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Marta Guimarães Mário Nora Tiago Ferreira Sara Andrade Andreia M. Ribeiro Vera Oliveira Marcos C. Carreira Felipe F. Casanueva Mariana P. Monteiro 《Obesity surgery》2013,23(5):710-717
Background
Restrictive bariatric surgery procedures currently used include adjustable gastric banding, sleeve gastrectomy (SG), and gastric plication (GP), of which the last two techniques still lack sufficient data and long-term studies on weight loss, surgical complications, resolution of comorbidities, and mechanisms of weight loss. Therefore, gastric plication and sleeve gastrectomy as a standalone procedure are still considered experimental. Our aim was to analyze the effects of SG and GP on body weight, food intake, and endocrine profile.Methods
Forty-four male Wistar rats were randomized into six weight-matched groups and submitted either to SG, GP, or sham-operated. Sham-operated rats were divided into pair-fed and fed ad libitum controls, one for each procedure. Animals were followed up for 21 days after surgery, while body weight and food intake were recorded daily, when fasting ghrelin, leptin, insulin and glucose plasma levels, and ghrelin expression in the stomach were measured.Results
Rats submitted to SG and GP showed a significant decrease in body weight gain to the same extent as rats pair-fed to the surgical groups when compared to sham-operated fed ad libitum controls. After surgery, SG rats showed no difference in body composition, ghrelin, leptin, insulin, or glucose levels, while GP rats displayed lower body fat content and leptin levels compared to controls. Ghrelin was also lower in GP rats compared to sham-operated pair-fed rats. Ghrelin expression displayed a pattern similar to circulating ghrelin.Conclusions
SG and GP result in weight loss, although with differences in body composition and metabolic and endocrine profiles. 相似文献3.
Anne-Sophie Schneck Antonio Iannelli Stéphanie Patouraux Déborah Rousseau Stéphanie Bonnafous Beatrice Bailly-Maitre Ophélia Le Thuc Carole Rovere Patricia Panaia-Ferrari Rodolphe Anty Albert Tran Philippe Gual Jean Gugenheim 《Surgical endoscopy》2014,28(2):592-602
Background
Sleeve gastrectomy (SG) has become a popular bariatric procedure. The mechanisms responsible for weight loss and improvement of metabolic disturbances have still not been completely elucidated. We investigated the effect of SG on body weight, adipose tissue depots, glucose tolerance, and liver steatosis independent of reduced caloric intake in high-fat-diet-induced obese mice.Methods
C57BI/6 J mice fed a high fat diet (45 %) for 33 weeks were divided into three groups: sleeve gastrectomy (SG, 13 mice), sham-operated ad libitum fed (SALF, 13 mice) and sham-operated pair fed (PFS, 13 mice). The animals were humanely killed 23 days after surgery.Results
In SG mice, food intake was reduced transiently, but weight loss was significant and persistent compared to controls (SG vs. PFS, P < 0.05; PFS vs. SALF, P < 0.05). SG mice showed improved glucose tolerance and lower levels of liver steatosis compared with controls (area under the curve, SG vs. PFS, P < 0.01; PFS vs. SALF, P < 0.05) (liver steatosis, SG vs. PFS, P < 0.05; PFS vs. SALF, P < 0.01). This was associated with a decrease in the ratios of the weight of pancreas, epididymal and inguinal adipose tissues to body weight, and an increase in the ratio of brown adipose tissue weight to body weight. Epididymal adipose tissue was also infiltrated by fewer activated T cells and by more anti-inflammatory regulatory T cells. Serum levels of fasting acyl ghrelin were still significantly decreased 3 weeks after surgery in SG mice compared to PFS mice (P < 0.05).Conclusions
Reduced white adipose tissue inflammation, modification of adipose tissue development (brown vs. white adipose tissue), and ectopic fat are potential mechanisms that may account for the reduced caloric intake independent effects of SG. 相似文献4.
Ivan Delgado-Enciso Alejandro García-Rivera M. Violeta M. Madrigal-Pérez Alejandrina Rodriguez-Hernandez Agustin Lugo-Radillo Hector R. Galvan-Salazar Alejandro D. Soriano-Hernández Fernando Gómez-Tapia Rafael Martinez-Martinez Laura L. Valdez-Velazquez Oscar A. Newton-Sanchez Rafael Gonzalez-Alvarez Iram P. Rodriguez-Sanchez Valery Melnikov Agustin Lara-Esqueda Jose Guzman-Esquivel 《International urology and nephrology》2014,46(5):895-899
Introduction
A high-fat diet and male obesity are aspects associated with germinal epithelial alterations and male infertility. Some reports have shown that certain tetracyclines can protect the germinal epithelium from toxic drugs. The aim of the present study design was to evaluate the possible effect of doxycycline on testicular germ cells in individuals fed a Western diet (atherogenic), using a murine model.Methods
Two groups of male mice (BALB/c) were fed a high-fat Western diet (HFD). One of these two groups was given doxycycline at a dose of 10 mg/kg/day (HFD+Dox). A third group was fed a standard rodent diet (SD group). After 6 months, the mice were euthanized and morphologic and histopathologic analyses were performed.Results
Germinal epithelial height was similar between the SD group (54 μm) and the HFD+Dox group (53 μm) (p = 0.26), and it was significantly reduced in the HFD group (47 μm) (p = 0.0001). The degree of germinal epithelial loss (DGEL) was significantly lower in the SD (10) and HFD+Dox (12.5) groups than in the HFD group (30) (p = 0.0001 and =0.007, respectively). There were no differences in the DGEL between the SD and HFD+Dox groups (p = 0.42).Conclusions
Doxycycline administration was shown to prevent germinal epithelial loss in the testes of mice fed a high-fat diet. Future studies are necessary to evaluate the clinical usefulness of doxycycline or its analogs in persons with a habitual high-fat diet. 相似文献5.
Eider Talavera-Urquijo Sarai Rodríguez-Navarro Marc Beisani Maria Teresa Salcedo-Allende Aisha Chakkur Marc Arús-Avilés Manel Cremades Salvador Augustin María Martell José M. Balibrea 《Obesity surgery》2018,28(1):142-151
Background
Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease and is found in 70% of obese people. The evidence available to date suggests that bariatric surgery could be an effective treatment by reducing weight and also by improving metabolic complications in the long term. This work aimed to compare, in a diet-induced NAFLD animal model, the effect of both sleeve gastrectomy (SG) and very-low calorie diet (VLCD).Methods
Thirty-five Wistar rats were divided into control rats (n = 7) and obese rats fed a high-fat diet (HFD). After 10 weeks, the obese rats were subdivided into four groups: HFD (n = 7), VLCD (n = 7), and rats submitted to either a sham operation (n = 7) or SG (n = 7). Both liver tissue and blood samples were processed to evaluate steatosis and NASH changes in histology (Oil Red, Sirius Red and H&E); presence of endothelial damage (CD31, Moesin/p-Moesin, Akt/p-Akt, eNOS/p-eNOS), oxidative stress (iNOS) and fibrosis (αSMA, Col1, PDGF, VEGF) proteins in liver tissue; and inflammatory (IL6, IL10, MCP-1, IL17α, TNFα), liver biochemical function, and hormonal (leptin, ghrelin, visfatin and insulin) alterations in plasma.Results
Both VLCD and SG improved histology, but only SG induced a significant weight loss, improved endothelial damage, and a decreased cardiovascular risk by reducing insulin resistance (IR), leptin, total cholesterol, and triglyceride levels. There were no relevant variations in the inflammatory and fibrosis markers.Conclusion
Our study suggests a slight superiority of SG over VLCD by improving not only the histology but also the IR and cardiovascular risk markers related to NAFLD.6.
Background
Gastric fundus invagination (GFI) is a novel weight loss procedure. The gastric fundus is invaginated inside the gastric lumen and anastomosed to the gastric antrum. In gastric plication (GP), the greater curvature is plicated inside the gastric lumen leaving a narrow gastric channel for food passage. This study compares GFI to GP in a diet-induced obesity rat model.Methods
Twenty Long-Evans male rats were fed a 60 % high fat diet for 6 weeks. At 14 weeks of age, the rats underwent either GFI (N?=?10) or GP (N?=?10) surgery. Body weight and food intake were measured for 6 weeks. Serum adipokines and ghrelin hormone were assayed. Six weeks after surgery, all rats were euthanized and the stomachs examined. The two-sample t test was used to compare the results between the two groups.Results
All GFI rats had an intact fundus invagination at 6 weeks following surgery. The greater curvature plication unfurled in three out of ten GP rats. Part of the fundus herniated through the plication suture line in one GP rat. There was no significant difference between the mean percent weight change for the GFI (4.2?±?4.1 %) and GP (8.8?±?6.0 %) groups. There was no difference in food intake between both groups. GFI was associated with a significant lower fasting ghrelin levels (101.1?±?13.1 versus 137.3?±?27.4; p?=?0.044) compared with GP.Conclusions
GFI offers a more effective and more durable surgical alternative for weight loss than GP. 相似文献7.
Lifante JC Milone L Korner J Kopsombut G Sebastian M Inabnet WB 《Obesity surgery》2012,22(7):1110-1116
Background
Bariatric surgery improves glucose homeostasis, but the mechanism of action is poorly understood. The aim of this study was to assess the effect of sleeve gastrectomy (SG) on glucose homeostasis in two obese populations of rats.Methods
Two strains of rats [Zucker fatty (ZF) and Zucker diabetic fatty (ZDF)] were each divided into two groups: sham and SG. Food intake was measured daily, and weight was measured bi-weekly. Oral glucose tolerance testing (OGTT) was performed before and 45?days after surgery.Results
In both strains of rats, there was no statistical difference in food intake and weight gain between the sham and SG rodents before and after surgery. In ZF rats, there was no change in fasting glucose or OGTT area under the curve (AUC) before or 45?days after surgery. In the ZDF rodents, the mean preoperative fasting glucose and OGTT AUC was 204?±?25 and 25,441?±?2,648, respectively. At 45?days after surgery, mean fasting glucose significantly increased in the sham (sham?=?529?±?26, p?=?0.0003) but not in the SG rodents (SG?=?289?±?46, p?=?0.1113). In ZDF sham animals, OGTT at 45?days showed a higher AUC compared to before surgery (44,983?±?6,338, p?=?0.006), whereas in ZDF SG rodents, the increase in AUC glucose approached but did not reach statistical significance (35,553?±?3,925, p?=?0.06).Conclusions
In ZF and ZDF rodents, SG did not influence food intake and weight evolution. In ZDF rodents, diabetes progressed in the sham group but not in the SG group. 相似文献8.
Tiago Rafael Onzi Armando José d’Acampora Fabricio Miri de Araújo Ricardo Baratieri Gilberto Kremer Humberto Fenner Lyra Jr. Joyce Tarnowsky Leitão 《Obesity surgery》2014,24(3):371-376
Background
Sleeve gastrectomy (SG) produces excellent results in weight reduction and resolution of comorbidities. The histology of the gastric mucosa can be affected by the surgical procedure, with alterations of inflammatory patterns. The objective of this study is to evaluate alterations of the inflammatory patterns of the gastric mucosa in SG and the results in weight loss and resolution of comorbidities.Methods
Morbidly obese patients were selected to undergo SG. Endoscopies were performed pre-operatively and post-operatively after 6 months, with an incisura and 3 cm before the pylorus biopsies. Data on weight, height, and associated diseases were collected. The data were compared, and the biopsies evaluate the inflammatory patterns.Results
There was a reduction of body weight with a pre-operative weight of 132.5?±?15.7 kg and a post-operative weight of 95.8 ±10.6 kg with a p?<?0.001. Also, the body mass index (BMI) was reduced significantly with a mean pre-operative of 42.6?±?10.6 kg/m2 and a post-operative of 30.9?±?3.2 kg/m2 with a p?<?0.001. The comorbidities were all resolved or improved. The pattern of gastric histology showed chronic gastritis with inflammatory activity associated with Helicobacter pylori in 33.3 % of the patients, along with foveolar hyperplasia at 58.3 %. The chronic gastritis with discrete inflammatory activity was reduced by 16.7 %, and the foveolar hyperplasia was reduced by 33.3 %.Conclusion
The inflammatory alterations in the pre-operative period were mainly foveolar hyperplasia and chronic gastritis associated with H. pylori, and they were reduced in the post-operative period. A significant reduction of weight and BMI occurred, and a resolution of comorbidities was observed. 相似文献9.
Kaijing Wang Xiaogang Zhou Giang Quach Jiajun Lu Wei Gao Anan Xu Jiangfan Zhu 《Obesity surgery》2016,26(4):797-804
Background
Sleeve gastrectomy plus side-to-side jejunoileal anastomosis (JI-SG), a relatively new approach to bariatric surgeries, has shown promising results for treating obesity and metabolic comorbidities. This study investigated the feasibility and safety of JI-SG in weight loss and diabetes remission compared with sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB).Methods
Forty 10-week-old male Zucker diabetic fatty rats were randomly assigned to four groups: control, SG, JI-SG, and RYGB. Their body weights, food intake, and levels of gut hormones (ghrelin, insulin, and glucagon-like peptide-1 (GLP-1)) and lipids were measured.Results
Rats in the SG, JI-SG, and RYGB groups demonstrated lower food intake and more weight loss 2 weeks postoperatively compared with control rats. Furthermore, rats in the JI-SG group achieved more weight loss (mean 242.7?±?11.2 g) compared with those in the SG and RYGB groups (SG, 401.4?±?15.1 g and RYGB, 298?±?12 g, both P?<?0.01). All surgery groups demonstrated a decreased fasting insulin, serum glucose, lipid levels, and increased GLP-1 postoperatively. The JI-SG group had lower fasting ghrelin levels than the RYGB group (168?±?19.8 ng/L vs. 182?±?16.7 ng/L, P?<?0.01) and higher fasting GLP-1 levels than the SG group (1.99?±?0.11 pmol/L vs. 1.71?±?0.12 pmol/L, P?<?0.01) at 12 weeks postoperatively. Over the experimental period, the ghrelin levels slowly increased in all surgical groups but remained lower than the preoperative and control levels.Conclusions
JI-SG induced higher ghrelin and GLP-1 levels and improved glycemic control in Zucker diabetic fatty rats. Compared with SG and RYGB, JI-SG appeared to be a simple, relatively safe, and more effective procedure for treating type 2 diabetes and obesity in this animal model.10.
A. Perathoner A. Weißenbacher R. Sucher E. Laimer J. Pratschke R. Mittermair 《Obesity surgery》2013,23(12):1966-1972
Background
Bariatric surgery has been established as the best option of treatment for morbid obesity. Recently, laparoscopic sleeve gastrectomy (SG) has become very popular because of good postoperative weight loss and low morbidity. The aim of this study was to report our single-center experience with SG regarding feasibility, morbidity, and outcome.Methods
From January 2006 to December 2011, 93 patients (68 female) with a median age of 46 years underwent laparoscopic SG at our department. Thirteen patients had a history of gastric banding with insufficient weight loss or band-related complications. Clinical outcome and laboratory findings were analyzed.Results
The mean preoperative and postoperative body mass index (BMI) was 44.1?±?6.9 and 33.4?±?6.8 kg/m2, respectively (p?<?0.001). The mean excessive body weight loss after a median follow-up of 11.9 months was 55.7 %?±?24.9 %. Three bleedings, two staple line leakages, and a deep wound infection required conversion to laparotomy (n?=?1), reoperation (n?=?4), or endoscopic stent implantation (n?=?2). Resolution of diabetes and dyslipidemia was seen in 85 and 50 % of patients, respectively. Blood test results of HbA1c, cholesterols, triglycerides, and leptin showed significant postoperative improvement.Conclusions
Laparoscopic SG represents a feasible bariatric procedure with good short-term weight loss, low morbidity rate, and efficient resolution of diabetes and dyslipidemia, especially in patients with lower BMI. The significant decrease of leptin necessitates further studies to understand the ambiguous role of leptin in bariatric surgery. 相似文献11.
Bielohuby M Stemmer K Berger J Ramisch J Smith K Holland J Parks K Pfluger PT Habegger KM Tschöp MH Seeley RJ Bidlingmaier M 《Obesity surgery》2012,22(1):140-151
Background
Vertical sleeve gastrectomy (VSG) effectively reduces body weight (BW) in obese rats and humans. However, post-surgical weight regain is frequently observed in subjects after VSG, but the underlying reasons remain poorly understood. We therefore investigated if post-surgical consumption of different diets can affect the outcome of VSG.Methods
VSG or sham operation was performed in Long–Evans rats with diet-induced obesity (n?=?37). After post-surgical recovery, rats were fed ad libitum either with standard chow (CH), high-fat (HF) or low-carbohydrate, high-fat (LCHF) diets. BW and food intake were measured every second day; serum leptin, cholesterol, HDL cholesterol, and triglycerides were analyzed 4 weeks after surgery. Energy expenditure and locomotor activity were determined by a combined indirect calorimetry system, lean and fat mass by nuclear magnetic resonance.Results
After 4 weeks, BW gain, fat mass, and leptin were lower in VSG rats when compared to sham controls (p?0.05). Energy expenditure and locomotor activity were not affected by VSG indicating that weight reduction derives from the significantly lower cumulative 4-week energy intake in VSG compared to sham. Sham rats fed LCHF consumed the most energy, followed by rats fed HF. In contrast, after VSG cumulative energy intake was highest in rats fed HF, but not different between CH and LCHF. Consistently, post-surgical BW and fat mass regain were highest in the HF-VSG group. Lipid profiles were improved by VSG but not differentially affected by diets.Conclusion
In conclusion, consumption of a HF diet but not the more energy-dense LCHF diet reduced the effectiveness of VSG in rats. 相似文献12.
Marina Martín María A. Burrell Javier Gómez-Ambrosi Víctor Valentí álvaro Bueno Beatriz Ramírez Sara Becerril Andoni Lancha Pablo del Sol Calderón Leire Méndez-Giménez Victoria Catalán Amaia Rodríguez Secundino Fernández Miguel Mu?oz-Navas Javier A. Cienfuegos Gema Frühbeck 《Obesity surgery》2012,22(4):634-640
Background
Sleeve gastrectomy (SG) has been used as a multipurpose surgical procedure for the treatment of morbid obesity. The aim of the study was to analyze gastric morphology and histology at two different time points after SG in rats.Methods
Thirty-five male Wistar rats were fed ad libitum during 3?months on a high-fat diet to induce obesity. Subsequently, 25 diet-induced obese rats underwent either SG (n?=?12) or a sham operation (n?=?13). The remaining ten obese animals encompassed the nonoperated control group (Co). Four weeks postoperatively, 15 rats (n?=?5 rats/experimental group) were sacrificed, while the remaining 20 rats were sacrificed after 16?weeks (animals/group; Co?=?5, sham?=?8, SG?=?7) to compare the gastric morphological and histopathological changes over time. Body weight and food intake were regularly recorded.Results
For both time periods, the Co groups exhibited the highest body weight, while the rats undergoing the SG showed the lowest weight gain (P?0.05). Initially, significant differences (P?0.005) in food intake relative to body weight were observed between the Co rats and animals undergoing surgery, which disappeared thereafter. The actual total stomach size after both experimental periods in the SG group was similar to that of non- and sham-operated rats mainly due to a forestomach enlargement, which was more pronounced after 16?weeks. Traits of gastritis cystica profunda characterized by gastric foveolae elongation with hyperplasia and cystic dilatation of the glands were observed in the residual stomachs of the sleeve-gastrectomized rats. These findings were mostly observed after 16?weeks of performing the SG, although they were also detected occasionally following 4?weeks postoperatively. No intestinal metaplasia was observed.Conclusion
After SG gastric macro- and microscopic changes with functional implications in both the short and long term take place. 相似文献13.
Baseline Abdominal Lipid Partitioning Is Associated with the Metabolic Response to Bariatric Surgery
Andrei Keidar Liat Appelbaum Chaya Schweiger Karen Hershkop Idit Matot Naama Constantini Jacob Sosna Ram Weiss 《Obesity surgery》2014,24(10):1709-1716
Background
The purpose of this study was to compare the effects of two bariatric procedures on abdominal lipid partitioning and metabolic response.Methods
Fifty-one patients (RYGB 31(11 M/20 F); (SG) 20(8 M/12 F)) who met the criteria of metabolic syndrome before the operation were followed following Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). Visceral and subcutaneous abdominal fat depots were assessed by CT before, 6 months, and 12 months following the operation.Results
Patients undergoing both procedures did not differ in baseline body mass index (BMI) (42.84?±?4.65 vs. 41.70?±?4.68 kg/m2) or abdominal lipid depots. BMI at 12 months post-op was similar (29.44?±?3.35 vs 30.86?±?4.31 kg/m2 for RYGB and SG, respectively). Both procedures led to a significant reduction in visceral and subcutaneous fat at 6 months (p?0.001 for both). The visceral-to-subcutaneous fat ratio was comparable at 6 months vs. baseline yet was lower at 12 months vs. baseline for both procedures (p?0.01). In patients who lost the diagnosis of metabolic syndrome, baseline visceral/subcutaneous fat was the only predictor of recovery (p?0.005). No difference was detected between procedures in dynamics of abdominal fat depots or remission of cardiovascular risk factors.Conclusions
RYGB and SG induce a similar effect on abdominal fat mobilization. The metabolic effects in individual patients are mostly determined by their baseline abdominal lipid partitioning. 相似文献14.
Charles Sabbagh Pierre Verhaeghe Abdennaceur Dhahri Olivier Brehant David Fuks Rachid Badaoui Jean-Marc Regimbeau 《Obesity surgery》2010,20(6):679-684
Background
Sleeve gastrectomy (SG) is an alternative to gastric bypass and laparoscopic adjustable gastric banding (GB).Methods
From January 2004 to January 2006, 111 patients with a follow-up longer than 24 months were prospectively followed. Three treatment groups were defined. Sleeve gastrectomy as first procedure (SGFP; n?=?50), sleeve gastrectomy after failure of GB (SG after GB; n?=?9) and GB (n?=?52). We compared morbidity, mortality, length of stay, number of procedures under general anaesthesia, excess weight loss (EWL) and quality of life.Results
Mean initial body mass index (BMI) was 50.4 (SG), 50.8 (SG after GB) and 43.8 (GB; p?=?0.000001). Mean operating time was 97.1 min (SGFP), 122.2 min (SG after GB) and 69.8 min (GB; p?<?0.0001). The reoperation rate under general anaesthesia was 2% (SGFP), 11% (SG after GB) and 30.76% (GB; p?=?0.00001).The fistula rate was 2% (SGFP), 0% (SG after GB) and 0% (GB). BMI at 24 months was 33.8 (SGFP), 35.3 (SG after GB) and 33.2 (GB; NS). EWL at 24 months was 67.4 (SGFP), 60.3 (SG after GB) and 58.6 (GB; NS). In the SGFP group and in the SG after GB group, the mean quality-of-life score was 1.1. In the GB group, the mean score was 0.95 (NS).Conclusions
Initial BMI was significantly higher in the SG group but was no longer significantly different from the BMI of the GB group at 12 and 24 months. Excess BMI loss was higher after SG than after GB. This reduction of BMI was considered to be a success for GB. Thus, results of SG should be considered as a success. Quality of life was not significantly different between the three groups. These results validated SG as first procedure or after failure of GB. 相似文献15.
Suleiman Al-Sabah Fahad Alasfar Ghanim Al-Khaledi Reshma Dinesh Mervat Al-Saleh Habib Abul 《Obesity surgery》2014,24(1):95-101
Background
Currently, the most effective treatment for obesity is bariatric surgery. Gastroduodenal bypass surgery produces sustained weight loss and improves glycemic control and insulin sensitivity. Previous studies have shown that sleeve gastrectomy (SG) produces similar results and implicate changes in incretin hormone release in these effects.Methods
Male Sprague–Dawley rats were divided into four groups; lean control (lean), diet-induced obesity (DIO), DIO animals that had undergone SG (SG), and DIO animals that had undergone a sham operation (sham).Results
After a 2-week recovery period, the incretin response to a standard test meal was measured. Blood sampling was performed in free-moving rats at various time points using chronic vascular access to the right jugular vein. There was a significant increase in the bodyweight of DIO animals fed a high-fat/high-sugar diet compared with the lean animals, which was reversed by SG. DIO caused an impairment of the GLP-1 response to a standard test meal, but not the GIP response. SG resulted in a dramatic increase in the GLP-1 response to a standard test meal but had no effect on the GIP response.Conclusions
A rapid rise in blood sugar was observed in the SG group following a standard test meal that was followed by reactive hypoglycemia. SG dramatically increases the GLP-1 response to a standard test meal but has no effect on GIP in a rat model of DIO. 相似文献16.
Eivind Grong Bård Kulseng Ingerid Brænne Arbo Christoffer Nord Maria Eriksson Ulf Ahlgren Ronald Mårvik 《Surgical endoscopy》2016,30(2):532-542
Background
In type 2 diabetes mellitus, there is a progressive loss of beta-cell mass. Bariatric surgery has in recent investigations showed promising results in terms of diabetes remission, but little is established regarding the effect of surgery on the survival or regeneration of pancreatic beta-cells. In this study, we aim to explore how bariatric surgery with its subsequent hormonal alterations affects the islets of Langerhans.Methods
Twenty-four Goto-Kakizaki rats were operated with duodenojejunostomy (DJ), sleeve gastrectomy (SG) or sham operation. From the 38th week after surgery, body weight, fasting blood glucose, glycosylated hemoglobin, mixed meal tolerance with repeated measures of insulin, glucagon-like peptide 1, gastrin and total ghrelin were evaluated. Forty-six weeks after surgery, the animals were euthanized and the total beta-cell mass in all animals was examined by three-dimensional volume quantification by optical projection tomography based on the signal from insulin-specific antibody staining.Results
Body weight did not differ between groups (P g = 0.37). SG showed lower fasting blood glucose compared to DJ and sham (P g = 0.037); HbA1c levels in SG were lower compared to DJ only (p < 0.05). GLP-1 levels were elevated for DJ compared to SG and sham (P g = 0.001), whereas gastrin levels were higher in SG compared to the two other groups (P g = 0.002). Beta-cell mass was significantly greater in animals operated with SG compared to both DJ and sham (p = 0.036).Conclusion
Sleeve gastrectomy is superior to duodenojejunostomy and sham operation when comparing the preservation of beta-cell mass 46 weeks after surgery in Goto-Kakizaki rats. This could be related to both the increased gastrin levels and the long-term improvement in glycemic parameters observed after this procedure.17.
Mirko Otto Mohamad Elrefai Johannes Krammer Christel Weiß Peter Kienle Till Hasenberg 《Obesity surgery》2016,26(3):479-485
Background
Bariatric surgery is a safe and established treatment option of morbid obesity. Mere percentage of excess weight loss (%EWL) should not be the only goal of treatment.Methods
One hundred seventy-three obese patients were included in the study. They underwent either Roux-en-Y gastric bypass (RYGB; n?=?127, mean body mass index (BMI) 45.7?±?5.7 kg/m2) or sleeve gastrectomy (SG; n?=?46, mean BMI 55.9?±?7.8 kg/m2) for weight reduction. Body weight and body composition were assessed periodically by bioelectrical impedance analysis.Results
After 1 year of observation, %EWL was 62.9?±?18.0 % in RYGB and 52.3?±?15.0 % in SG (p?=?0.0024). Body fat was reduced in both procedures with a slight preference for SG, and lean body mass was better preserved in the RYGB group. Due to significant differences in the initial BMI between the two groups, an analysis of covariance was performed, which demonstrated no significant differences in the %EWL as well as in the other parameters of body composition 1 year after surgery. Using percentage of total weight loss to evaluate the outcomes between the two procedures, no significant difference was found (31.7?±?8.4 % in RYGB and 30.5?±?7.6 % in SG patients, p?>?0.4).Conclusions
Excess weight loss is highly influenced by the initial BMI. Total weight loss seems to be a better measurement tool abolishing initial weight differences. SG and RYGB do not differ in terms of body composition and weight loss 1 year after surgery.18.
El. Sdralis M. Argentou N. Mead I. Kehagias Th. Alexandridis F. Kalfarentzos 《Obesity surgery》2013,23(7):965-971
Background
Increased visceral adipose tissue is a risk factor for the metabolic complications associated with obesity and promotes a low-grade chronic inflammatory process. Resection of the great omentum in patients submitted to a bariatric procedure has been proposed for the amelioration of metabolic alterations and the maximization of weight loss. The aim of the present study was to investigate the impact of omentectomy performed in patients with morbid obesity undergoing sleeve gastrectomy (SG) on metabolic profile, adipokine secretion, inflammatory status, and weight loss.Methods
Thirty-one obese patients were randomized into two groups: SG alone or with omentectomy. Adiponectin, omentin, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP), blood lipids, fasting glucose, insulin, and insulin resistance were measured before surgery and at 7 days, and 1, 3 and 12 months after surgery.Results
During the 1-year follow-up, body mass index (BMI) decreased markedly and comparably in both groups (p?<?0.001). Insulin, IL-6, and hs-CRP levels decreased significantly compared to baseline (p?<?0.05) in both groups with no significant difference between groups. Adiponectin and high-density lipoprotein cholesterol levels were significantly and similarly increased compared to baseline (p?<?0.001) in both groups. Omentin levels increased significantly (p?<?0.05) in the control group and decreased in the omentectomy group 1 year postoperatively. There was no significant change in TNF-α levels in either group.Conclusions
The theoretical advantages of omentectomy in regard to weight loss and obesity-related abnormalities are not confirmed in this prospective study. Furthermore, omentectomy does not induce important changes in the inflammatory status in patients undergoing SG. 相似文献19.
Serum Vitamin D Increases with Weight Loss in Obese Subjects 6 Months After Roux-en-Y Gastric Bypass
Muriel Coupaye Marie Christine Breuil Pauline Rivière Benjamin Castel Catherine Bogard Thierry Dupré Simon Msika Séverine Ledoux 《Obesity surgery》2013,23(4):486-493
Background
Malabsorptive surgical procedures lead to deficiencies in fat-soluble vitamins. However, results concerning serum vitamin D (25OHD) after gastric bypass (GBP) are controversial. The aim of the study was to assess the influence of GBP on 25OHD and calcium metabolism.Methods
Parameters of calcium metabolism were evaluated in 202 obese subjects before and 6 months after GBP. Thirty of them were matched for age, gender, weight, skin color, and season with 30 subjects who underwent sleeve gastrectomy (SG). A multivitamin preparation that provides 200 to 500 IU vitamin D3 per day was systematically prescribed after surgery.Results
In the 202 patients after GBP, serum 25OHD significantly increased from 13.4?±?9.1 to 22.8?±?11.3 ng/ml (p?<?0.0001), whereas parathyroid hormone (PTH) did not change. Despite a decrease in calcium intake (p?<?0.0001) and urinary calcium/creatinine ratio (p?=?0.015), serum calcium increased after GBP (p?<?0.0001). Preoperatively, 91 % of patients had 25OHD insufficiency (<30 ng/ml), 80 % deficiency (<20 ng/ml), and 19 % secondary hyperparathyroidism (>65 pg/ml) vs. 76, 44, and 17 %, respectively, following GBP. Serum 25OHD was negatively correlated with BMI at 6 months after GBP (R?=??0.299, p?<?0.0001). In the two groups of 30 subjects, serum 25OHD and PTH did not differ at 6 months after GBP or SG.Conclusions
At 6 months after GBP, serum 25OHD significantly increased in subjects supplemented with multivitamins containing low doses of vitamin D. These data suggest that weight loss at 6 months after surgery has a greater influence on vitamin D status than malabsorption induced by GBP. 相似文献20.
Gastric Bypass and Sleeve Gastrectomy: the Same Impact on IL-6 and TNF-α. Prospective Clinical Trial
Elaine Cristina Viana Karine L. Araujo-Dasilio Gustavo Peixoto Soares Miguel Josefina Bressan Elenice Moreira Lemos Margareth Ribeiro Moyses Gláucia Rodrigues de Abreu João Luiz Moreira Coutinho de Azevedo Perseu Seixas Carvalho Maria Rita S. Passos-Bueno Flávia Imbroisi Valle Errera Nazaré Souza Bissoli 《Obesity surgery》2013,23(8):1252-1261