Changes in Body Composition and Biochemical Parameters Following Laparoscopic One Anastomosis Gastric Bypass: 1-Year Follow-Up

Effect of different bariatric surgery methods on metabolic syndrome in patients with severe obesity

Bariatric surgery (BS) has been as a currently developed treatment of choice for metabolic syndrome (MetS). Which, in turn, is well-known as serious public health concern. Therefore, this study assessed the outcomes of different procedures of BS and possible predictors for improving MetS. This single-center retrospective cohort analysis included bariatric candidates between 2009 and 2017. The operational approach was chosen based on the patient's condition, as well as the patient's metabolic profile and the surgeon's experience. All desired information was evaluated at baseline and 6, 12, and 24 months after the operation. Of the 1111 patients included, 918 (82.6%) were female. There was no considerable trend in the improvement of MetS over the follow-up period of each surgery group. After 6 to 24 months of follow-up, waist circumference reduction was significant in all three types of surgery, and sleeve gastrectomy resulted in the best (but not significant) improvement rates after 24 months (P = 0.079). One anastomosis gastric bypass had highest decrease in percentage of excess weight loss than other procedures (P < 0.001). Each year increase in age was associated with a 4% decrease in MetS remission. In addition, the male gender, was correlated with MetS improvement positively (P = 0.049). Each one-unit increase in hemoglobin A1c (HbA1c) reduced the MetS remission rate by 40%. All three methods of BS were similarly effective in MetS. Consider the predictive value of age, gender, and HbA1c before determining the optimum procedure for each patient is recommended.

Identification of the role of autophagy-related TNFSF10/ hsa-let-7a-5p axis in vitiligo development and potential herbs exploring based on a bioinformatics analysis

Background

Vitiligo is a common clinical disorder caused by the destruction of epidermal melanocytes, which is often associated with autoimmune mechanisms. Autophagy plays a crucial role in maintaining cellular homeostasis and exhibits close associations with various autoimmune disorders. While dysautophagy of melanocytes is associated with vitiligo pathogenesis, there is a lack of studies on autophagy-related genes (ARGs) in blood samples from individuals with vitiligo.

Methods

Blood samples from individuals with vitiligo and healthy controls were compared to identify differentially expressed genes (DEGs), which were subsequently subjected to further analysis. Then, miRNAs correlated with core genes were predicted by five distinct online tools, and those miRNAs that appeared in three or more tools at the same time were chosen for further enrichment analysis. Furthermore, in vitro experiments of targeting core genes were conducted.

Results

The results showed that there were a total of 30 ARGs among DEGs, with 13 up-regulated genes and 17 down-regulated genes. Based on the functional enrichment analysis of DEGs and projected miRNAs, we hypothesized that autophagy and apoptosis may synergistically contribute to the progression of vitiligo, with the TNFSF10/hsa-let-7a-5p axis potentially playing an important role that should not be ignored. In addition, epigallocatechin-3-gallate (EGCG) was found to be the common component in BAI GUO, CHA YE, and MEI ZHOU JIN LV MEI, which were discovered to be potential in vitiligo treatment by inducing cell autophagy and apoptosis targeting TNFSF10.

Conclusion

It was the first time that TNFSF/hsa-let-7a-5p was discovered to be involved in the development of vitiligo through autophagy and apoptosis. Meanwhile, we observed that BAI GUO, CHA YE, and MEI ZHOU JIN LV MEI were promising to treat vitiligo by regulating autophagy and apoptosis via TNFSF10. These findings could lead to new directions for investigating the pathogenesis and therapy of vitiligo.

Short-Term Changes on Body Composition After Sleeve Gastrectomy and One Anastomosis Gastric Bypass

Introduction: Changes in body composition after different bariatric surgeries have been studied extensively, but most of them have emphasized on Roux-en-Y gastric bypass. Only a few studies have assessed the effects of sleeve gastrectomy (SG). Also, the effect of one anastomosis gastric bypass (OAGB) on body composition is not fully apprehended. Furthermore, there is no agreement on how much fat-free mass (FFM) loss is tolerable in weight loss interventions. Therefore, we decided to assess the reduction in fat mass (FM) and FFM at 1, 3, 6, and 12 months after two types of bariatric surgery in a single center. Methods: In the current retrospective cross-sectional study, the patients' hospital records were analyzed. We included patients who had SG or OAGB and a complete 1-year follow-up record. We recorded demographic data as well as weight, body mass index (BMI), FM, and FFM before and at 1, 3, 6, and 12 months after surgery in a predesigned checklist. Results: We analyzed 311 patients (43 males and 268 females) in the SG (N = 192, 61.7%) and OAGB (N = 119, 38.3%) groups. Both the SG and OAGB groups demonstrated a statistically significant reduction in weight, BMI, FM, and FFM indices at 12 months after the intervention (P < .001). Moreover, no statistically significant difference was observed between the SG and OAGB groups regarding the mean of all body composition indices at 3, 6, and 12 months after the intervention. Conclusion: We found that SG and OAGB effectively decreased weight and body composition indices, comprising FM and FFM, with no significant difference between each other.

Body Composition Changes Following Sleeve Gastrectomy Vs. One-Anastomosis Gastric Bypass: Tehran Obesity Treatment Study (TOTS)

PURPOSE

This study aimed to evaluate body composition changes and the determinants of fat-free mass loss (FFML) up to 3 years after sleeve gastrectomy (SG) and one-anastomosis gastric bypass (OAGB).

MATERIALS AND METHODS

A prospective study was conducted on 3864 patients with severe obesity who underwent either SG (2746, 76.1% women, mean age: 39.2 ± 11.6 years, and BMI: 44.3 ± 5.6 kg/m2) or OAGB (1118, 82.2% women, age: 39.9 ± 10.7 years, BMI: 45.6 ± 6.3 kg/m2). Body composition parameters were measured by bioelectrical impedance analysis preoperatively and 1, 3, 6, 9, 12, 18, 24, and 36 months after surgery. Changes in body composition were assessed using the propensity matched generalized estimated equation (GEE) method. The determinants of fat-free mass loss/weight loss (FFML/WL%) were defined using a mixed-model GEE analysis.

RESULTS

Means of FM, FFM, and FFML/WL% decreased significantly in both study groups (Ptrend < 0.001). Changes in BMI, EWL%, FM, and FFML/WL% were different between the two groups (Pbetween < 0.05). The results showed a better FFM preservation and a greater FM loss over time in the OAGB group compared to the SG group (Pinteraction < 0.05). FFML during the first 3 months was greater in the SG compared to the OAGB group (P < 0.001). SG surgery, higher preoperative BMI, and female gender were associated with greater FFML/WL%.

CONCLUSION

In the SG compared to the OAGB group, FFML was greater, especially early after the surgery, emphasizing the need for therapeutic interventions such as regular exercise programs and dietary intake modifications.

Five-year Changes in Body Composition in Type 2 Diabetes Mellitus Patients with a BMI < 32.5 kg/m2 Undergoing Laparoscopic Roux-en-Y Gastric Bypass Surgery

PURPOSE

Information is scarce on the five-year effect of laparoscopic Roux-en-Y Gastric Bypass (LRYGB) on body composition for Type 2 diabetes mellitus (T2DM) patients with a low BMI. This study aimed to evaluate the five-year changes in body composition in a Chinese T2DM cohort with a BMI < 32.5 kg/m² after LRYGB.

METHODS

Twenty-seven T2DM patients were assessed preoperatively (baseline) and 3 months, 6 months, 1 year, 3 years, and 5 years after LRYGB with dual-energy X-ray absorptiometry (DXA).

RESULTS

DXA assessments were completed in 100%, 85%, 85%, 85%, 48%, and 37% at baseline and 3 months, 6 months, 1 year, 3 years, and 5 years, respectively. For the whole body, fat-free mass and muscle mass decreased from 6 months to 5 years after LRYGB (P < 0.05), while bone mineral content decreased at 5 years after LRYGB (P < 0.05). Fat mass of different regions decreased from 3 months to 1 year (P < 0.05), and a similar magnitude of variation was observed in body fat mass percentage. A fat redistribution characterized by the regional fat proportion of trunk and android decreasing and the regional fat proportion of limbs gaining (P < 0.05) occurred at 5 years after LRYGB.

CONCLUSION

For low BMI patients with T2DM, LRYGB led to a short-term reduction in FM and a lasting reduction in FFM. A metabolically healthy fat redistribution occurring 5 years after LRYGB might be a promising mechanism to explain the lasting benefits of LRYGB for T2DM patients with a low BMI.

Tumor infiltrating immune cells (TIICs) as a biomarker for prognosis benefits in patients with osteosarcoma

BACKGROUND

Osteosarcoma is a rare malignant bone tumor in adolescents and children. Poor prognosis has always been a difficult problem for patients with osteosarcoma. Recent studies have shown that tumor infiltrating immune cells (TIICs) are associated with the clinical outcome of osteosarcoma patients. The aim of our research was to construct a risk score model based on TIICs to predict the prognosis of patients with osteosarcoma.

METHODS

CIBERSORTX algorithm was used to calculate the proportion of 22 TIIC types in osteosarcoma samples. Kaplan-Meier curves were drawn to investigate the prognostic value of 22 TIIC types. Forward stepwise approach was used to screen a minimal set of immune cell types. Multivariate Cox PHR analysis was performed to construct an immune risk score model.

RESULTS

Osteosarcoma samples with CIBERSORTX output p value less than 0.05 were selected for research. Kaplan-Meier curves indicated that naive B cells (p = 0.047) and Monocytes (p = 0.03) in osteosarcoma are associated with poor prognosis. An immune risk score model was constructed base on eight immune cell types, and the ROC curve showed that the immune risk score model is reliable in predicting the prognosis of patients with osteosarcoma (AUC = 0.724). Besides, a nomogram model base on eight immune cell types was constructed to predict the survival rate of patients with osteosarcoma.

CONCLUSIONS

TIICs are closely related to the prognosis of osteosarcoma. The immune risk score model based on TIICs is reliable in predicting the prognosis of osteosarcoma.