Effect of pistachio diet on lipid parameters,endothelial function,inflammation, and oxidative status: A prospective study

ObjectiveRecent studies have suggested that nuts have favorable effects beyond lipid lowering. We aimed to investigate effect of the Antep pistachio (Pistacia vera L.) on blood glucose, lipid parameters, endothelial function, inflammation, and oxidation in healthy young men living in a controlled environment.MethodsA Mediterranean diet was administered to normolipidemic 32 healthy young men (mean age 22 y, range 21–24) for 4 wk. After 4 wk, participants continued to receive the Mediterranean diet but pistachio was added for 4 wk by replacing the monounsaturated fat content constituting ≈20% of daily caloric intake. Fasting blood samples and brachial endothelial function measurements were performed at baseline and after each diet.ResultsCompared with the Mediterranean diet, the pistachio diet decreased glucose (P < 0.001, ?8.8 ± 8.5%), low-density lipoprotein (P < 0.001, ?23.2 ± 11.9%), total cholesterol (P < 0.001, ?21.2 ± 9.9%), and triacylglycerol (P = 0.008, ?13.8 ± 33.8%) significantly and high-density lipoprotein (P = 0.069, ?3.1 ± 11.7%) non-significantly. Total cholesterol/high-density lipoprotein and low-density lipoprotein/high-density lipoprotein ratios decreased significantly (P < 0.001 for both). The pistachio diet significantly improved endothelium-dependent vasodilation (P = 0.002, 30% relative increase), decreased serum interleukin-6, total oxidant status, lipid hydroperoxide, and malondialdehyde and increased superoxide dismutase (P < 0.001 for all), whereas there was no significant change in C-reactive protein and tumor necrosis factor-α levels.ConclusionIn this trial, we demonstrated that a pistachio diet improved blood glucose level, endothelial function, and some indices of inflammation and oxidative status in healthy young men. These findings are in accordance with the idea that nuts, in particular pistachio nuts, have favorable effects beyond lipid lowering that deserve to be evaluated with prospective follow-up studies.     

Assessment of energy expenditure,physical activity and sleep pattern in patients with frequent symptomatic ventricular ectopic beats

BackgroundVentricular ectopic beats (VEBs) are considered as benign ventricular arrhythmias in patients without structural heart disease. However, symptomatic frequent VEBs can adversely affect energy metabolism. The present study aimed to determine the effect of symptomatic frequent VEBs on energy expenditure, physical activity and sleep pattern.MethodsThirty-seven patients with symptomatic frequent VEBs and no structural heart diseases were enrolled. Patients underwent simultaneous 24-hour-ambulatory Holter electrocardiogram monitoring and the BodyMedia armband device monitoring which measures energy expenditure. Data acquired from both devices were compared with the data acquired from healthy volunteers in the control group.ResultsTotal energy expenditure (TEE) was higher in the patient group than the control group (1470 ± 353 kcal vs 1125 ± 275 kcal, P < 0.001). Average metabolic equivalence (aMETs) (1.1 ± 0.2 vs. 1.3 ± 0.2, P = 0.028), physical activity duration (PAD) (0.35 vs. 0.48, P = 0.007) and sleep duration (SDN) (3.15 vs. 4.31, P = 0.004) were significantly lower in the patient group than control group. VEBs frequency was inversely correlated with only SDN (r = −0.374, P = 0.027).ConclusionTotal energy expenditure (TEE) is increased in patients with symptomatic frequent VEBs in comparison with healthy subjects while PAD, average metabolic equivalence (aMETs) and SDN are decreased. VEBs frequency was inversely correlated with SDN.     

Association of dietary factors with plasma homocysteine and coronary heart disease outcome

ObjectiveThe aim of the present study was to investigate the association between serum levels of vitamins B12, B6, folic acid and hyperhomocysteinemia with the risk of coronary heart disease (CHD).Material and methodsA case control study was carried out involving 105 newly diagnosed coronary heart disease patient of both gender (age range 25–60 years) and 105 age and sex matched normal healthy individuals at Punjab Institute of Cardiology, Lahore. Fasting blood samples were collected from both cases and controls. Sera were analyzed for folic acid, vitamin B6 and B12 using high performance liquid chromatography (HPLC). Plasma homocysteine was analyzed by fluorescence polarization immunoassay (FPIA) and traditional risk factors were also assessed.ResultsMean plasma homocysteine level in cases (22.33 ± 9.22 μmol/L) was significantly higher (P = 0.0001) than controls (12.5 ± 3.73 μmol/L). Mean serum folic acid concentration, serum vitamin B6 and vitamin B12 were significantly lower in cases than the mean levels in controls (P < 0.05). When compared to controls the data revealed significantly greater deficiency of folic acid, vitamin B6 and B12 in coronary heart disease patients. Statistically significant inverse correlation was observed between folic acid, vitamin B6, B12 and plasma homocysteine concentration (r = ?0.463, r = ?0.431 and r = ?0.294, respectively).ConclusionNutritional deficiency of folic acid, vitamin B12 and B6 were common in coronary heart disease patients with an inverse correlation of plasma homocysteine concentration with these vitamins. Substantial deficiency of these vitamins along with hyperhomocysteinemia could be further aggravating the risk of CHD in Pakistani population.     

Acute kidney injury in infective endocarditis: A retrospective analysis

BackgroundAcute kidney injury (AKI) is associated with high case fatality in infective endocarditis (IE), but epidemiological data on the frequency of AKI during IE is scarce. We aimed to describe the frequency and risk factors for AKI during the course of IE using Kidney Disease: Improving Global Outcomes consensual criteria.MethodsUsing the French hospital discharge database (French acronym PMSI), we retrospectively reviewed the charts of 112 patients presenting with a first episode of probable or definite IE between January 2010 and May 2015.ResultsSeventy-seven patients (68.8%) developed AKI. In univariate analysis, risk factors for AKI were cardiac surgery for IE (n = 29, 37.7% vs. n = 4, 1.4%, P < 0.0005), cardiac failure (n = 29, 36.7% vs. n = 1, 2.9%, P < 0.0005), diabetes mellitus (n = 14, 18.2% vs. n = 1, 0.9%, P = 0.034), and prosthetic valve IEs (n = 24, 31.2% vs. n = 4, 11.4%). No differences were observed for gentamicin exposure (n = 57, 64% vs. n = 32, 86.5%, P = 0.286). Prosthetic valve IE, cardiac failure, and vancomycin exposure were independently associated with AKI with respective odds ratio of 5.49 (95% CI 1.92–17.9), 4.37 (95% CI 4.37–465.7), and 1.084 (1.084–16.2). Mean length of hospital stay was significantly longer in patients presenting with AKI than in controls (respectively 52.4 ± 22.1 days vs. 39.6 ± 12.6, P < 0.005).ConclusionAKI is very frequent during IE, particularly in patients with prosthetic valve IE, cardiac failure, and those receiving vancomycin.     

Elevated systolic blood pressure of children in the United States is associated with low serum 25-hydroxyvitamin D concentrations related to body mass index: National Health and Examination Survey 2007-2010

A negative association between serum 25-hydroxyvitamn D (25[OH]D) concentrations and blood pressure has been found in adults; whether a similar relationship exists in children remains unclear. We hypothesized that serum 25(OH)D concentrations of children would negatively correlate with blood pressure. Using a nationally representative sample of children aged 8 to 18 years from the National Health and Nutrition Examination Survey 2007-2010 (n = 2908), we compared serum 25(OH)D levels with diastolic and systolic blood pressure by vitamin D nutritional status categories. A high percentage of children were either vitamin D deficient (28.8%) or vitamin D insufficient (48.8%). Prehypertension was defined as blood pressure as ≥90th to <95th percentile and hypertension as ≥95th percentile by age, height, and sex national blood pressure percentile norms for children. Vitamin D–deficient children aged 8 to 13 years had higher systolic blood pressure (104.8 ± 0.7 mm Hg) than did vitamin D–sufficient children (102.3 ± 0.6 mmHg; P < .05). Controlling for age, sex, race/ethnicity, and income, systolic blood pressure was inversely associated with serum 25(OH)D concentrations (P < .03), but not when also controlling for body mass index (P = .63). A higher percentage of vitamin D–deficient and vitamin D–insufficient children (1.7%) vs vitamin D–sufficient children (0.6%) had prehypertension or hypertension. In conclusion, the association of low serum 25(OH)D concentrations with elevated systolic blood pressure in children is likely related to body weight and markers of adiposity.     

Vitamin D,bone mineral density and body mass index in eating disorder patients

AimTo investigate associations of vitamin D with BMD and BMI in ED patients.MethodsVitamin D, BMD and BMI for 50 patients admitted to a specialised ED inpatient unit were measured. Patients were aged 15–54 years with BMI 8–25 kg/m².ResultsOf the patients, 18% were vitamin D deficient. There was a significant linear relationship between vitamin D and BMD T-score at the lumbar spine (p = 0.029), femoral neck (p < 0.001) and total hip (p = 0.001). There was no relationship between vitamin D and BMI. There was a significant linear relationship between BMI and BMD T-score at the lumbar spine (p < 0.001), femoral neck (p = 0.008) and total hip (p = 0.001).ConclusionsLow vitamin D and low BMI are associated with low BMD in ED patients. Despite widespread belief that it is not necessary, our findings suggest it is appropriate to measure vitamin D in ED patients. It should not be assumed ED patients take supplements.     

Overweight and obesity in Eastern Morocco: Prevalence and associated risk factors among high school students

BackgroundOverweight and obesity in children and adolescents have become a major public health problem affecting most countries worldwide. The purpose of the study was to assess the prevalence and risk factors of overweight and obesity among public high school students in Eastern Morocco.MethodsA cross-sectional survey was conducted between February and May 2014 among a sample of 2271 students (1086 girls and 1185 boys). References from the International Obesity Task Force (IOTF) were used to determine the prevalence of overweight and obesity.ResultsThe prevalence of overweight and obesity reached 12.2% (14.2% in girls vs 10.4% in boys, P < 0.01) and 3.0% (3.1% in girls vs 2.8% in boys), respectively. Risk factors associated with overweight and obesity were urban residence (OR = 1.76; [1.18–2.63]; P < 0.01), father's income ≥ 5000 MAD (OR = 1.32; [1.02–1.70]; P < 0.05), father's overweight (including obesity) (OR = 1.87; [1.38–2.54]; P < 0.001) and female sex (OR = 1.31; [1.02–1.68]; P < 0.05).ConclusionThe prevalence of overweight/obesity has reached an alarming rate among high school students in the Eastern region of Morocco. The findings of the present study suggest an urgent need to set up a strategy to prevent and combat this epidemic.     

Multimodal-lifestyle intervention produces reduction of the fat mass rather than body weight loss in men with obesity: A prospective cohort study

Background and the objectiveBody composition changes throughout the multimodal-lifestyle intervention of obesity is underinvestigated. This study evaluated the effectiveness of the multimodal-lifestyle intervention in reduction of fat mass together with preservation of fat free mass.MethodsAdult male subjects with overweightness or obesity (n = 99) were enrolled in a prospective cohort study for 12 months. Patients were educated about healthy diet, physical activity, and some behavioral changes. Anthropometric measurements and body composition analysis by bioelectric impedance analysis (InBody-720) were reported before, during and after the study period.ResultsConcerning adherent subjects, the mean ± standard error of the mean (SEM) of percent weight loss, percent fat mass loss, percent fat free mass and total body water changes after 6 months were 7.24 ± 0.98, 16.28 ± 2.35, 0.76 ± 0.64 and 0.82 ± 0.65, respectively, and after 1 year they were 10.14 ± 0.78, 25.22 ± 3.59, 1.22 ± 1.06 and 1.27 ± 1.07, respectively. There were significant changes between before- and after-measurements of weight, BMI, waist circumference, fat mass and percent body fat (P < 0.05) for all studied intervals.ConclusionsMultimodal-lifestyle intervention might be effective in loss of fat mass rather than reduction of the total body weight together with preservation of the lean body mass.     

Valeurs de référence de la vitamine D chez la Femme du Sud Tunisien

IntroductionTotal 25 Hydroxyvitamin D (25OHD) is currently considered as the most representative metabolite of vitamine D status. Low levels of Vitamin D have been reported in many countries even in sunnier regions especially in Tunisia. We aimed to establish a Vitamin D reference range in healthy South Tunisian women, using electrochimiluminesence assay.MethodsCross-sectional study has been conducted in the south of Tunisia including Tunisian healthy women. Each participant underwent a questionnaire, clinical examination, food survey and biological exploration. 25OHD reference range was determined according to the recommendations of the Clinical and Laboratory Standards Institute.Results279 women accepted to participate in the study, 21 were excluded for hypocalcemia with/without hyperparathyroidism. 258 women were included with a mean age of 41,29 ± 17,06 years. 72% of participants were dark-skinned vs. 28% with a light phototype. No participants reached the recommended daily intakes of vitamin D and calcium. The average of 25OHD was 7,88 ± 6,08 ng/mL (IC 95%: 7,06 et 8,7). 25OHD levels were lower in dark skinned (P = 0,06) and veiled women compared to others subgroups (P = 0,03).ConclusionThere are a multitude of challenges that still deserve to be addressed. Despite recent technologies advances, 25OHD assessment and standardization remains complicated and needs to be discussed with clinicians when establishing practical guidelines and diagnosis cutoffs.     

High-fructose diet elevates myocardial superoxide generation in mice in the absence of cardiac hypertrophy

ObjectiveDietary fructose intake has increased considerably in recent decades and this has been paralleled by an increase in the incidence of insulin resistance, especially in children and adolescents. The impact of a high-fructose diet on the myocardium is not fully understood. The aims of this study were to characterize the murine metabolic and cardiac phenotypes associated with a high-fructose diet and to determine whether this diet imparts differential effects with age.MethodsJuvenile (4 wk) and adult (14 wk) C57Bl/6 mice were fed a 60% fructose diet or isoenergetic control (starch) diet for 6 wk.ResultsAt completion of the dietary intervention (at ages 10 and 20 wk), fructose-fed mice were normotensive; hyperinsulinemia and cardiac hypertrophy were not evident. Interestingly, fructose-fed mice exhibited lower blood glucose levels (10 wk: 4.81 ± 0.28 versus 5.42 ± 0.31 mmol/L; 20 wk: 4.88 ± 0.30 versus 5.96 ± 0.42 mmol/L, P < 0.05) compared with controls. Nicotinamide adenosine dinucleotide phosphate–driven myocardial superoxide production was significantly increased in fructose-fed mice at both ages (by approximately 29% of control at 10 wk of age and 16% at 20 wk, P < 0.01). No increase in aortic superoxide production was observed. Fructose feeding did not alter gene expression of the antioxidant thioredoxin-2, suggesting an imbalance between myocardial reactive oxygen species generation and antioxidant induction.ConclusionThese findings indicate that increased myocardial superoxide production may represent an early and primary cardiac pathologic response to the metabolic challenge of excess dietary fructose in juveniles and adults that can be detected in the absence of cardiac hypertrophy and hypertension.     

Comparative 25-OH-vitamin D level in institutionalized women older than 65 years from two cities in Spain and Argentina having a similar solar radiation index

ObjectiveThe present study evaluated and compared vitamin D nutritional status and calcium–phosphorus metabolism in institutionalized women >65 y from two cities that have a similar sun irradiation index (heliophany).MethodsThe study was carried out in women living in similar social-status institutions from geographic cities having a similar solar radiation index (Lleida, Spain, n = 49, and suburban Buenos Aires, Argentina [BA], n = 48) at the end of summer.ResultsFish consumption was higher in the Lleida group, as was red-meat consumption in the BA group. In both groups mean calcium intake was 800 mg/d. The daily intake of vitamin D was higher in the BA group (P < 0.001). A total of 90% in Lleida and 86% in BA had 25-hydroxyvitamin D (25OHD) levels <20 ng/mL. A significant inverse correlation between individual 25OHD and parathyroid hormone (PTH) levels was observed in the two groups of women (r = ?0.329, P = 0.035). PTH levels >100 pg/mL were found in 24% and 20% of women in Lleida and BA, respectively. There was a marked increase in carboxy-terminal telopeptide cross-links of type I collagen levels and a decrease in 25OHD with an increase in PTH levels (P < 0.05). Conversely, bone alkaline phosphatase increased significantly only when the PTH concentration duplicated the reference range.ConclusionEven at the end of summer, vitamin D deficiency/insufficiency was prevalent in the two studied institutionalized elderly women. In the narrow range of the dietary calcium intake (close to 800 mg/d) of both studied groups, secondary hyperparathyroidism was absent when 25OHD levels were >17 ng/dL, indicating changes in the regulation control of serum PTH and consequently the changes in this threshold. As a result, vitamin D deficiency must be reversed to avoid the increment in bone turnover and to ensure the endocrine and paracrine functions of vitamin D for overall health and well-being.     

Functional signs in patients consulting for presumed Lyme borreliosis

IntroductionLittle is known about the functional symptoms associated with Lyme borreliosis (LB) in Europe. We aimed to assess functional symptoms associated with presumed LB and to compare patients with and without confirmed LB.Materials and methodsWe performed a retrospective monocenter study. Patients consulting for presumed LB were included.ResultsBetween November 2015 and June 2018, 355 patients were included (mean age: 51 years, 52% of women) of which 48 had LB: erythema migrans (42%), early disseminated LB (50%; 35% of neuroborreliosis cases), and late disseminated LB (8%). The most frequently reported functional symptoms were neuropathic pain (23%), arthralgia (23%), and asthenia (17%). Other functional symptoms were rare (≤ 10%). Three hundred and seven (86%) patients did not have LB. Patients with confirmed LB reported fewer functional symptoms than patients without LB (1.8 (± 1.7) vs. 3.6 (± 2.5), P < 0.001) with a shorter duration of symptoms (< 3 months in 48% vs. 16% of cases, P < 0.001). They less often reported asthenia (17% vs. 59%, P < 0.001), widespread pain (10% vs. 31%, P = 0.003), myalgia (10% vs. 32%, P = 0.002), memory disorders (4% vs. 16%, P = 0.03), irritability (2% vs. 23%, P ± 0.001), and sadness (0% vs. 16%, P = 0.003).ConclusionIn patients consulting for presumed LB, patients diagnosed with LB had fewer and shorter functional symptoms than patients without LB.     

Economic challenges of using innovative medical devices in major public health pathologies: Example of acute ischemic stroke management by mechanical thrombectomy

BackgroundActivity-based Funding can induce financial imbalances for health institutions if innovative medical devices (MD) used to perform acts are included in Diagnosis Related Groups (DRG) tariff. To be reimbursed in addition to the DRG tariff, innovative MD must have received a favorable evaluation by the French National Authority for Health (Haute Autorité de Santé) and be registered on the positive list. The aim of this study was to evaluate the expenses and incomes generated by each scenario (before and after the reimbursement of MD), and the financial reports. This study concerned the management of ischemic stroke by mechanical thrombectomy devices, in high-volume French hospital.MethodsAll patients who have had an acute ischemic stroke and admitted to the interventional neuroradiology unit between January 2016 and December 2017 were included retrospectively in this monocentric study. They were divided into four subgroups based on the severity of the DRG. The cost study was carried out using the French National Cost Study Methodology adjusted for the duration of the stays and by micro-costing on MD.ResultsA total of 267 patients were included. Over the study period, the average cost of the hospital stay was €10,492 ± 6364 for a refund of €9838 ± 6749 per patient. The acts performed became profitable once the MD were registered on the positive list (€−1017 ± 3551 vs. €560 ± 2671; P < 0.05). Despite this reimbursement, this activity remained in deficit for DRG lowest severity (level 1) patients (€−492 ± 1244). Specific MD used for mechanical thrombectomy represented 37% of the total cost of stay.ConclusionThe time required to evaluate MD reimbursement files is too long compared to their development. As a result, practitioners are in difficulty to be able to carry out acts according to the consensual practices of their learned societies, without causing any financial deficit of their institutions.     

Association of major dietary patterns with socioeconomic and lifestyle factors of adult women living in Tehran,Iran

ObjectivesTo detect major dietary patterns and their relation with demographic, socioeconomic, and lifestyle factors in adult women living in Tehran, Iran.MethodsIn a cross-sectional study, 460 women 20–50 y of age were selected by a stratified random-sampling method. Factor analysis was conducted to ascertain the major dietary patterns, and analysis of covariance was fitted to assess the relation between demographic, socioeconomic, and lifestyle variables and adherence to major dietary patterns.ResultsTwo major dietary patterns were extracted: healthy and unhealthy. After adjustment for confounders, age (b = 0.31, P < 0.01), university degree (b = 0.85, P < 0.01), housing size >20 m²/head (b = 0.30, P < 0.01), total family income US >$500/mo (b = 0.25, P < 0.05), physical activity (b = 0.01, P < 0.05), and history of hypertension (b = 0.36, P < 0.05) were positively associated and duration of residence in Tehran (b = ?0.01, P < 0.05) was negatively associated with a healthy dietary pattern. Conversely, ethnicity (Turk versus Fars; b = 0.30, P < 0.01) and smoking (b = 0.64, P < 0.01) were positively associated and age (b = ?0.33, P < 0.01) was negatively associated with an unhealthy dietary pattern.ConclusionOur findings support the association between demographic, socioeconomic, lifestyle factors and dietary patterns of the studied women. Therefore, it is suggested these factors should be considered in future studies on the association between dietary patterns and disease.     

The evaluation of consumed food portions as a screening test for malnutrition in the older people living in a nursing home: A cross-sectional pilot study

IntroductionThe Self Evaluation of Food Intake (SEFI®) is a simple tool to assess food intake.AimsTo evaluate the validity of SEFI® to screen malnutrition compared to the Mini Nutritional Assessment (MNA)® as the reference method (primary) and other screening tools (secondary); to assess the feasibility of SEFI® (secondary) in older people living in a nursing home.MethodsQuantitative, non-interventional, cross-sectional, monocentric pilot study. Patients were included in a 143-beds nursing home. The SEFI® visual analogue scale (VAS) from 0 to 10, and the evaluation of consumed portions of served food by the general practioner (SEFI® consumed portions) were performed after the MNA®. Malnutrition was defined as MNA®<17.StatisticsYouden method and receiver operating characteristic (ROC) curves.ResultsOut of 128 patients, 93 were included: 72% women, mean age (±SD), 88 ± 7 yr, body mass index, 25.9 ± 6.1, MNA®<17, 26% (24/93), SEFI® consumed portions ≤50%, 29% (27/93) of patients. The feasibility of SEFI®  VAS and consumed portions were respectively 0 and 100% (93/93). The predictive performance of SEFI® consumed portions for the diagnosis of malnutrition was good: area under the curve = 0.81 [95% confidence interval (CI), 0.69–0.93]; sensitivity 75.0% (n = 18/24, 95%CI, 57.7–92.3), specificity 87.0% (n = 60/69, 77.0–94.9), positive predictive value 66.7% (n = 18/27, 48.9–84.4), and negative predictive value 90.9% (n = 60/66, 80.0–93.9).ConclusionsSEFI® is feasible and useful for detecting malnutrition in nursing home residents.     

The medication discrepancy detection service: A cost-effective multidisciplinary clinical approach

ObjectiveTo estimate the effectiveness of a Medication Discrepancy Detection Service (MDDS), a collaborative service between the community pharmacy and Primary Care.DesignNon-controlled before-and-after study.SettingBidasoa Integrated Healthcare Organisation, Gipuzkoa, Spain.ParticipantsThe service was provided by a multidisciplinary group of community pharmacists (CPs), general practitioners (GPs), and primary care pharmacists, to patients with discrepancies between their active medical charts and medicines that they were actually taking.OutcomesThe primary outcomes were the number of medicines, the type of discrepancy, and GPs’ decisions. Secondary outcomes were time spent by CPs, emergency department (ED) visits, hospital admissions, and costs.ResultsThe MDDS was provided to 143 patients, and GPs resolved discrepancies for 126 patients. CPs identified 259 discrepancies, among which the main one was patients not taking medicines listed on their active medical charts (66.7%, n = 152). The main GPs’ decision was to withdraw the treatment (54.8%, n = 125), which meant that the number of medicines per patient was reduced by 0.92 (9.12 ± 3.82 vs. 8.20 ± 3.81; p < .0001). The number of ED visits and hospital admissions per patient were reduced by 0.10 (0.61 ± .13 vs 0.52 ± 0.91; p = .405 and 0.17 (0.33 ± 0.66 vs. 0.16 ± 0.42; p = .007), respectively. The cost per patient was reduced by €444.9 (€1003.3 ± 2165.3 vs. €558.4 ± 1273.0; p = .018).ConclusionThe MDDS resulted in a reduction in the number of medicines per patients and number of hospital admissions, and the service was associated with affordable, cost-effective ratios.     

Évolution du syndrome métabolique après sleeve gastrectomie chez un groupe d’obèses tunisiens

Aims of the studyDescribe the evolution of metabolic syndrome and its components, six months and one year after sleeve gastrectomy.Materials and methodsIt is a prospective study including 40 obese patients (7 men and 33 women) who underwent sleeve gastrectomy between 2016 and 2018. Clinical and biological parameters were collected before the intervention, at six months and one year after surgery. Metabolic syndrome has been defined according to the international diabetes federation's diagnostic criteria of 2009. Insulin resistance was assessed using the HOMA (homeostasis model assessment) method and defined by a HOMA-IR index ≥ 2.4.ResultsThe mean patients’ age was 34.6 ± 8.2 years. The mean body mass index (BMI) was 50.2 ± 8.3 kg/m². The frequency of metabolic syndrome decreased from 67% (27 patients) before the intervention to 12% (5 patients) after six months (P <0.05) and to 7% (3 patients) one year after sleeve gastrectomy (P < 0.05), the remission's rate was 89%. The frequency of insulin resistance decreased from 89% before intervention to 4% after one year (P < 0.05). Mean excess weight loss (EWL) was 40.2 14% at six months and 55.8 20.5% at one year.ConclusionSleeve gastrectomy improves significantly insulin resistance and all components of the metabolic syndrome in the short-term. These metabolic benefits could contribute to the reduction of cardiovascular risk in obese subjects in the long-term.