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1.
Bortolotto JW Margis R Ferreira AC Padoin AV Mottin CC Guaragna RM 《Obesity surgery》2007,17(7):934-940
2.
Bortolotto JW Reis C Ferreira A Costa S Mottin CC Souto AA Guaragna RM 《Obesity surgery》2005,15(9):1265-1270
Background: The purpose of this study was to determine the total content of trans fatty acids (TFA) in subcutaneous, retroperitoneal and visceral fat of morbidly obese and non-obese patients submitted to
bariatric surgery or plastic and abdominal surgery. Methods: The adipose tissues were obtained by surgery; lipids were extracted,
saponified and esterified. TFA were measured by FTIR-ATR spectroscopy. Results: The TFA average in obese patients was 6.3%
for retroperitoneal and 8.7% for visceral fat. For non-obese patients, the figures were 6.9% (subcutaneous) and 9.3% (visceral).
There was no difference between the groups. However, the TFA depot in visceral fat was higher than other fatty tissues for
morbidly obese (P<0.001) and non-obese (P<0.05) patients. Conclusions: Our values for TFA content in all adipose tissues analyzed are higher than reported in other
countries (3-6%). We showed more TFA in visceral adipose tissue than in other abdominal fat (subcutaneous and retroperitoneal)
stores. The visceral adipose tissue level is worrisome because the higher rate of lipolysis in this tissue appears to be an
important indicator of metabolic alterations and the levels of TFA found in adipose tissue presumably reflect the higher dietary
intake of TFA by Brazilians. 相似文献
3.
The FTO Obesity Gene. Genotyping and Gene Expression Analysis in Morbidly Obese Patients 总被引:1,自引:0,他引:1
Zabena C González-Sánchez JL Martínez-Larrad MT Torres-García A Alvarez-Fernández-Represa J Corbatón-Anchuelo A Pérez-Barba M Serrano-Ríos M 《Obesity surgery》2009,19(1):87-95
BACKGROUND: Obesity has emerged as one of the most serious public health concerns in the twenty-first century. the fat mass and obesity associated gene (FTO) has been found to contribute to the risk of obesity in humans. Our aims in this study were to investigate the association of rs9939609 single nucleotide polymorphism (SNP) of the FTO gene with different obesity-related parameters, to assess the FTO gene expression in subcutaneous and visceral adipose tissues from morbidly obese and its correlations with other adipocytokine gene expressions. METHODS: The association between the rs9939609 FTO gene variant and obesity related parameters in 75 obese/morbidly obese adult patients and 180 subjects with body mass index (BMI) < 30 kg/m(2) (control group) was examined. Gene expression analyses: subcutaneous adipose tissue samples were obtained from 52 morbidly obese and five subjects with BMI < 30 kg/m(2). Visceral adipose tissue was also obtained from 35 morbidly obese patients. Weight, height, BMI, SBP, DBP, fasting glucose, lipid profile, proinsulin, insulin, leptin, and adiponectin (RIA) of patients were also obtained. Insulin resistance by HOMA(IR). rs9939609 of FTO genotyping using allele discrimination in real-time PCR. Genomic study of RNA extraction of adipose tissue and real-time PCR (RT-PCR) of adipocytokines and a housekeeping gene were quantified using TaqMan probes. Relative quantification was calculated using the DeltaDelta Ct formula. RESULTS: The minor-(A) allele frequency of rs9939609 FTO gene in the whole population was 0.39. A strong association between this A allele and obesity was found, even after age-sex adjustment (p = 0.013). We found higher levels of FTO mRNA in subcutaneous adipose tissue from morbidly obese than in the control group (p = 0.021). FTO gene expression was lower in visceral than in subcutaneous adipose depot. However, this finding did not reach the level of statistical significance. A negative correlation between subcutaneous FTO gene expression and serum triglyceride levels and a positive correlation with leptin, perilipin, and visfatin gene expressions was found. In the visceral adipose tissue, these positive correlations were statistically significant only for perilipin. CONCLUSIONS: Our results show: (1) A strong association between rs9939609 SNP of the FTO gene variant and obesity in Spanish morbidly obese adult patients; (2) positive correlations between FTO mRNA and leptin, perilipin, and visfatin gene expressions in subcutaneous adipose tissue; (3) FTO and perilipin gene expressions were positively correlated in visceral fat depot. Overall these results may suggest a role of FTO in the regulation of lipolysis as well as in total body fat rather in fat distribution patterns. 相似文献
4.
5.
Antibiotic prophylaxis for surgery in morbidly obese patients 总被引:7,自引:0,他引:7
The rate of wound infections in morbidly obese patients who underwent gastroplasty surgery at our institution was 16.5% compared with a rate of 2.5% in normal-weight patients who underwent clean-contaminated surgery. Both groups received 1 gm of cefazolin intramuscularly before surgery was performed. We hypothesized that this regimen of prophylaxis did not provide adequate tissue levels in the morbidly obese. Morbidly obese patients who were undergoing gastroplasty were randomly selected to receive 1 gm cefazolin in the buttock fat, buttock muscle, or by intravenous injection. A fourth group of morbidly obese patients received 2 gm of cefazolin intravenously. Normal-weight patients who were undergoing upper abdominal surgery received 1 gm of cefazolin intravenously. At incision and closure, both blood and tissue levels of cefazolin were significantly (p less than 0.001) lower for all morbidly obese patients who received 1 gm cefazolin when compared with the blood and tissue levels of the drug found in normal-weight patients. The cefazolin levels obtained were below the minimal inhibitory concentrations of greater than 2 micrograms/ml for gram-positive cocci and of greater than 4 micrograms/ml for gram-negative rods. Only when the morbidly obese patient received 2 gm cefazolin were both the serum and adipose tissue levels adequate. For a 4-month period, all morbidly obese patients received 2 gm cefazolin prophylaxis, and the wound infection rate dropped to 5.6% compared with the previous rate of 16.5% (p less than 0.03). We conclude that antibiotic prophylaxis must be specially tailored to the needs of these obese patients. 相似文献
6.
7.
Süsleyici-Duman B Zengin K Kayhan FE Koldemir M Dağıstanlı FK Cağatay P Oztürk M Taşkın M 《Obesity surgery》2011,21(11):1766-1773
Background
Fat mass and obesity-associated protein (FTO) gene expression is known to correlate with obesity. Our aim was to investigate the FTO gene expression in paired omental and subcutaneous human adipose tissues from morbid and obese patients. To understand the role of CD68-positive macrophages in adipose tissues, the correlation with adiposity parameters such as adipocyte diameter and adipocyte radius was also measured. Drug and adiposity correlations were also analyzed.Methods
Paired omental and subcutaneous adipose tissue were excised during elective surgery from morbidly obese (n?=?9) and obese (n?=?5) patients. FTO expressions were determined by quantitative PCR. Tissue sections were analyzed for their CD68 protein expressions by immunuhistochemistry.Results
Omental and subcutaneous adipose tissue FTO gene expression levels were not found to differ significantly among morbidly obese and obese study groups. Serum aspartate aminotransferase e and alanine transaminase levels were found to be in negative correlation with subcutaneous fat tissue FTO expression rate. Antidiabetic drug use was found to be in correlation with adiposity. Both subcutaneous and omental fat cell diameters were found to have correlation with antidiabetic drug use. Omental fat cell diameter was found to enlarge together with omental CD68 protein expression. Subcutaneous macrophage number decreased while omental fat cell radius increased. Omental macrophage number was found in correlation with subcutaneous macrophage number.Conclusions
Antidiabetic therapy was found to increase adiposity in omental and subcutaneous fat. Further research is needed with larger samples to explore the exact role of FTO in obesity. 相似文献8.
Relationship among Adiponectin, Adiponectin Gene Expression and Fatty Acids Composition in Morbidly Obese Patients 总被引:1,自引:0,他引:1
Hernandez-Morante JJ Milagro FI Larque E Lujan J Martinez JA Zamora S Garaulet M 《Obesity surgery》2007,17(4):516-524
Background he aim of this study was to examine the relationship between adiponectin plasma circulating levels and its gene expression
in two abdominal fat depots (subcutaneous and visceral) with the fatty acid composition of plasma and adipose tissue in morbidly
obese subjects.
Methods 20 patients (10 women and 10 men) were selected. All were morbidly obese (BMI ≥40 kg/m2) and admitted for gastric surgery. Plasma samples and adipose tissue from both subcutaneous and visceral regions were obtained.
Plasma adiponectin and adipose adiponectin expression were analyzed.
Results Adiponectin mRNA expression in the subcutaneous tissue was significantly higher (P = 0.048) than in visceral tissue. Circulating adiponectin values, were positively associated with the proportion of n-3 polyunsaturated fatty acids in plasma (r = 0.62, P = 0.002). The visceral depot showed greater statistical associations between adiponectin gene expression and fatty acids
profile, being saturated fatty acids associated with a decrease (r = −0.68, P = 0.015), whereas monounsaturated were related to an increase in this adipose region (r = 0.67, P = 0.017).
Conclusions e demonstrated significant associations between adipose tissue adiponectin gene expression and fatty acid composition. These
associations were more evident in relation to the visceral depot, an adipose tissue region highly implicated in the metabolic
syndrome. 相似文献
9.
10.
H Corominola L J Conner L S Beavers R A Gadski D Johnson J F Caro R Rafaeloff-Phail 《Diabetes》2001,50(12):2822-2830
Obesity is associated with an increased risk for developing type 2 diabetes, insulin resistance, hypertension, dyslipidemia, cardiovascular disease, respiratory dysfunction, and certain forms of cancer. Insulin resistance in many type 2 diabetic patients is the result of increased visceral adiposity. To identify novel genes implicated in type 2 diabetes and/or obesity and to elucidate the molecular mechanisms underlying both diseases, we analyzed gene expression in omental fat from lean and obese nondiabetic subjects and obese type 2 diabetic patients using mRNA differential display and subtracted library techniques. After screening over 13,800 subtracted cDNA clones and 6,912 cDNA amplification products, we identified 2,078 cDNAs that showed potential differential expression in the omental fat of lean versus obese nondiabetic subjects versus obese type 2 diabetic patients. Data analysis showed that 70.7% of these clones corresponded to unknown genes (26.7% matched express sequence tags [ESTs]) and 29.3% corresponded to known genes. Reverse Northern and classic Northern analyses further confirmed that the expression of five of these cDNA clones was elevated in obese nondiabetic subjects and obese type 2 diabetic patients. Four candidate genes were further evaluated for tissue distribution, which showed expression primarily in adipose and skeletal muscle tissue, and chromosomal localization. We concluded that both mRNA differential display and subtracted cDNA libraries are powerful tools for identifying novel genes implicated in the pathogenesis of obesity and type 2 diabetes. 相似文献
11.
Adiponectin Expression and Adipose Tissue Lipolytic Activity in Lean and Obese Women 总被引:2,自引:0,他引:2
Background: The authors evaluated whether adipose adiponectin expression is related to adipose tissue lipolytic activity and
fatty acid oxidation rate in lean and obese women. Methods:The study consisted of 60 adult females distributed in a wide range
of adiposity (BMI 24.0-53.4 kg/m2 ). Body composition was estimated by bioelectrical impedance. Respiratory quotient was measured by open-circuit indirect
calorimetry. RT-PCR assays were performed to measure TNFα and adiponectin expression in subcutaneous adipose tissue biopsies.
Lipolysis studies were performed in fresh tissue samples obtained from subcutaneous abdominal depots during bariatric surgery
in 19 morbidly obese females or by an incisional biopsy or during abdominal elective surgery in normal weight and obese females.
Glycerol release was measured with a colorimetric endpoint method. Results: Patients with a higher degree of adiposity showed
lower adipose tissue adiponectin expression and hormone-sensitive lipase (HSL) activity than women in the low range of adiposity.
HSL activity was positively related to adiponectin expression. No relationship was observed between adiponectin and TNFα subcutaneous
adipose tissue expression. The positive relationship between respiratory quotient and adiponectin expression was in the limit
of statistical significance (P=0.05). Percentage of body fat and mRNA adiponectin explained 26% of the variance of the adipose tissue HSL activity. Conclusions:
Low adipose tissue adiponectin expression observed in obese people may contribute to the progression of obesity and its co-morbidities
by modulating hormone-sensitive lipase activity and fatty acid oxidation. 相似文献
12.
Kapoor A Nassir A Chew B Gillis A Luke P Whelan P 《Journal of endourology / Endourological Society》2004,18(7):657-660
BACKGROUND AND PURPOSE: Laparoscopic radical nephrectomy is rapidly becoming accepted as the preferred management of low-stage renal masses not amenable to partial nephrectomy. Minimally invasive surgery is advantageous to decrease perioperative and postoperative morbidity and allows patients to return to normal activities faster. Obesity has been a relative contraindication to this technique, and these patients have traditionally undergone open surgery. We present a review of 23 morbidly obese patients in comparison with patients who were not morbidly obese who underwent radical laparoscopic nephrectomy and nephroureterectomy at our institution. PATIENTS AND METHODS: Hospital charts between April 2001 and October 2003 were reviewed for morbidly obese patients undergoing transperitoneal laparoscopic renal surgery who were compared with age- and sex-matched control patients who underwent laparoscopic renal surgery in the same institution for similar indications. The data were collected at the time of the surgery. RESULTS: Twenty-three patients with a mean BMI of 42.2 kg/m2 underwent successful transperitoneal laparoscopic surgery. The mean specimen mass was 865 g, which was significantly larger than in the control group. The mean operative time was 200 minutes, which was around half an hour longer than in the matched group. The mean estimated blood loss was 243 mL, which was comparable to that of the controls. There were two perioperative complications, and the mean hospital stay was 4.5 days, 1 day longer than in the control group. CONCLUSIONS: Laparoscopic transperitoneal renal surgery is technically more difficult in morbidly obese patients but is a feasible, effective, minimally invasive method of removing renal malignancies. It offers decreased respiratory and cardiac morbidity in this higher-risk population. This study showed a complication profile similar to that in non-obese patients. 相似文献
13.
Gene expression profiles of nondiabetic and diabetic obese mice suggest a role of hepatic lipogenic capacity in diabetes susceptibility 总被引:5,自引:0,他引:5
Lan H Rabaglia ME Stoehr JP Nadler ST Schueler KL Zou F Yandell BS Attie AD 《Diabetes》2003,52(3):688-700
Obesity is a strong risk factor for the development of type 2 diabetes. We have previously reported that in adipose tissue of obese (ob/ob) mice, the expression of adipogenic genes is decreased. When made genetically obese, the BTBR mouse strain is diabetes susceptible and the C57BL/6J (B6) strain is diabetes resistant. We used DNA microarrays and RT-PCR to compare the gene expression in BTBR-ob/ob versus B6-ob/ob mice in adipose tissue, liver, skeletal muscle, and pancreatic islets. Our results show: 1) there is an increased expression of genes involved in inflammation in adipose tissue of diabetic mice; 2) lipogenic gene expression was lower in adipose tissue of diabetes-susceptible mice, and it continued to decrease with the development of diabetes, compared with diabetes-resistant obese mice; 3) hepatic expression of lipogenic enzymes was increased and the hepatic triglyceride content was greatly elevated in diabetes-resistant obese mice; 4) hepatic expression of gluconeogenic genes was suppressed at the prediabetic stage but not at the onset of diabetes; and 5) genes normally not expressed in skeletal muscle and pancreatic islets were expressed in these tissues in the diabetic mice. We propose that increased hepatic lipogenic capacity protects the B6-ob/ob mice from the development of type 2 diabetes. 相似文献
14.
Baranova A Gowder SJ Schlauch K Elariny H Collantes R Afendy A Ong JP Goodman Z Chandhoke V Younossi ZM 《Obesity surgery》2006,16(9):1118-1125
Background: Adipose tissue is an active endocrine organ that secretes a variety of metabolically important substances including
adipokines. These factors affect insulin sensitivity and may represent a link between obesity, insulin resistance, type 2
diabetes (DM), and nonalcoholic fatty liver disease (NAFLD). This study uses real-time polymerase chain reaction (PCR) quantification
of mRNAs encoding adiponectin, leptin, and resistin on snap-frozen samples of intra-abdominal adipose tissue of morbidly obese
patients undergoing bariatric surgery. Methods: Morbidly obese patients undergoing bariatric surgery were studied. Patients
were classified into two groups: Group A (with insulin resistance) (N=11; glucose 149.84 ± 40.56 mg/dL; serum insulin 8.28
± 3.52 μU/mL), and Group B (without insulin resistance) (N=10; glucose 102.2 ± 8.43 mg/dL; serum insulin 3.431 ± 1.162 μU/mL).
Results: Adiponectin mRNA in intra-abdominal adipose tissue and serum adiponectin levels were significantly lower in Group
A compared to Group B patients (P<0.016 and P<0.03, respectively). Although serum resistin was higher in Group A than in Group B patients (P<0.005), resistin gene expression was not different between the two groups. Finally, for leptin, neither serum level nor gene
expression was different between the two groups. Serum adiponectin level was the only predictor of nonalcoholic steatohepatitis
(NASH) in this study (P=0.024). Conclusions: Obese patients with insulin resistance have decreased serum adiponectin and increased serum resistin.
Additionally, adiponectin gene expression is also decreased in the adipose tissue of these patients. This low level of adiponectin
expression may predispose patients to the progressive form of NAFLD or NASH. 相似文献
15.
Ng VV Booth MI Stratford JJ Jones L Sohanpal J Dehn TC 《Annals of the Royal College of Surgeons of England》2007,89(7):696-702
INTRODUCTION
Obesity has long been regarded as a risk factor for the development of gastro-oesophageal reflux disease (GORD). It has been claimed that surgical efficacy of laparoscopic anti-reflux operations is decreased in obese patients. The aim of this study was to assess whether laparoscopic anti-reflux surgery is effective in obese patients with GORD compared to non-obese patients.PATIENT AND METHODS
A total of 366 patients (mean age 44 years; range, 12–86 years) underwent laparoscopic anti-reflux surgery between 1997–2003. Of these, 74 patients were considered obese; 58 patients had a body mass index (BMI) of 30–34 kg/m2 and 16 were classified as morbidly obese with a BMI ≥ 35 kg/m2. Pre-operative symptomatic scoring, indications for surgery, pH studies, operative times and complications were compared between obese and non-obese patients. Symptomatic outcome and Visick score between the two groups were assessed at 6 weeks, 6 months and 1 year following surgery.RESULTS
Failure of medical treatment was the main reason for surgery in all groups. Operative time was longer in obese patients (mean time 93 min compared to 81 min; P = 0.0007), the main difficulty being gaining access because of their body habitus. All groups found the procedure to be effective in symptomatic outcome, 91% of obese patients compared to 92% of non-obese patients scored Visick I or II at 6 weeks'' postoperatively. Similar Visick scoring was shown between the two groups at 6 months and 1 year, and in the morbidly obese group.CONCLUSIONS
The outcome of laparoscopic anti-reflux surgery is similar between obese and non-obese patients with no trend towards a worse outcome in the obese or morbidly obese. Obesity should not be seen as a contra-indication, although it may be more technically challenging in this group of patients. Good results can be achieved in obese patients. 相似文献16.
Comparison of IL-8, IL-6 and PGE2 Formation by Visceral (Omental) Adipose Tissue of Obese Caucasian Compared to African-American Women 总被引:1,自引:1,他引:0
Background: One of the key consequences of obesity is an enhanced release of cytokines such as IL-8 and IL-6 by adipose tissue.
There may be differences in adiposity, inflammatory markers, and medical co-morbidity between morbidly obese African-American
(AA) and Caucasian (CA) women. We hypothesized that there are ethnic differences in inflammatory markers and medical co-morbidities.
Methods: We compared the mRNA content in omental fat and the release of IL-8, IL-6 and PGE2 after a 4-hour incubation of explants of adipose tissue in women undergoing bariatric surgery. In addition, medical co-morbidities
and fat measurements were examined and compared. Results: Medication usage differed, with CA women being three times more
likely to report taking medication for depression compared to AA women (P≤0.001). IL-8 and PGE2 release over 4 hours by omental fat in vitro was the same in CA and AA women. Similar results were seen with respect to the COX-2 mRNA and IL-8 mRNA values at the start
and at the end of the incubation. In CA and AA women, the IL-6 mRNA content in fat immediately after removal from the patients
was the same. Conclusions: In morbidly obese women seeking bariatric surgery, there are little ethnic differences between
cytokine release by omental adipose tissue explants in vitro, or the mRNA content in omental adipose tissue of IL-6, IL-8 or COX-2. The only noted difference between AA and CA morbidly
obese women was the greater use of antidepressants by CA women. 相似文献
17.
Claire R. Edwards A. Katharine Hindle Patricia S. Latham Sidney W. Fu Fred J. Brody 《Surgical endoscopy》2013,27(4):1310-1314
Background
Morbidly obese patients are at risk for nonalcoholic steatohepatitis (NASH) even in the absence of risk factors for liver disease. Unfortunately, NASH is usually not clinically evident, and a definitive, noninvasive test for NASH does not exist. Resistin, a cytokine originating from adipose tissue, is involved in insulin resistance and also initiates proinflammatory signaling from hepatic stellate cells. This study explores the relationship between resistin expression and liver pathology in bariatric surgery patients.Methods
Blood samples from 30 patients undergoing bariatric surgery were collected. Total RNA was extracted and cDNA was synthesized. Quantitative RT-PCR was used to quantify relative gene expression using 18s rRNA gene as an internal control. Wedge liver biopsies from these patients were sectioned and stained. Based on a previously published scoring method, biopsies were assigned an overall NASH severity score and subscores for steatosis, inflammation, and fibrosis. Results were analyzed by using Student’s t test.Results
Resistin mRNA levels ranged from 0.5 to 9.7. A group of five patients with very high resistin expression (>4) was identified. These patients had a significantly higher average NASH score compared with the rest of the group (7.9 vs. 4.48, p = 0.019). Steatosis and inflammation scores were significantly higher in the high-resistin group (p < 0.05 for both comparisons). There also was a trend toward higher fibrosis score in this group, which approached statistical significance (p = 0.051).Conclusions
In morbidly obese patients, high resistin expression in serum is associated with hepatic steatosis, inflammation, and fibrosis. The development of elevated resistin expression may represent a link between obesity and the onset of steatohepatitis. 相似文献18.
The natriuretic peptide system in obesity-related hypertension: new pathophysiological aspects 总被引:1,自引:0,他引:1
The association between obesity and hypertension is well known but the pathophysiology of weight-related changes on blood pressure is still a matter of debate. Although obesity-related hypertension is considered to be sodium-sensitive, little attention has been given to a possible pathophysiological role of Atrial Natriuretic Peptides (ANP) and their receptors (NPr) system. Since the early phase of weight loss induced by very-low-calorie diet or fasting is followed by a significant increase in diuresis and natriuresis together with an increase in circulating ANP, we focused our attention on the possible role of adipose tissue in mediating these changes. We first demonstrated that human and rat adipose tissue contain high levels of mRNA specific for both type A (NPr-A), which is biologically active, and type C (NPr-C) which is biologically inactive, receptors. We then demonstrated in the rat that fasting exerts a tissue-specific and gene-specific suppression of NPr-C gene expression in adipose tissue that appears to be accompanied by an increased biological activity of ANP. These experimental observations were confirmed in man studying gene expression of NPr-A and NPr-C in adipose tissue obtained through subcutaneous peri-umbilical needle aspiration in obese and non-obese hypertensive patients. We found that NPr-A: NPr-C mRNA ratio was significantly lower in obese hypertensive patients as compared with non-obese hypertensives. These findings suggest that overxpression of the clearance receptor in the obese may trap more molecules of circulating ANP so reducing their biological activity at renal level. More recent results were obtained in obese hypertensive patients in whom the intravenous bolus injection of ANP (0.6 mg/kg body weight) was performed before and after four days of very-low-calorie diet which induced a weight loss accompanied by a significant reduction of BP and an increase in the urinary excretion of cGMP. The infusion of ANP after low-calorie diet was followed by an increase of ANP levels similar to that observed before diet, but plasma cGMP, diuresis and natriuresis significantly increased only after caloric restriction and the effects of ANP infusion on BP were more pronounced. Taken together our studies suggest that the abundance of NPr-C in adipose tissue may play a significant role in explaining at least part of the sodium retention characteristic of obesity associated hypertension. 相似文献
19.
X. Julia Xu Caroline Apovian Donald Hess Brian Carmine Asish Saha Neil Ruderman 《Diabetes》2015,64(9):3155-3159
Morbidly obese individuals are predisposed to a wide range of disorders, including type 2 diabetes, atherosclerotic cardiovascular disease, fatty liver disease, and certain cancers. Remarkably, all of these disorders can be improved or prevented by Roux-en-Y gastric bypass (RYGB) surgery. We have reported that decreased AMPK activity, together with increased oxidative stress and inflammation in adipose tissue, is associated with insulin resistance in morbidly obese bariatric surgery patients. In the current study, we assessed how these parameters are affected by RYGB surgery. Eleven patients (average age of 46 ± 4 years) were studied immediately prior to surgery and 3 months postoperatively. We measured subcutaneous adipose tissue AMPK phosphorylation (threonine 172, an index of its activation), malonyl-CoA content, protein carbonylation (a marker of oxidative stress), plasma adiponectin, and mRNA expression of several inflammatory cytokines. After surgery, AMPK activity increased 3.5-fold and oxidative stress decreased by 50% in subcutaneous adipose tissue. In addition, malonyl-CoA levels were reduced by 80%. Furthermore, patients had improvements in their BMI and insulin sensitivity (HOMA) and had increased circulating high–molecular weight adiponectin and decreased fasting plasma insulin levels. In contrast, the expression of inflammatory markers in subcutaneous adipose tissue was unchanged postoperatively, although plasma CRP was diminished by 50%. 相似文献
20.
Outcome Following Bariatric Surgery in Super versus Morbidly Obese Patients: Does Weight Matter? 总被引:4,自引:2,他引:2
Mark Bloomston MD Emmanuel E Zervos MD Mario A Camps MD Sarah E Goode RN Alexander S Rosemurgy MD 《Obesity surgery》1997,7(5):414-419
Background: Numerous investigators have attempted to identify prognostic indicators for successful outcome following bariatric
surgery. The purpose of this study was to determine whether degree of obesity affects outcome in super obese [>225% ideal
body weight (IBW)] versus morbidly obese patients (160-225% IBW) undergoing gastric restrictive/bypass procedures. Methods:
Since 1984, 157 patients underwent either gastric bypass or vertical banded gastroplasty. Super obese (78) and morbidly obese
(79) patients were followed prospectively, documenting outcome and complications. Results: Super obese patients reached maximum
weight loss 3 years following bariatric surgery, exhibiting a decrease in body mass index (BMI) from 61 to 39 kg/m2 and an average loss of 42% excess body weight (EBW). Morbidly obese patients had a decrease in BMI from 44 to 31 kg/m2 and carried 39% EBW at 1 year. After their respective nadirs, each group began to regain the lost weight with the super obese
exhibiting a current BMI of 45 kg/m2 (61% EBW) versus 34 kg/m2 (52% EBW) in the morbidly obese at 72 months cumulative follow-up. Currently, loss of 50% or more of EBW occurred in 53%
of super obese patients versus 72% of morbidly obese (P < 0.01). Twenty-six percent of super obese patients returned to within 50% of ideal body weight (IBW) while 71% of morbidly
obese were able to reach this goal (P < 0.01). Co-morbidities and complications related to surgery were similar in each group. Conclusions: Super obese patients
have a greater absolute weight loss after bariatric surgery than do morbidly obese patients. Using commonly utilized measures
of success based on weight, morbidly obese patients tend to have better outcomes following bariatric surgery. 相似文献