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Adawi H, Aggarwal A, Jain S, Othman MA, Othman AAA, Zakri RA, Namazi SAM, Sori SA, Abuzawah LHA, Madkhali ZM. Influence of Bariatric Surgery on Oral Microbiota: A Systematic Review. Eur J Dent 2023; 17:602-614. [PMID: 36075269 PMCID: PMC10569860 DOI: 10.1055/s-0042-1753471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
The study aims to systematically review the available literature to evaluate the changes in oral microbiota in patients after bariatric surgery (BS) and correlates these alterations in microorganisms with common oral manifestations. Relevant Electronic databases were systematically searched for indexed English literature. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed for framework designing, application, and reporting of the current systematic review. The focused PICO question was: "Is there any change in oral microbiota (O) of patients (P) who underwent BS (I) when compared with non-BS groups (C)?' Seven articles were selected for qualitative synthesis. On application of the National Institutes of Health (NIH) quality assessment tool, six studies were found to be of fair quality and one was of good quality. All the seven included studies evaluated the effect of BS on oral microbiota in humans. The outcomes of this review suggest that considerable changes take place in oral microbiota after BS which can be correlated with common oral manifestations. These changes are mainly due to the indirect effect of BS and may vary with the individuals. Due to variations in the included studies, it is difficult to proclaim any persistent pattern of oral microbiota found after BS.
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Affiliation(s)
- Hafiz Adawi
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Aparna Aggarwal
- Private Practice, Vitaldent Dental Clinic, Faridabad, Haryana, India
| | - Saurabh Jain
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Maha A. Othman
- Experimental Oral Pathology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Ahlam A. A. Othman
- Department of Fixed Prosthodontics, Faculty of Dentistry, Sana'a University, Sana'a, Yemen
| | | | | | - Sara A.Y. Sori
- College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Wijdeveld M, van Olst N, van der Vossen EWJ, de Brauw M, Acherman YIZ, de Goffau MC, Gerdes VEA, Nieuwdorp M. Identifying Gut Microbiota associated with Gastrointestinal Symptoms upon Roux-en-Y Gastric Bypass. Obes Surg 2023:10.1007/s11695-023-06610-6. [PMID: 37093508 DOI: 10.1007/s11695-023-06610-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 04/25/2023]
Abstract
PURPOSE Roux-en-Y gastric bypasses (RYGB) are frequently accompanied by long-term gastrointestinal (GI) symptoms. Direct mechanistic insight into the causation of these symptoms is lacking, but changes in the intestinal microbiome have been proposed to play a role. With this study, we aimed to investigate whether a microbial predisposition exists before RYGB which is associated with GI symptoms during follow-up and to evaluate which microbial groups are involved. MATERIALS AND METHODS In total, 67 RYGB patients were included. Shotgun metagenomic sequencing was performed on fecal samples obtained just before and 1 year after surgery. To assess GI symptoms, patients filled out Gastrointestinal Quality of Life Index (GIQLI) questionnaires and were divided into groups based on their total GIQLI score and change in score (postsurgery versus baseline). Extremely randomized tree predictor models were used to identify the most distinctive microbial species associated with postoperative GI symptoms. RESULTS Beta diversity differed significantly between baseline and 1-year post-surgery samples, with the post-surgery microbiome resembling a more dysbiotic profile. The most predictive species regarding total GIQLI (AUC 0.77) or delta GIQLI score (AUC 0.83) were identified. Many of these species are known butyrate producers or species known to support them and/or species with anti-inflammatory properties, including Coprococcus eutactus, Faecalibacterium prausnitzii, and Ruminococcus callidus. CONCLUSION Beneficial commensal gut microbiota related to a high GI score were associated to adequate intestinal fermentative capacity, suggesting these species might have protective properties against postoperative GI malfunctioning.
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Affiliation(s)
- Madelief Wijdeveld
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, Room D3-211, 1105, AZ, Amsterdam, The Netherlands.
| | - Nienke van Olst
- Department of Bariatric Surgery, Spaarne Gasthuis, Spaarnepoort 1, 2134, Hoofddorp, The Netherlands
| | - Eduard W J van der Vossen
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, Room D3-211, 1105, AZ, Amsterdam, The Netherlands
| | - Maurits de Brauw
- Department of Bariatric Surgery, Spaarne Gasthuis, Spaarnepoort 1, 2134, Hoofddorp, The Netherlands
| | - Yair I Z Acherman
- Department of Bariatric Surgery, Spaarne Gasthuis, Spaarnepoort 1, 2134, Hoofddorp, The Netherlands
| | - Marcus C de Goffau
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, Room D3-211, 1105, AZ, Amsterdam, The Netherlands
- Tytgat Institute for Liver and Intestinal Research, Amsterdam University Medical Centers, Meibergdreef 69, 1105, BK, Amsterdam, The Netherlands
- Sanger Institute, Saffron Walden, Cambridge, CB10 1RQ, UK
| | - Victor E A Gerdes
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, Room D3-211, 1105, AZ, Amsterdam, The Netherlands
- Department of Bariatric Surgery, Spaarne Gasthuis, Spaarnepoort 1, 2134, Hoofddorp, The Netherlands
| | - Max Nieuwdorp
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, Room D3-211, 1105, AZ, Amsterdam, The Netherlands
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Gutiérrez-Repiso C, Garrido-Sánchez L, Alcaide-Torres J, Cornejo-Pareja I, Ocaña-Wilhelmi L, García-Fuentes E, Moreno-Indias I, Tinahones FJ. Predictive Role of Gut Microbiota in Weight Loss Achievement after Bariatric Surgery. J Am Coll Surg 2022; 234:861-871. [PMID: 35426398 DOI: 10.1097/xcs.0000000000000145] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Bariatric surgery induces changes in gut microbiota that have been suggested to contribute to weight loss and metabolic improvement. However, whether preoperative gut microbiota composition could predict response to bariatric surgery has not yet been elucidated. STUDY DESIGN Seventy-six patients who underwent sleeve gastrectomy were classified according to the percentage of excess weight loss (%EWL) 1 year after surgery in the responder group: >50%EWL (n=50) and the nonresponder group: <50%EWL (n=26). Patients were evaluated before surgery, and 3 months and 1 year after surgery. Gut microbiota composition was analyzed before surgery (n=76) and 3 months after bariatric surgery (n=40). RESULTS Diversity analysis did not show differences between groups before surgery or 3 months after surgery. Before surgery, there were differences in the abundance of members belonging to Bacteroidetes and Firmicutes phyla (nonresponder group: enriched in Bacteroidaceae, Bacteroides, Bacteroides uniformis, Alistipes finegoldii, Alistipes alistipes, Dorea formicigenerans, and Ruminococcus gnavus. Responder group: enriched in Peptostreptococcaceae, Gemmiger, Gemiger formicilis, Barnesiella, Prevotellaceae, and Prevotella; linear discriminant analysis >2; p < 0.05). Prevotella-to-Bacteroides ratio was significantly lower in the nonresponder group compared to the responder group (p = 0.048). After surgery, the responder group showed an enrichment in taxa that have been shown to have beneficial effects on host metabolism. Before surgery, PICRUSt analysis showed an enrichment in pathways involved in the biosynthesis components of the O-antigen polysaccharideunits in lipopolysaccharides in the nonresponder group. CONCLUSIONS Preoperative gut microbiota could have an impact on bariatric surgery outcomes. Prevotella-to-Bacteroides ratio could be used as a predictive tool for weight loss trajectory. Early after surgery, patients who experienced successful weight loss showed an enrichment in taxa related to beneficial effects on host metabolism.
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Affiliation(s)
- Carolina Gutiérrez-Repiso
- From the Unidad de Gestión Clínica de Endocrinología y Nutrición (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn) (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Instituto de Salud Carlos III, Madrid, Spain
| | - Lourdes Garrido-Sánchez
- From the Unidad de Gestión Clínica de Endocrinología y Nutrición (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn) (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Alcaide-Torres
- From the Unidad de Gestión Clínica de Endocrinología y Nutrición (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn) (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Instituto de Salud Carlos III, Madrid, Spain
| | - Isabel Cornejo-Pareja
- From the Unidad de Gestión Clínica de Endocrinología y Nutrición (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn) (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Instituto de Salud Carlos III, Madrid, Spain
| | - Luis Ocaña-Wilhelmi
- Unidad de Gestión Clínica de Cirugía General y del Aparato Digestivo (Ocaña-Wilhelmi), Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Departamento de Especialidades Quirúrgicas, Bioquímica e Inmunología (Ocaña-Wilhelmi), Universidad de Málaga, Málaga, Spain
| | - Eduardo García-Fuentes
- Unidad de Gestión Clínica de Aparato Digestivo (García-Fuentes), Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd) (García-Fuentes), Instituto de Salud Carlos III, Madrid, Spain
| | - Isabel Moreno-Indias
- From the Unidad de Gestión Clínica de Endocrinología y Nutrición (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn) (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Instituto de Salud Carlos III, Madrid, Spain
| | - Francisco J Tinahones
- From the Unidad de Gestión Clínica de Endocrinología y Nutrición (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn) (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Medicina y Dermatología (Tinahones), Universidad de Málaga, Málaga, Spain
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Stefura T, Zapała B, Gosiewski T, Skomarovska O, Pędziwiatr M, Major P. Changes in the Composition of Oral and Intestinal Microbiota After Sleeve Gastrectomy and Roux-En-Y Gastric Bypass and Their Impact on Outcomes of Bariatric Surgery. Obes Surg 2022; 32:1439-1450. [PMID: 35188608 PMCID: PMC8986729 DOI: 10.1007/s11695-022-05954-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/31/2022] [Accepted: 02/03/2022] [Indexed: 01/14/2023]
Abstract
Background We aimed to assess the changes in composition of bacterial microbiota at two levels of the digestive tract: oral cavity and large intestine in patients 6 months after bariatric surgery. Methods This was a prospective cohort study including patients undergoing bariatric surgery. Before surgery and 6 months after the procedure, oral swabs were obtained and stool samples were provided. Our endpoint was the analysis of the differences in compositions of oral and fecal microbiota prior and after the surgical treatment of obesity. Results Bacteria from phylum Bacteroidetes seemed to increase in abundance in both the oral cavity and the large intestine 6 months after surgery among patients undergoing bariatric surgery. The subgroup analysis we conducted based on the volume of weight-loss revealed that patients achieving at least 50% of excess weight loss present similar results to the entire study group. Patients with less favorable outcomes presented an increase in the population of bacteria from phylum Fusobacteria and a decrease of phylum Firmicutes in oral cavity. Conclusion Intestinal microbiota among these patients underwent similar changes in composition to the rest of the study group. Bariatric surgery introduces a significant change in composition of oral and intestinal microbiota. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s11695-022-05954-9.
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Affiliation(s)
- Tomasz Stefura
- 2nd Department of General Surgery, Faculty of Medicine, Jagiellonian University Medical College, Jakubowskiego 2 st, 30-688 Cracow, Poland
| | - Barbara Zapała
- Department of Clinical Biochemistry, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Cracow, Poland
| | - Tomasz Gosiewski
- Department of Microbiology, Division of Molecular Medical Microbiology, Faculty of Medicine, Jagiellonian University Medical College, 31-121 Cracow, Poland
| | - Oksana Skomarovska
- 2nd Department of General Surgery, Faculty of Medicine, Jagiellonian University Medical College, Jakubowskiego 2 st, 30-688 Cracow, Poland
| | - Michał Pędziwiatr
- 2nd Department of General Surgery, Faculty of Medicine, Jagiellonian University Medical College, Jakubowskiego 2 st, 30-688 Cracow, Poland
- Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery), 30-688 Cracow, Poland
| | - Piotr Major
- 2nd Department of General Surgery, Faculty of Medicine, Jagiellonian University Medical College, Jakubowskiego 2 st, 30-688 Cracow, Poland
- Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery), 30-688 Cracow, Poland
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Bariatric Surgery and Liver Disease: General Considerations and Role of the Gut-Liver Axis. Nutrients 2021; 13:nu13082649. [PMID: 34444807 PMCID: PMC8399840 DOI: 10.3390/nu13082649] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/23/2021] [Accepted: 07/27/2021] [Indexed: 02/07/2023] Open
Abstract
Weight loss is a therapeutic solution for many metabolic disorders, such as obesity and its complications. Bariatric surgery aims to achieve lasting weight loss in all patients who have failed after multiple dietary attempts. Among its many benefits, it has been associated with the regression of non-alcoholic fatty liver disease (NAFLD), which is often associated with obesity, with evidence of substantial improvement in tissue inflammation and fibrosis. These benefits are mediated not only by weight loss, but also by favorable changes in systemic inflammation and in the composition of the gut microbiota. Changes in microbial metabolites such as short-chain fatty acids (SCFAs), capable of acting as endocrine mediators, and bile acids (BAs) as well as modifications of the gut-brain axis, are among the involved mechanisms. However, not all bariatric surgeries show beneficial effects on the liver; those leading to malabsorption can cause liver failure or a marked worsening of fibrosis and the development of cirrhosis. Nevertheless, there are still many unclear aspects, including the extent of the benefits and the magnitude of the risks of bariatric surgery in cirrhotic patients. In addition, the usefulness and the safety of these procedures in patients who are candidates to or who have undergone liver transplant need solid supporting evidence. This paper aims to review literature data on the use of bariatric surgery in the setting of chronic liver disease.
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Stefura T, Zapała B, Gosiewski T, Skomarovska O, Dudek A, Pędziwiatr M, Major P. Differences in Compositions of Oral and Fecal Microbiota between Patients with Obesity and Controls. ACTA ACUST UNITED AC 2021; 57:medicina57070678. [PMID: 34209298 PMCID: PMC8306358 DOI: 10.3390/medicina57070678] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/20/2021] [Accepted: 06/25/2021] [Indexed: 12/12/2022]
Abstract
Background and Objectives: The aim of this study was to compare the differences in compositions of oral and fecal bacterial microbiota between patients with morbid obesity and normal-weight controls. Material and Methods: This was a prospective cohort study. The study included group 1 (patients with BMI ≥ 40 kg/m2) and group 2 (patients with BMI from 18.5 to 24.9 kg/m2). Our endpoint was the analysis of the differences in compositions of oral and fecal microbiota between the groups. Oral swabs and fecal samples were collected from the patients. The analysis of microbiota was conducted using next-generation sequencing. Results: Overall, the study included 96 patients; 52 (54.2%) were included in group 1, 44 (39.8%)-in group 2. In group 1, oral microbiota included significantly more bacteria from genera Veillonella, Oribacterium and Soonwooa, whereas, in group 2, Streptobacillus, Parvimonas and Rothia were more common. Fecal microbiota in group 1 included more Bacteroides, Odoribacter and Blautia and group 2 was more abundant in Ruminococcus, Christensenella and Faecalibacterium. Conclusions: Both oral and fecal gastrointestinal microbiota differs significantly among patients with severe obesity and lean individuals.
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Affiliation(s)
- Tomasz Stefura
- 2nd Department of General Surgery, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Cracow, Poland; (T.S.); (O.S.); (A.D.); (M.P.)
| | - Barbara Zapała
- Department of Clinical Biochemistry, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Cracow, Poland;
| | - Tomasz Gosiewski
- Division of Molecular Medical Microbiology, Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, 33-332 Cracow, Poland;
| | - Oksana Skomarovska
- 2nd Department of General Surgery, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Cracow, Poland; (T.S.); (O.S.); (A.D.); (M.P.)
| | - Alicja Dudek
- 2nd Department of General Surgery, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Cracow, Poland; (T.S.); (O.S.); (A.D.); (M.P.)
| | - Michał Pędziwiatr
- 2nd Department of General Surgery, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Cracow, Poland; (T.S.); (O.S.); (A.D.); (M.P.)
- Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery), 31-501 Cracow, Poland
| | - Piotr Major
- 2nd Department of General Surgery, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Cracow, Poland; (T.S.); (O.S.); (A.D.); (M.P.)
- Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery), 31-501 Cracow, Poland
- Correspondence: ; Tel.: +48-12-400-26-01
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Mateo-Gavira I, Sánchez-Toscano E, Mayo-Ossorio MÁ, Pacheco-García JM, Prada-Oliveira JA, Vílchez-López FJ. Evaluation of Clinical Factors Predictive of Diabetes Remission Following Bariatric Surgery. J Clin Med 2021; 10:jcm10091945. [PMID: 34062745 PMCID: PMC8124312 DOI: 10.3390/jcm10091945] [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: 03/24/2021] [Revised: 04/25/2021] [Accepted: 04/28/2021] [Indexed: 11/16/2022] Open
Abstract
Bariatric surgery is an effective treatment for achieving significant weight loss and improving metabolic comorbidities such as type 2 diabetes mellitus (T2DM). The aim of our study was to investigate clinical factors related to T2DM remission in obese patients who had undergone bariatric surgery. METHODS A cohort of patients with T2DM and a minimum of class II obesity undergoing bariatric surgery had their clinical and anthropometric variables assessed. The statistical evaluation included multivariate analyses of clinical factors predicting a T2DM remission two years post-surgery. RESULTS 83 patients were included (mean age 44.13 ± 10.38 years). Two years post-surgery, the percentage of excess weight lost was 63.43 ± 18.59%, and T2DM was resolved in 79.5% of the patients. T2DM remission was directly related to a high body mass index (BMI) (OR: 1.886; p = 0.022) and the absence of macro-vascular complications (OR: 34.667; p = 0.002), while it was inversely associated with T2DM with a duration longer than 5 years (OR: 0.022; p = 0.040) and baseline insulin treatment (OR: 0.001; p = 0.009). 15.6% of the patients presented early complications and 20.5% developed late complications. CONCLUSION In our study sample, bariatric surgery proved to be an effective and safe technique for sustained medium-term weight loss and the resolution of T2DM. A higher baseline BMI, a shorter T2DM duration, non-insulin treatment, and the absence of macro-vascular complications are factors predictive of T2DM remission.
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Affiliation(s)
- Isabel Mateo-Gavira
- Endocrinology and Nutrition Department, Hospital Universitario Puerta del Mar, 11009 Cádiz, Spain; (I.M.-G.); (E.S.-T.)
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Spain; (M.Á.M.-O.); (J.M.P.-G.); (J.A.P.-O.)
| | - Esteban Sánchez-Toscano
- Endocrinology and Nutrition Department, Hospital Universitario Puerta del Mar, 11009 Cádiz, Spain; (I.M.-G.); (E.S.-T.)
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Spain; (M.Á.M.-O.); (J.M.P.-G.); (J.A.P.-O.)
| | - Mª Ángeles Mayo-Ossorio
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Spain; (M.Á.M.-O.); (J.M.P.-G.); (J.A.P.-O.)
- General Surgery Department, Hospital Universitario Puerta del Mar, 11009 Cádiz, Spain
| | - José Manuel Pacheco-García
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Spain; (M.Á.M.-O.); (J.M.P.-G.); (J.A.P.-O.)
- General Surgery Department, Hospital Universitario Puerta del Mar, 11009 Cádiz, Spain
| | - Jose Arturo Prada-Oliveira
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Spain; (M.Á.M.-O.); (J.M.P.-G.); (J.A.P.-O.)
- School of Medicine, Cadiz University (UCA), 11003 Cádiz, Spain
| | - Francisco Javier Vílchez-López
- Endocrinology and Nutrition Department, Hospital Universitario Puerta del Mar, 11009 Cádiz, Spain; (I.M.-G.); (E.S.-T.)
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Spain; (M.Á.M.-O.); (J.M.P.-G.); (J.A.P.-O.)
- Correspondence: ; Tel.: +34-956-003-095
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