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1.
Fernando Granado-Lorencio Alberto Simal-Antón Javier Salazar-Mosteiro Carmen Herrero-Barbudo Encarnación Donoso-Navarro Inmaculada Blanco-Navarro Belen Pérez-Sacristán 《Obesity surgery》2010,20(11):1524-1529
Background
The available evidence indicates a progressive increase in the incidence and severity of the deficiency of certain vitamins and related clinical conditions (i.e., metabolic bone disease). Because of the potential role of fat-soluble vitamins and carotenoids in bone metabolism, our aim was to assess the time-course changes of fat-soluble vitamins and serum markers of bone metabolism in candidates for obesity surgery and following two bariatric procedures. 相似文献2.
Joao Lindolfo C. Borges Isabella Santiago de M. Miranda Marta M.S. Sarquis Victoria Borba Sergio Setsuo Maeda Marise Lazaretti-Castro Neil Blinkey 《Journal of clinical densitometry》2018,21(2):157-162
The high prevalence of obesity is a worldwide problem associated with multiple comorbidities, including cardiovascular diseases. Vitamin D deficiency with secondary hyperparathyroidism is common in obese individuals and can be aggravated after bariatric surgery. Moreover, there is no consensus on the optimal supplementation dose of vitamin D in postbariatric surgical patients. We present new data on the variability of 25(OH)D response to supplementation in postmenopausal obese women. It is important to recognize and treat vitamin D deficiency before bariatric surgery to avoid postoperative complications, such as metabolic bone disease with associated high fracture risk. The objective of this article is to discuss the bone metabolism consequences of vitamin D deficiency after bariatric surgery. 相似文献
3.
Cristina Prat M.D. Ph.D. Pilar Ricart M.D. Xavier Ruyra M.D. Ph.D. Josep Domínguez Ph.D. Jordi Morillas M.D. Silvia Blanco M.Sc Teresa Tomasa M.D. Ph.D. Tomás Torres M.D. Luisa Cámara M.D. Sónia Molinos M.D. Vicente Ausina M.D. Ph.D. 《Journal of cardiac surgery》2008,23(6):627-632
Abstract Background and Aim: Monitorization of complications in patients underlying cardiac surgery may be difficult because cardiopulmonary bypass (CPB) can lead to a systemic inflammatory response syndrome because of exposure of blood to nonphysiological surfaces. The purpose of the study was to establish the baseline levels of procalcitonin (PCT) after cardiac surgery in our population in order to analyze a possible induction of the inflammatory response that might interfere with the diagnosis of infection by PCT. Methods: Serum samples from patients undergoing coronary artery bypass grafting or valve replacement were collected at the time of admission to intensive care unit, after surgery as well as in the first and second postoperative days. Patients were followed for the development of postoperative complications. PCT levels were measured by immunoluminometric assay. Results: The mean PCT values were significantly higher in the first postoperative day in all the groups except the control group. No increased PCT levels were found related neither to duration of CPB, nor to time of aortic clamping. Only patients who presented complications had significantly increased PCT values immediately after surgery (p = 0.004), in the first postoperative day (p < 0.0001), and in the second postoperative day (p < 0.0001) with respect to those who recovered uneventfully. Conclusions: A slight and transient increase in PCT levels was observed in the first postoperative day after cardiac surgery. Significant elevation of PCT was only observed when complications were present. 相似文献
4.
Calcium and Vitamin D Depletion and Elevated Parathyroid Hormone following Biliopancreatic Diversion
Background: Biliopancreatic diversion (BPD) is associated with a 70% excess weight loss (EWL) at 10 years, but there are concerns
regarding long-term nutritional sequelae. Metabolic bone disease has been documented following Roux-en-Y gastric bypass. Methods:
Patients who underwent a BPD from 1998 to 2001 were studied. A questionnaire was designed to review BPD patients and collect
information on weight loss, frequency of gastrointestinal disturbances and compliance with multivitamin recommendations. The
review included a blood test for vitamin D, parathyroid hormone (PTH), alkaline phosphatase (ALP) and calcium. Results: Of
the 82 patients who underwent BPD during this period, the median %EWL at 36 months was 73.0%. 75.6% suffered diarrhea. At
median follow-up of 32 months (18-50), 25.9% of patients were hypocalcemic, 50% had low vitamin D, 23.8% had elevated ALP,
and 63.1% had elevated PTH, despite 82.9% taking multivitamins. Conclusion: BPD results in significant weight loss. However,
1 in 4 patients are hypocalcemic, and 1 in 2 have a low vitamin D, despite multivitamin supplementation. BPD patients require
routine calcium and vitamin D supplementation for life. Long-term sequelae from these abnormal serum levels are not known. 相似文献
5.
Background Roux-en-Y gastric bypass (RYGBP) has become a common surgical procedure to treat morbid obesity. Furthermore, it strongly
reduces the incidence of type 2 diabetes and mortality. However, there is scant information on how magnesium status is affected
by RYGBP surgery. Previous bariatric surgery methods, like jejunoileal bypass, are associated with hypomagnesemia.
Methods Twenty-one non-diabetic morbidly obese patients who underwent RYGBP were evaluated before and 1 year after surgery and compared
to a matched morbidly obese control group regarding serum magnesium. Groups were matched regarding weight, BMI, abdominal
sagittal diameter and fasting glucose, blood pressure, and serum magnesium concentrations before surgery in the RYGBP group.
Results The serum magnesium concentrations increased by 6% from 0.80 to 0.85 mmol/l (p = 0.019) in the RYGBP group while a decrease by 4% (p = 0.132) was observed in the control group. The increase in magnesium concentration at the 1-year follow-up in the RYGBP
group was accompanied by a decreased abdominal sagittal diameter (r
2 = 0.32, p = 0.009), a lowered BMI (r
2 = 0.28, p = 0.0214), a lowered glucose concentration (r
2 = 0.28, p = 0.027) but not by a lowered insulin concentration (p = 0.242), a lowered systolic (p = 0.789) or a lowered diastolic (p = 0.785) blood pressure.
Conclusion RYGBP surgery in morbidly obese subjects is characterized by reduced visceral adiposity, lowered plasma glucose, and increased
circulating magnesium concentrations. The inverse association between lowered central obesity, lowered plasma glucose and
increased magnesium concentrations, needs further detailed studies to identify underlying mechanisms. 相似文献
6.
Background: The authors examined associations between lifetime Axis I and Axis II disorders and weight loss following gastric
surgery for morbid obesity. Methods: 44 morbidly obese subjects who had undergone vertical banded gastroplasty (VBG) were
systematically interviewed with the Diagnostic Interview Schedule (DIS) and were administered the Personality Diagnostic Questionnaire
(PDQ). Subjects were followed-up 6 months post-VBG to determine weight loss. Results: The subjects had a mean ± SD age of
37.7 ± 10.6 years.Their baseline weight was 135.3 ± 28.0 kg and their baseline body mass index (BMI) was 50.0 ± 7.4. 34 (77%)
were female. Results of linear regressions show a significant association between baseline BMI and weight loss at 6-month
follow-up. After adjustment for baseline BMI, there was a non-significant trend toward increased weight loss in association
with alcohol abuse/dependence. Similarly, among our analysis of 41 subjects who had received the PDQ, we found a non-significant
trend toward increased weight loss in association with "any" PDQ diagnosis and with antisocial personality disorder/trait
after adjusting for baseline BMI. Conclusion: The data suggest that Axis I and Axis II diagnoses were not predictive of weight
loss following VBG during a 6-month follow-up. 相似文献
7.
Background: Vitamin B12 deficiency after gastric surgery for obesity is due to a failure of separation of vitamin B12 from protein foodstuffs and to a failure of absorption of crystalline vitamin B12 in the presence of intrinsic factor. The purpose of this study was to determine which of four oral doses of crystalline vitamin
B12 was most effective in treating vitamin B12 deficiency in 102 patients. Methods and Results: At time of entry into the study, the patients had a serum vitamin B12 < 100 pmol L −1, were 29.9 ± 21.7 months post-op, were 37 ± 8 years old and had a body mass index of 30 ± 6 kg m−2. Eight (8%) had had a vertical banded gastroplasty and 94 (92%) a gastric bypass. For the first 3 months all patients received
350 μg per day of crystalline vitamin B12 and all increased their serum vitamin B12 levels to over 100 pmol L−1. The patients were then assigned to receive for a further 3 month period one of four oral doses of crystalline vitamin B12-100 μg, 250 μg, 350 μg and 600 μg. Serum vitamin B12 levels were greater than 150 pmol L−1 after 6 months in 83.3% of patients who received 100 μg; 92.3% of patients who received 250 μg; 94.7% after 350 μg and 95.2%
after 600 μg (p%0.525). Conclusion: At least 350 μg per day is the appropriate oral dose of crystalline vitamin B12 after gastric surgery for obesity to correct low serum vitamin B12 levels in 95% of patients. 相似文献
8.
Salvatore R Maddi PhD S Ross Fox MD Richard H Harvey MA John L Lu BS Deborah M Khoshaba PsyD Michelle Persico BA 《Obesity surgery》2001,11(6):680-685
Background: Although there has been some disagreement, there is growing evidence now that psychopathology is a comorbidity
of morbid obesity among patients seeking bariatric surgery.The aim of this study was to determine whether psychopathology
decreases following this surgery. Methods: Utilizing a national sample, this study focused on pre- and post-surgery scores
on the Minnesota Multiphasic Personality Inventory, Second Edition (MMPI-2). The MMPI-2 was administered first during the
pre-surgery medical examination, and again between 6 months and 1 year following surgery. Results:Validity scale scores on
the pre- and postsurgery MMPI-2s indicated that there was no impediment to interpreting the clinical scale scores of these
tests.There was a pervasive pattern of statistically significant decreases in pre- to post-surgery clinical scale scores.
Further, comparison of MMPI-2 clinical scale scores to available test norms showed that the number of participants showing
signs of mental disorders was unusually high before surgery, and at or below the test norms following surgery. Conclusions:There
is clear evidence in this study that psychopathology declines following bariatric surgery.The unusually high levels of psychopathology
before surgery may be a joint function of the factors producing the morbid obesity, and a reaction to the obesity itself.That
psychopathology declines following surgery to levels expected in the general population indicates that the patients were becoming
more positive about their lives. 相似文献
9.
Gómez-Ambrosi J Salvador J Rotellar F Silva C Catalán V Rodríguez A Jesús Gil M Frühbeck G 《Obesity surgery》2006,16(3):262-269
Background: Obesity is considered a state of low-grade chronic inflammation, which may favor the development of cardiovascular
diseases. Serum amyloid A (SAA) is an acute phase protein synthesized in response to infection, inflammation, injury, and stress. The aim of the present
study was to compare the circulating concentrations of SAA and the mRNA expression in omental adipose tissue between lean
and obese individuals and to analyze the effect of weight loss after gastric bypass. Methods: 16 lean volunteers (BMI 20.5
± 0.6 kg/m2) and 24 obese patients (BMI 47.0 ± 1.2 kg/m2) were included in the study. Serum concentrations of SAA were measured by ELISA. In addition, the concentrations of SAA in
18 morbidly obese patients (7 male/11 female; BMI 44.6 ± 1.9 kg/m2) were measured before and after weight loss following Roux-en-Y gastric bypass (RYGBP). SAA expression in omental adipose
tissue was quantified by RT-PCR in biopsies from obese patients undergoing RYGBP and from age-matched lean individuals subjected
to Nissen fundoplication. Results: Obese patients exhibited significantly increased circulating SAA concentrations (6.6 ±
0.5 vs 39.3 ± 9.1 μg/ml; P<0.01) compared to lean subjects. A significant positive correlation was found between logSAA and body fat (r=0.631, P<0.0001). Obese patients showed significantly increased (P<0.05) mRNA expression of SAA in omental adipose tissue compared to lean subjects. Weight loss significantly decreased SAA
concentrations after RYGBP (final BMI 28.5 ± 0.9 kg/m2, P<0.0001 vs initial) from 47.5 ± 14.5 to 15.7 ± 2.9 μg/ml (P<0.05). Conclusion: It can be concluded that serum SAA and mRNA expression of SAA in omental adipose tissue are increased
in obese patients contributing to the obesity-associated cardiovascular disease risk. Moreover, weight loss reduces SAA concentrations,
which may contribute to the beneficial effects accompanying weight reduction. 相似文献
10.
目的:观察围手术期脊柱结核患者的血清前白蛋白(PA)水平,初步探讨其对临床诊治的指导价值.方法:选取2013年6月—2017年6月我院收治的162名脊柱结核患者作为研究对象,以年龄大于65岁为老年组、小于65岁为非老年组,其中老年组35例,非老年组127例.男82例,女80例.化疗方案为3 HREZ/5-7 HRE,手... 相似文献
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Discrepancies Between Serum and Erythrocyte Concentrations of Vitamin E in Hemodialysis Patients: Role of HDL-Bound Fraction of Vitamin E 总被引:2,自引:0,他引:2
M. Taccone-Gallucci R. Lubrano† D. Bandino† G. Citti‡ D. Attard-Barbini‡ V. Mazzarella§ M. Elli C. Meloni§ M. Morosetti C. Tozzo R. Antonini¶ G. Urbinati¶ O. Giardini† C. U. Casciani 《Artificial organs》1988,12(5):379-381
Recently, we have demonstrated that hemodialysis (HD) patients have higher serum and lower erythrocyte concentrations of vitamin E than controls. It is known that transfer of vitamin E from serum to erythrocyte is mostly due to high-density lipoproteins (HDL). For a better definition of the pattern of distribution of vitamin E in HD patients, we have dosed the amount of vitamin bound to serum HDL fraction. In 8 patients and in 8 healthy controls, we have determined the concentration of serum erythrocyte and HDL-bound vitamin E. The latest was obtained on an ultracentrifuged HDL fraction. HDL fractions from HD patients have been found to contain larger amounts of vitamin E than controls. The previously described higher serum and lower erythrocyte concentrations of vitamin E in HD patients have been confirmed in the study. The deficit of vitamin E in the membranes of erythrocytes from HD patients has been shown to be the result of increased consumption of the vitamin in the erythrocyte membranes, where it represents the major antioxidant agent. However, the finding of increased amounts of vitamin bound to HDL in HD patients suggests that the transfer of the vitamin to the erythrocyte membranes may also be defective. 相似文献
13.
Background: The pharmacokinetic variables of drug clearance and volume of distribution are usually corrected for body weight
or surface area. Only recently have the relationships which exist between body size, physiologic function and pharmacokinetic
variables been evaluated in the obese population. These effects are not widely known, and data on this and the effects of
bariatric surgical procedures are scantily documented in the surgical literature. Methods: Literature review. Results: Drugs
with a low or moderate affinity for adipose tissue have a moderate increase in the volume of distribution (Vd), and this correlates
with the increase in lean body mass (LBM). Highly lipophilic drugs, with some exceptions, show the expected increase in Vd
and prolongation of elimination half-life, indicating a marked distribution into adipose tissue. Drug absorption, in general,
is slowed by delayed gastric emptying and is normal when gastric emptying is normal or increased. Most drug absorption occurs
in the small intestine where duration of drug/mucosal contact is the most important factor. Conclusions: Drugs whose distribution
is restricted to LBM should utilize a loading dose based on ideal body weight (IBW). For those drugs which distribute freely
into adipose tissue, the loading dose should be based on total body weight (TBW). Adjustment of the maintenance dose depends
on clearance rates. In a few cases dosage adjustment depends on pharmacodynamic data, since drug clearance does not conform
to these recommendations, for reasons which remain to be defined. Following bariatric surgery, in the absence of delayed gastric
emptying or uncontrolled diarrhea, drug absorption rates are usually comparable to the non-operated patient. 相似文献
14.
Macgregor AM 《Obesity surgery》1994,4(2):129-143
This review examines the energetics and metabolic parameters which influence the effectiveness of gastric restrictive surgery
in achieving weight loss in the clinically severely obese patient. Among the subjects discussed are the metabolic determinents
and consequences of obesity, energy expenditure and its components, factors other than dietary restriction and weight loss
which affect energy expenditure, and the metabolic risk factors for weight gain. The role of exercise is reviewed, including
the effects of exercise on energy balance and the thermic effect of food. The value of combining exercise with diet restriction,
the effect of caloric restriction on the capacity to exercise and the place of exercise in the obese diabetic are examined.
Finally, the metabolic consequences of gastric restrictive surgery, the adaptive response to surgically induced weight loss
and nutritional recommendations following gastric restrictive surgery are reviewed. 相似文献
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Yeon Ji Lee Yoon-Seok Heo Hye Soon Park Seoung Hee Lee Seul Ki Lee Yeon Jin Jang 《Obesity surgery》2014,24(4):604-610
Background
Remodeling of the extracellular matrix (ECM) of adipose tissue is regarded as part of the pathophysiology of obesity. Secreted protein acidic and rich in cysteine (SPARC) was the first ECM protein described in adipose tissue. Matrix metalloproteinases (MMPs) also play a role in ECM remodeling, and MMP-2 and MMP-9 may be associated with abnormal ECM metabolism. Here, we investigated changes in serum SPARC, MMP-2, and MMP-9 concentrations after bariatric surgery in obese adults.Methods
We recruited 34 obese patients who were scheduled to undergo bariatric surgery for weight loss. We analyzed changes in serum SPARC, MMP-2, and MMP-9 concentrations before and 9 months after bariatric surgery and any associations between changes in SPARC, MMP-2, and MMP-9 concentrations and obesity-related parameters.Results
Serum leptin levels significantly decreased, and the serum adiponectin level significantly increased after bariatric surgery. The serum SPARC concentration decreased significantly from 165.0?±?18.2 to 68.7?±?6.7 ng/mL (p?<?0.001), and the MMP-2 concentration also decreased significantly from 262.2?±?15.2 to 235.9?±?10.5 ng/mL (p?<?0.001). Changes in the serum SPARC concentration were significantly correlated with HOMA-IR changes, and changes in the serum MMP-9 concentration were found to inversely correlate with serum adiponectin changes.Conclusion
These findings show that significant decreases in serum SPARC and MMP-2 concentrations occur after bariatric surgery. Our results thus suggest that weight loss via bariatric surgery could alter the ECM environment, and that these changes are related to certain metabolic changes. 相似文献17.
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