Short-term effects of Roux-en-Y gastric bypass or gastric sleeve on bone mineral density and calciotropic hormones: a systematic review and meta-analysis

Roux-en-Y gastric bypass (RYGB) and gastric sleeve (GS) have been associated with significant reductions in bone mineral density (BMD) and fluctuations in serum levels of calciotropic hormones. These changes pose a risk to bone health. The study assessed the short-term (12 and 24 months) effects of RYGB and GS on BMD and calciotropic hormones. PubMed, Embase, and Cochrane Library databases were searched. Analyses considered follow-up (12 and 24 months) with BMD as main outcome at three sites (femoral neck, total hip, and lumbar spine) and one for each calciotropic hormone (25 OH vitamin D and parathyroid hormone [PTH]). Estimated effect sizes were calculated as standardized mean differences (SMD), confidence interval of 95%, and P value. Nine studies totaling 473 participants (RYGB = 261 and GS = 212) were included. RYGB resulted in lower BMD than GS at 12 months for femoral neck (SMD = -0.485, 95% CI [-0.768, -0.202], P = .001), lumbar spine (SMD = -0.471, 95% CI [-0.851, -0.092], P = .015), and total hip (SMD = -0.616, 95% CI [-0.972, -0.259], P = .001), and at 24 months for total hip (SMD = -0.572, 95% CI [-0.907, -0.238], P = .001). At 24 months, 25 OH vitamin D was lower in RYGB than GS (SMD = -0.958 [-1.670, -0.245], P = .008) and PTH levels were higher in RYGB than in GS (SMD = 0.968 [0.132, 1.804, P = .023]). RYGB demonstrated significant reduction in regional BMD. It also induces lower serum 25 OH vitamin D and higher PTH levels than GS. The results support the need for preventive bone health measures in the short-term postoperative period, especially in the case of RYGB.

Inflammation, fibrosis and E1 glycoprotein persistence in joint tissue of patients with post-Chikungunya chronic articular disease

INTRODUCTION

Chikungunya chronic joint disease causes debilitating arthralgia, significantly impacting the quality of life of affected individuals.

METHODS

In this study, patients underwent clinical follow-ups, joint biopsies, and pre-biopsy and 24 months post-biopsy serum dosage of cytokines.

RESULTS

All participants were female and had pain in 12 joints on average, with 41.17% exhibiting moderate disease activity. Histopathological analysis revealed collagen deposition. Indirect immunofluorescence detected the CHIKV glycoprotein E1 antigen, and an increase in cytokines.

CONCLUSIONS

Persistent inflammation and ineffective antiviral immune responses leading to antigen persistence may contribute to chronic CHIKV arthritis.

High-Protein Diet Associated with Resistance Training Improves Performance and Decreases Adipose Index in Rats

The study tested the hypothesis that a high protein diet based on isolated whey protein (IWP) associated with strength training improves performance and reduces body fat without promoting health damage. Male Wistar rats, 45 days old, were divided into four groups (n = 8/group): normoprotein sedentary (IWP 14%; NS); hyperprotein sedentary (IWP 35%; HS); normoprotein trained (IWP 14%; NT) and hyperprotein trained (IWP 35%; HT). All groups performed the maximum load test at the beginning and after the vertical ladder training protocol for 6 weeks (3x/week). The performance improved in HT when compared to other groups. There was no difference in the plasma levels of testosterone, IGF-1 and the hematological parameters remained normal. The relative weights of the kidneys were higher in the groups fed with high protein; the liver was higher in HT compared to NS and NT, and the heart was higher in HS compared to NS and NT. Concerning relative muscle weight, quadriceps, and gastrocnemius, HT showed higher value compared to NT. Diet containing 35% isolate whey protein associated with resistance training improved performance as well as increased muscles and organs weight of the animals, without damaging the tissues related to protein metabolism (confirmed by unchanged hematological parameters), which may minimize the risk of developing cardiometabolic disorders.

Heteropterys tomentosa A. Juss: Toxicological and adaptogenic effects in experimental models

BACKGROUND

The constant pursuit of improved athletic performance characterizes high-performance sport and the use of medicinal plants as dietary supplements is becoming widespread among athletes to enhance long-term endurance performance.

AIM

The present study evaluated the toxicity of Heteropterys tomentosa (HEHt) and its acute adaptogenic effects.

METHODS

The in vitro safety profile was evaluated on CHO-k1 cells using the alamar Blue assay, at concentrations ranging from 3.125 to 200 µg/mL. In vivo acute oral toxicity was conducted in male and female mice with oral administration of graded doses of HEHt from 400 to 2000 mg/kg. A subchronic oral toxicity study was completed by oral administration of HEHt (50, 200 or 1000 mg/kg) and vehicle for 30 days in male Wistar rats. Clinical observations and toxicological related parameters were determined. Blood was collected for biochemical and hematological analyses, while histological examinations were performed on selected organs. Thereafter, an adaptogenic test consisting of progressive loads until exhaustion was conducted in rats ( n = 5/group) orally pre-treated with the vehicle and HEHt (25, 100 or 400 mg/kg).

RESULTS

HEHt exhibited no cytotoxic effects on the CHO-k1 cells and, apparently, no acute toxicity in mice and no subchronic toxicity in rats. An ergogenic effect was observed only at the dose of 25 mg/kg compared with the vehicle in relation to time to exhaustion and exercise load ( p = .011 and .019, respectively). HEHt is safe at up to 400 mg/kg, contains astilbin and taxifolin as the major phytochemical compounds, and exhibited a potential adaptogenic effect.

CONCLUSIONS

These results justify its anecdotal usage as a tonic, show that the hydroethanolic maceration of the root does not cause toxicity, and provide scientific evidence of its potential as a source of new adaptogenic substance(s).