar
- Obesity Unit, Garcilaso Clinic, Garcilaso, 7, 28010, Madrid, Spain.
| | - Lorea Zubiaga
- Centre Hospitaliere Regionelle Universitaire, Lille, France
| | - Carolina Llavero
- Obesity Unit, Garcilaso Clinic, Garcilaso, 7, 28010, Madrid, Spain
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5
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Sasaki A, Yokote K, Naitoh T, Fujikura J, Hayashi K, Hirota Y, Inagaki N, Ishigaki Y, Kasama K, Kikkawa E, Koyama H, Masuzaki H, Miyatsuka T, Nozaki T, Ogawa W, Ohta M, Okazumi S, Shimabukuro M, Shimomura I, Nishizawa H, Saiki A, Seki Y, Shojima N, Tsujino M, Ugi S, Watada H, Yamauchi T, Yamaguchi T, Ueki K, Kadowaki T, Tatsuno I. Metabolic surgery in treatment of obese Japanese patients with type 2 diabetes: a joint consensus statement from the Japanese Society for Treatment of Obesity, the Japan Diabetes Society, and the Japan Society for the Study of Obesity. Diabetol Int 2021; 13:1-30. [PMID: 34777929 PMCID: PMC8574153 DOI: 10.1007/s13340-021-00551-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Indexed: 12/20/2022]
Abstract
Bariatric surgery has been shown to have a variety of metabolically beneficial effects for patients with type 2 diabetes (T2D), and is now also called metabolic surgery. At the 2nd Diabetes Surgery Summit held in 2015 in London, the indication for bariatric and metabolic surgery was included in the “algorithm for patients with type T2D”. With this background, the Japanese Society for Treatment of Obesity (JSTO), the Japan Diabetes Society (JDS) and the Japan Society for the Study of Obesity (JASSO) have formed a joint committee to develop a consensus statement regarding bariatric and metabolic surgery for the treatment of Japanese patients with T2D. Eventually, the consensus statement was announced at the joint meeting of the 38th Annual Meeting of JSTO and the 41st Annual Meeting of JASSO convened in Toyama on March 21, 2021. In preparing the consensus statement, we used Japanese data as much as possible as scientific evidence to consider the indication criteria, and set two types of recommendation grades, “recommendation” and “consideration”, for items for which recommendations are possible. We hope that this statement will be helpful in providing evidence-based high-quality care through bariatric and metabolic surgery for the treatment of obese Japanese patients with T2D.
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Affiliation(s)
- Akira Sasaki
- Department of Surgery, Iwate Medical University, 2-1-1 Idaidori, Yahaba, 028-3695 Japan
| | - Koutaro Yokote
- Department of Endocrinology Hematology, and Gerontology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takeshi Naitoh
- Department of Lower Gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Junji Fujikura
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Karin Hayashi
- Department of Neuropsychiatry, Toho University Sakura Medical Center, Sakura, Chiba Japan
| | - Yushi Hirota
- Division of Diabetes and Endocrinology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Nobuya Inagaki
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasushi Ishigaki
- Division of Diabetes and Metabolism, Department of Internal Medicine, Iwate Medical University, Yahaba, Japan
| | - Kazunori Kasama
- Weight loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Eri Kikkawa
- Weight loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Hidenori Koyama
- Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo College of Medicine, Nishinomiya, Hyogo Japan
| | - Hiroaki Masuzaki
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology, Department of Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Takeshi Miyatsuka
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takehiro Nozaki
- Clinical Trial Center, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan
| | - Wataru Ogawa
- Division of Diabetes and Endocrinology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masayuki Ohta
- Global Oita Medical Advanced Research Center for Health, Oita University, Oita, Japan
| | - Shinichi Okazumi
- Department of Surgery, Toho University Sakura Medical Center, Sakura, Chiba Japan
| | - Michio Shimabukuro
- Department of Diabetes, Endocrinology and Metabolism, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hitoshi Nishizawa
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Atsuhito Saiki
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Sakura, Japan
| | - Yosuke Seki
- Weight loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Nobuhiro Shojima
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Motoyoshi Tsujino
- Department of Endocrinology and Metabolism, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Satoshi Ugi
- Division of Endocrinology and Metabolism, Department of Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Hiroaki Watada
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Toshimasa Yamauchi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Sakura, Japan
| | - Koujiro Ueki
- Department of Molecular Diabetic Medicine, Diabetes Research Center, National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Ichiro Tatsuno
- Chiba Prefectural University of Health Sciences, Chiba, Japan
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6
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Silecchia G, Boru CE, M Marinari G, Gentileschi P, Morino M, Olmi S, Foletto M, Bernante P, Morganti R, Tascini C, Anselmino M, Bianciardi E, Campanelli M, Fiorello L, Mancini R, Oldani A, Rottoli M, Salzano A, Trotta M. Laparoscopic bariatric surgery is safe during phase 2-3 of COVID-19 pandemic in Italy: A multicenter, prospective, observational study. Diabetes Res Clin Pract 2021; 177:108919. [PMID: 34133962 PMCID: PMC8200253 DOI: 10.1016/j.diabres.2021.108919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/01/2021] [Accepted: 06/09/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Sars-Cov-2 epidemic in Italy caused one of the greatest 2020 European outbreaks, with suspension of elective bariatric/metabolic surgery (BMS). From May 2020 a significant decline of the epidemic has been observed (phase 2); National Health Service protocols permitted elective BMS' resumption. A new, more severe COVID-19 surge, the "second wave", started on October 2020 (phase 3). AIM The primary end point was to analyze the outcomes of any Sars-Cov-2 infection and related morbidity/mortality within 30 POD after laparoscopic BMS during phase 2-3; secondary end points were readmission and reoperation rates. METHODS Study design prospective, multicenter, observational. SETTING Eight Italian high-volume bariatric centers. All patients undergoing BMS from July 2020 through January 2021 were enrolled according to the following criteria: no Sars-Cov-2 infection; primary procedures; no concomitant procedure; age > 18 < 60 years; compensated comorbidities; informed consent including COVID-19 addendum; adherence to specific admission, in-hospital and follow-up protocols. Data were collected in a prospective database. Patients undergone BMS during July-December 2019 were considered a control group. RESULTS 1258 patients were enrolled and compared with 1451 operated on in 2019, with no differences for demographics, complications, readmission, and reintervention rates. Eight patients (0·6%) tested positive for Sars-Cov-2 infection after discharge, as well as and 15 healthcare professionals, with no related complications or mortality. CONCLUSIONS Introduction of strict COVID-19 protocols concerning the protection of patients and health-care professionals guaranteed a safe resumption of elective BMS in Italy. The safety profile was, also, maintained during the second wave of outbreak, thus allowing access to a cure for the obese population.
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Affiliation(s)
- Gianfranco Silecchia
- Division of General Surgery and Bariatric Center of Excellence IFSO-EC, Department of Medico-Surgical Sciences and Biotechnologies, University "La Sapienza" of Rome, Via Corso della Repubblica 79, Latina, LT 04100, Italy.
| | - Cristian E Boru
- Division of General Surgery and Bariatric Center of Excellence IFSO-EC, Department of Medico-Surgical Sciences and Biotechnologies, University "La Sapienza" of Rome, Via Corso della Repubblica 79, Latina, LT 04100, Italy.
| | - Giuseppe M Marinari
- Bariatric Unit, Humanitas Clinical and Research Hospital, IRCCS Rozzano, Milan Via A. Manzoni 56, Rozzano, MI 20089, Italy.
| | - Paolo Gentileschi
- Department of Bariatric and Metabolic Surgery, San Carlo of Nancy Hospital and "Tor Vergata" University of Rome, Via Aurelia 275, Roma, RM 00165, Italy.
| | - Mario Morino
- General Surgery, Department of Surgical Sciences, University of Turin, Via Corso Bramante 88, Turin, TO 10126, Italy.
| | - Stefano Olmi
- Department of General and Oncological Surgery, Center of Bariatric Surgery, Policlinico San Marco di Zingonia, Bergamo Corso Europa 7, Zingonia, BG 24040, Italy.
| | - Mirto Foletto
- Bariatric Surgery Unit, Azienda Ospedaliera of University of Padova, Via Nicolò Giustiniani 2, Padova, PD 35128, Italy.
| | - Paolo Bernante
- Metabolic and Obesity Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Centre for the Study and Research of Treatment for Morbid Obesity, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Via Giuseppe Massarenti 9, Bologna, BO 40138, Italy.
| | - Riccardo Morganti
- Section of Statistics, University Hospital of Pisa, Via Roma, 67, Pisa, PI 56126, Italy.
| | - Carlo Tascini
- Infectious Diseases Clinic, DAME, University of Udine, P.le S. Maria della Misericordia, 15, Udine, UD 33100, Italy.
| | - Marco Anselmino
- Bariatric and Metabolic Surgery Unit, Azienda Ospedaliera at University of Pisa, Via Roma, 67, Pisa, PI 56126, Italy.
| | - Emanuela Bianciardi
- Department of Bariatric and Metabolic Surgery, San Carlo of Nancy Hospital and "Tor Vergata" University of Rome, Via Aurelia 275, Roma, RM 00165, Italy
| | - Michela Campanelli
- Department of Bariatric and Metabolic Surgery, San Carlo of Nancy Hospital and "Tor Vergata" University of Rome, Via Aurelia 275, Roma, RM 00165, Italy
| | - Luigi Fiorello
- Bariatric Surgery Unit, Azienda Ospedaliera of University of Padova, Via Nicolò Giustiniani 2, Padova, PD 35128, Italy
| | - Rudj Mancini
- Bariatric and Metabolic Surgery Unit, Azienda Ospedaliera at University of Pisa, Via Roma, 67, Pisa, PI 56126, Italy
| | - Alberto Oldani
- Department of General and Oncological Surgery, Center of Bariatric Surgery, Policlinico San Marco di Zingonia, Bergamo Corso Europa 7, Zingonia, BG 24040, Italy
| | - Matteo Rottoli
- Metabolic and Obesity Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Centre for the Study and Research of Treatment for Morbid Obesity, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Via Giuseppe Massarenti 9, Bologna, BO 40138, Italy
| | - Antonio Salzano
- General Surgery, Department of Surgical Sciences, University of Turin, Via Corso Bramante 88, Turin, TO 10126, Italy
| | - Manuela Trotta
- Bariatric Unit, Humanitas Clinical and Research Hospital, IRCCS Rozzano, Milan Via A. Manzoni 56, Rozzano, MI 20089, Italy
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7
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Torrego-Ellacuría M, Barabash A, Larrad-Sainz A, Hernández-Nuñez GM, Matía-Martín P, Pérez-Ferre N, Marcuello C, Sánchez-Pernaute A, Torres AJ, Calle-Pascual AL, Rubio MA. Weight Regain Outcomes After Bariatric Surgery in the Long-term Follow-up: Role of Preoperative Factors. Obes Surg 2021; 31:3947-3955. [PMID: 34146246 DOI: 10.1007/s11695-021-05497-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/14/2021] [Accepted: 05/20/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE Weight regain (WR) compromises the effectiveness of bariatric surgery. The objective of this study was to determine differences in long-term WR prevalence using different definitions and analyze possible preoperative predictors involved. METHODS Single-center retrospective cohort study including 445 adults who underwent 3 modalities of bariatric surgery between 2009 and 2014. EXPOSURE age, gender, ethnicity, body mass index (BMI), type 2 diabetes (T2D), hypertension (HTN), and type of surgery. MAIN OUTCOMES WR at year 6 assessed by 4 definitions and 6 multivariate models based on common thresholds. RESULTS Our cohort (71.1% female) had a mean age of 44.78 ± 11.94 years, and mean presurgery BMI of 44.94 ± 6.88 kg/m2, with a median follow-up of 6 years (IQR=5-8). The prevalences of T2D and HTN were 36.0% and 46.7% respectively. WR rates over thresholds ranged from 25.4 to 68.1%, with significant differences between groups in the WR measured as the percentage of maximum weight loss (MWL) and the increase in excess weight loss (EWL). Presurgery BMI was a significant predictor in 3 models; restrictive techniques were associated with WR in all the models except for those considering WR over 10 kg and WR over 15% from nadir as dependent variables. CONCLUSIONS In this long-term study, WR defined as percentage of MWL and increase in EWL from nadir had the greatest significance in logistic regression models with preoperative BMI and type of surgery as independent variables. These findings could serve to establish a standardized outcome reporting WR in other longitudinal studies. KEY POINTS • Lack of standardized outcome to measure weight regain after bariatric surgery. • Lowest rates of weight regain in malabsorptive techniques in all definitions applied. • Weight regain measured as percentage of maximum weight lost.
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Affiliation(s)
- Macarena Torrego-Ellacuría
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, Profesor Martín Lagos s/n, 28040, Madrid, Spain
| | - Ana Barabash
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, Profesor Martín Lagos s/n, 28040, Madrid, Spain.,Faculty of Medicine, Department of Medicine, Universidad Complutense, Madrid, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Angélica Larrad-Sainz
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, Profesor Martín Lagos s/n, 28040, Madrid, Spain
| | - Gemma Maria Hernández-Nuñez
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, Profesor Martín Lagos s/n, 28040, Madrid, Spain
| | - Pilar Matía-Martín
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, Profesor Martín Lagos s/n, 28040, Madrid, Spain.,Faculty of Medicine, Department of Medicine, Universidad Complutense, Madrid, Spain
| | - Natalia Pérez-Ferre
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, Profesor Martín Lagos s/n, 28040, Madrid, Spain
| | - Clara Marcuello
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, Profesor Martín Lagos s/n, 28040, Madrid, Spain
| | - Andrés Sánchez-Pernaute
- Faculty of Medicine, Department of Medicine, Universidad Complutense, Madrid, Spain.,Department of Surgery, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Antonio José Torres
- Faculty of Medicine, Department of Medicine, Universidad Complutense, Madrid, Spain.,Department of Surgery, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Alfonso Luis Calle-Pascual
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, Profesor Martín Lagos s/n, 28040, Madrid, Spain.,Faculty of Medicine, Department of Medicine, Universidad Complutense, Madrid, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Miguel Angel Rubio
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, Profesor Martín Lagos s/n, 28040, Madrid, Spain. .,Faculty of Medicine, Department of Medicine, Universidad Complutense, Madrid, Spain.
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8
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Guarisco G, Leonetti F. Covid-19 and diabesity: when a pandemia cross another pandemia. Eat Weight Disord 2021; 26:1283-1286. [PMID: 32666376 PMCID: PMC7359919 DOI: 10.1007/s40519-020-00958-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/07/2020] [Indexed: 02/06/2023] Open
Abstract
The Covid-19 epidemic is having a strong impact on the population with pre-existing chronic diseases. The collision between the Covid-19 pandemic and the current diabesity epidemic has highlighted that obese and diabetic patients have a worse prognosis due to the impairment of the immune response to infections and due to the mechanical limits that make the management of the hospitalized patients with severe obesity more difficult. The limitations imposed on accessibility to non-urgent care during the lockdown of "phase 1" of this pandemic have created the need to revolutionize clinical practice to meet the health demands of chronic and high-risk diseases such as obesity and diabetes. The use of technology and risk stratification to establish the priority of access to the treatments that we have been forced to undertake will be useful tools for a new phase of a more efficient and successful treatment of diabesity.
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Affiliation(s)
- Gloria Guarisco
- Diabetes Unit, Department of Medical-Surgical Sciences and Biotechnologies, Santa Maria Goretti Hospital, Sapienza University of Rome, Via Guido Reni 1, 04100, Latina, Italy.
| | - Frida Leonetti
- Diabetes Unit, Department of Medical-Surgical Sciences and Biotechnologies, Santa Maria Goretti Hospital, Sapienza University of Rome, Via Guido Reni 1, 04100, Latina, Italy
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9
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Silecchia G. Obesity surgery and eating and weight disorders: a new topical collection of EWD. Eat Weight Disord 2021; 26:757-758. [PMID: 32458334 DOI: 10.1007/s40519-020-00937-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Gianfranco Silecchia
- Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Corso della repubblica 79, 040100, Latina, Italy.
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Fonseca H, Oliveira J. Have We Disregarded Resistance Exercise for the Prevention of Postbariatric Surgery Weight and Comorbidities Relapse? Obesity (Silver Spring) 2020; 28:2255-2256. [PMID: 33230965 DOI: 10.1002/oby.23020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/14/2020] [Accepted: 08/13/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Hélder Fonseca
- Research Centre in Physical Activity, Health and Leisure (CIAFEL) Faculty of Sport, University of Porto (FADE-UP), Porto, Portugal
| | - José Oliveira
- Research Centre in Physical Activity, Health and Leisure (CIAFEL) Faculty of Sport, University of Porto (FADE-UP), Porto, Portugal
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11
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Yeo C, Ahmed S, Oo AM, Koura A, Sanghvi K, Yeo D. COVID-19 and Obesity-the Management of Pre- and Post-bariatric Patients Amidst the COVID-19 Pandemic. Obes Surg 2020; 30:3607-3609. [PMID: 32385668 PMCID: PMC7210102 DOI: 10.1007/s11695-020-04670-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Charleen Yeo
- Department of Upper Gastrointestinal and Bariatric and Metabolic Surgery, Tan Tock Seng Hospital, Singapore, Singapore.
| | - Saleem Ahmed
- Department of Upper Gastrointestinal and Bariatric and Metabolic Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | - Aung Myint Oo
- Department of Upper Gastrointestinal and Bariatric and Metabolic Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | - Aaryan Koura
- Department of Upper Gastrointestinal and Bariatric and Metabolic Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | - Kaushal Sanghvi
- Department of Upper Gastrointestinal and Bariatric and Metabolic Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | - Danson Yeo
- Department of Upper Gastrointestinal and Bariatric and Metabolic Surgery, Tan Tock Seng Hospital, Singapore, Singapore
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