Different Types Of Bariatric Surgery Research Articles

Effect of bariatric surgery on metabolism in diabetes and obesity comorbidity: Insight from recent research

Obesity is a prevalent cause of diabetes mellitus (DM) and is a serious danger to human health. Type 2 DM (T2DM) mostly occurs along with obesity. Foodborne obesity-induced DM is caused by an excessive long-term diet and surplus energy. Bariatric surgery can improve the symptoms of T2DM in some obese patients. But different types of bariatric surgery may have different effects. There are some models built by researchers to discuss the surgical procedures’ effects on metabolism in diabetes animal models and diabetes patients. It is high time to conclude all this effects and recommend procedures that can better improve metabolism.

Early and late complications arising from various bariatric surgical procedures in a tertiary center in Saudi Arabia

Background Individuals who are obese or morbidly obese face a significantly higher risk of experiencing postoperative complications. To evaluate high-risk patients undergoing bariatric surgery and mitigate the likelihood of further postoperative complications, various indicators are utilized. There are no prior reports about bariatric surgical procedures-related early/late complications that came out from the western region of Saudi Arabia. Aim This retrospective study aims to evaluate both short-term and long-term postoperative complications after several bariatric surgeries, including sleeve gastrectomy, Roux-en-Y gastric bypass, and revisional bariatric surgery. Patients and methods The assessment of complications in 328 patients who underwent bariatric surgery involved analyzing demographic data, medical and surgical history, preoperative and postoperative BMI, histopathologic findings, and early and late complications. These data were obtained from a prospectively maintained database. Results Of the total participants, 241 underwent sleeve gastrectomy, 43 underwent gastric bypass, and 44 had revisional bariatric surgery. Complication rates varied among the different bariatric surgeries. Specifically, SG patients had the lowest early major complication rate (2.1%), while gastric bypass patients had a rate of 4.7%. Conversely, the ‘revisional’ operations reported the highest rate of early complications at 9.1%. Late complications demonstrated varying rates, with sleeve gastrectomy patients experiencing the highest incidence of gastroesophageal reflux disease at 39%, and gastric bypass patients showing the highest rate of nutritional deficiency at 58%. Conclusion The study found that the baseline characteristics of patients did not exert a statistically significant influence on the occurrence of postoperative complications. However, different types of bariatric surgeries presented varying complication rates. Patients who underwent gastric bypass tended to have the highest rate of nutritional deficiency, while sleeve gastrectomy patients exhibited the highest rate of gastroesophageal reflux disease. Selecting the appropriate bariatric surgical procedure warrants careful consideration of patients’ preferences, demographic characteristics, presence of other medical conditions, and a comprehensive understanding of the potential advantages and disadvantages of each surgical option. Collectively, our findings would help discussing the expected outcome with the patients before surgery.

UPDATE ON MICRONUTRIENTS IN BARIATRIC SURGERY: A COMPREHENSIVE SYSTEMATIC REVIEW

Background: Obesity is a major problem in the world and bariatric surgery is an effective solution for weight loss and resolving related health issues. There are three different types of bariatric surgeries. However, nutritional imbalances are a common issue after these procedures. Therefore, individuals who opt for bariatric surgery require continuous monitoring of their micronutrient levels and ongoing supplementation. This study aims to serve as a comprehensive systematic review of updates on micronutrients in bariatric surgery in the literature of the last 10 years. Methods: This review adhered to the PRISMA 2020 guidelines and analyzed English literature published between 2014 and 2024, inclusive of full-text articles. Articles such as editorials, review papers from the same journal, and those without a DOI were not included in the review. The literature was obtained from various online platforms, including PubMed, SagePub, and Science Direct. Result: Our team of researchers initially collected 3165 articles from credible sources that included PubMed, SagePub, and Science Direct. Following a rigorous three-level screening process, only six articles were found to be directly relevant to our ongoing systematic review and were then selected for further analysis through thorough full-text reading. Conclusion: Bariatric surgery, especially RYGB, can cause micronutrient deficiencies. Vitamin deficiencies (A, D) are common and iron deficiency anemia is prevalent. Zinc, copper, and selenium deficiencies can also occur. Regular supplement intake is crucial to maintain optimal micronutrient levels.

Analysis of the efficacy of sleeve gastrectomy, one-anastomosis gastric bypass, and single-anastomosis sleeve ileal bypass in the treatment of metabolic syndrome

The objective of this study was to evaluate and compare the effectiveness of three different types of bariatric surgeries, namely, sleeve gastrectomy (SG), one-anastomotic gastric bypass (OAGB), and single anastomosis sleeve ileal (SASI) bypass, in the treatment of metabolic syndrome (MS). The optimal approach for managing MS remains uncertain, and thus this study aimed to provide a recent analysis of the efficacy of these surgical procedures. This retrospective study evaluated data of individuals who underwent SG, OAGB, and SASI bypass. The primary outcome measures included weight, body mass index (BMI), glucolipid metabolic index, and the occurrence of treatment-related complications within 6 to 12 months post-surgery. A total of 324 patients were included in this study. Of these, 264 patients underwent SG, 30 underwent OAGB, and 30 underwent SASI bypass. A significant decrease in weight was observed at the 6-month and 12-month marks following all three surgical procedures. Of these, patients who underwent SASI bypass exhibited the greatest reduction in weight and BMI post-surgery. Furthermore, the SASI bypass was associated with a significantly higher percentage of total weight loss (%TWL) and excess body mass index loss (%EBMIL) compared to SG and OAGB. Patients who underwent OAGB and SASI bypass demonstrated notable improvements in type 2 diabetes mellitus (T2DM). Patients who underwent SASI bypass and OAGB experienced greater postoperative comfort and reported fewer complaints of discomfort compared to the other procedure. Based on the retrospective analysis of the data, SASI bypass was associated with greater reductions in weight and BMI, higher percentages of %TWL and %EBMIL, and better improvement in T2DM compared to SG and OAGB. Therefore, both SASI bypass and OAGB were found to be more effective than SG in the treatment of MS.

Significance of Hormone Alteration Following Bariatric Surgery.

The prevalence of obesity has increased significantly over the last several decades, and with its increase comes a wide variety of comorbidities, such as diabetes and cardiovascular disease. Traditionally, diet and exercise have been prescribed for individuals to try and regain control of their weight and health status. Despite this successful method, the compliance rate is significantly below the desired amount. Over the last few decades, a new treatment has been offered to significantly decrease an individual's weight to an optimal BMI between 18 and 25 kg/m2. Bariatric surgery has been proposed to be the most appropriate treatment for obesity, and there are several different types of bariatric surgery: Roux-en-Y gastric bypass (RYGB), biliopancreatic diversion with duodenal switch (BPD-DS), adjustable gastric band (AGB), and sleeve gastrectomy (SG). Hormones may be significantly involved in losing and maintaining weight loss. This paper aims to evaluate hormone changes in appetite suppression, appetite activation, glycemic control, and lipid metabolism and how these impact overall weight loss concerning the most prominent surgeries. The hormones assessed were ghrelin, insulin, leptin, GLP-1, PYY, and adiponectin, and their levels before and after each surgery were compared. RYGB is one of the most successful types of bariatric surgeries, and this correlates with it having the most suppressed levels of ghrelin, insulin, and leptin following surgery with a slow return to normal. RYGB has also led to the most significant increased levels of PYY, pre- and post-prandial GLP-1, and adiponectin. Hormones following SG followed the hormone trend after RYGB but were not as prominent. BDP-DS has the highest success rate. However, numerous adverse effects have limited the amount of studies assessing the surgery. What was present was not as significant as RYGB, possibly due to manipulation.

Impact of Bariatric Surgery on Patients' Satisfaction and Quality of Life: A Narrative Review

Context: Obesity is a significant health issue that has been considered an epidemic in the world during the last 20 years and has persistently increased over time. The World Health Organization recently reported that the worldwide prevalence of overweight among adults was more than 1.9 billion, and approximately 650 million adults were obese. Bariatric surgery remains the most successful and effective long-term option for treating morbid obesity and obesity-related co-morbidities due to the significant outcomes in long-term weight loss, resolution of obesity-related co-morbidities, reduction of cardiovascular complications, and the causes of obesity-related mortality.
 Aim: This review sought to provide a comprehensive and critical summary of existing literature on the impact of bariatric surgery on patients’ satisfaction and quality of life.
 Methods: A systematic search was undertaken between 2018 and 2022 with specific inclusion criteria. Search terms were determined to select the best relevant studies using a wide search in different databases, including PubMed, Medline, EBSCO, EBMR, and ERIC. The review used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to identify the literature used in this review. The review identified fifty studies that met the eligibility criteria and were involved in this review.
 Results: The result indicates that quality of life was improved in most of the studies after the different types of bariatric surgeries. Also, the satisfaction level was high in most of the retrieved studies. Besides, all co-morbidities associated with obesity were reduced significantly.
 Conclusion: The findings demonstrate that each surgical procedure has negative and positive outcomes. The finding also recognized the impact of bariatric surgery in improving the patients' satisfaction, enhancing their quality of life, and remission of obesity-related co-morbidity diseases. Bariatric surgery is strongly suggested in the treatment of morbidly obese patients.

Nutritional Implications of Bariatric Surgery on Pregnancy Management-A Narrative Review of the Literature.

One in three women of reproductive age is obese. The mainstay treatment for obesity is bariatric surgery, and the following weight reduction results in a decrease in pregnancy adverse effects, including gestational diabetes mellitus, pregnancy-induced hypertension, and macrosomia. However, nutritional and vitamin deficiencies due to changes in the gastrointestinal tract after bariatric surgery are associated with an increase in the risk of fetal growth retardation and small for gestational-age neonates. The purpose of this review was to analyze the available recent literature on the subject of the management of pregnancy after bariatric surgery. We searched for available articles from 2007 to 2023 and chose articles of the greatest scientific and clinical value. Micronutrient, vitamin, and protein supplementation is recommended in the prenatal period and throughout the pregnancy. It is advised that pregnant women with a history of bariatric surgery should be provided with regular specialist dietary care. There is still a lack of recommendations about the optimum gestational weight gain after different types of bariatric surgery and for patients of different metabolic statuses. Women of reproductive age undergoing bariatric procedures should be provided with appropriate counseling about adequate contraception, the recommended time-to-conception interval, and the positive and negative influence of bariatric surgery on perinatal outcomes.

Impact of bariatric surgery on glucose and lipid metabolism and liver and kidney function in food-induced obese diabetic rats.

Obesity usually causes diabetes mellitus (DM) and is a serious danger to human health. Type 2 DM (T2DM) mostly occurs along with obesity. Foodborne obesity-induced DM is caused by an excessive long-term diet and surplus energy. Bariatric surgery can improve the symptoms of T2DM in some obese patients. But different types of bariatric surgery may have different effects. To investigate the effect of bariatric surgery on glucose and lipid metabolism and liver and kidney function in rats. Male Sprague-Dawley rats aged 6-8 wk underwent Roux-en-Y gastric bypass surgery (RYGB), sleeve gastrectomy (SG), or gastric banding (GB). Glucose and insulin tolerance tests, analyses of biochemical parameters, histological examination, western blot, and quantitative real-time polymerase chain reaction were conducted. In comparison to the sham operation group, the RYGB, SG, and GB groups had decreased body weight and food intake, reduced glucose intolerance and insulin insensitivity, downregulated biochemical parameters, alleviated morphological changes in the liver and kidneys, and decreased levels of protein kinase C β/ P66shc. The effect in the RYGB group was better than that in the SG and GB groups. These results suggest that RYGB, SG and GB may be helpful for the treatment of foodborne obesity-induced DM.

The Incidence of Cholelithiasis After Bariatric Surgery in Saudi Arabia and Its Associated Risk Factors.

Saudi Arabia has one of the highest obesity rates (35.4%) in the world, and bariatric surgery (BS) has emerged as the most effective treatment for obesity and its comorbidities. Despite its effectiveness, it is a known risk factor for cholelithiasis. The aim of this study is to identify the incidence and risk factors that contribute to the development of symptomatic cholelithiasis after different types of bariatric surgery in Saudi Arabia. This is a cross-sectional study conducted among the Saudi adult population. The sample size was 706 participants who underwent bariatric surgery from all over Saudi Arabia. Data collection was done through a validated online self-reported survey. Out of 706 participants who fulfilled the inclusion criteria, it was found that the incidence of gallstones (GS) after bariatric surgery was 18.8%. The most incidence was during the first year of surgery, where the number of individuals reached 80.4%. The majority were in females (22.9%) and those who underwent Roux-en-Y gastric bypass (RYGB) surgery (51.2%). Patients who had a body mass index (BMI) of >25kg/m² significantly had a higher incidence ofgallstones (23.1%) compared to those who had a lesser BMI (15.8%). As the analysis showed, the medicationused to prevent the occurrence of gallstones can be considered one of the protective factors, where 85.4% of individuals who used these medications did not develop cholelithiasis. The incidence of gallstones after bariatric surgery was high, particularly within the first year of surgery. The increase in postoperative gallstone formation is correlated with hyperlipidemia and Roux-en-Y gastric bypass as basic predictive factors. On the contrary, the medication used to prevent the occurrence of gallstones is considered a protective factor.

Metabolic bariatric surgery and combined multilevel surgery as a treatment for obstructive sleep apnea patient with obesity


 
 
 Body mass index (BMI) and the degree of obstructive sleep apnea (OSA) are strongly correlated. Managing obesity is an important strategy for preventing and treating OSA. Bariatric surgery can lead to significant weight loss and improvements in metabolic function, which can have beneficial effects on OSA symptoms within obese population. There is a relative lack of data directly comparing the different types of bariatric surgery and multilevel upper airway surgery for the treatment of obstructive sleep apnea (OSA). While there is some evidence to suggest that bariatric surgery can improve OSA symptoms in obese individuals, and multilevel upper airway surgery can improve OSA symptoms in some cases of anatomical obstruction, there is limited research directly comparing these treatment options. Therefore, this review provides an update on the relationship between OSA, MBS and MLS for demonstrating the significance of multidisciplinary surgery approach for obese patients with OSA.
 
 

Predicting serious complication risks after bariatric surgery: external validation of the Michigan Bariatric Surgery Collaborative risk prediction model using the Dutch Audit for Treatment of Obesity.

Risk-prediction tools can support doctor-patient (shared) decision making in clinical practice by providing information on complication risks for different types of bariatric surgery. However, external validation is imperative to ensure the generalizability of predictions in a new patient population. To perform an external validation of the risk-prediction model for serious complications from the Michigan Bariatric Surgery Collaborative (MBSC) for Dutch bariatric patients using the nationwide Dutch Audit for Treatment of Obesity (DATO). Population-based study, including all 18 hospitals performing bariatric surgery in the Netherlands. All patients registered in the DATO undergoing bariatric surgery between 2015 and 2020 were included as the validation cohort. Serious complications included, among others, abdominal abscess, bowel obstruction, leak, and bleeding. Three risk-prediction models were validated: (1) the original MBSC model from 2011, (2) the original MBSC model including the same variables but updated to more recent patients (2015-2020), and (3) the current MBSC model. The following predictors from the MBSC model were available in the DATO: age, sex, procedure type, cardiovascular disease, and pulmonary disease. Model performance was determined using the area under the curve (AUC) to assess discrimination (i.e., the ability to distinguish patients with events from those without events) and a graphical plot to assess calibration (i.e., whether the predicted absolute risk for patients was similar to the observed prevalence of the outcome). The DATO validation cohort included 51,291 patients. Overall, 986 patients (1.92%) experienced serious complications. The original MBSC model, which was extended with the predictors "GERD (yes/no)," "OSAS (yes/no)," "hypertension (yes/no)," and "renal disease (yes/no)," showed the best validation results. This model had a good calibration and an AUC of .602 compared with an AUC of .65 and moderate to good calibration in the Michigan model. The DATO prediction model has good calibration but moderate discrimination. To be used in clinical practice, good calibration is essential to accurately predict individual risks in a real-world setting. Therefore, this model could provide valuable information for bariatric surgeons as part of shared decision making in daily practice.

Comparing bariatric surgery and medical therapy for obese adolescents with type 2 diabetes

BackgroundMounting evidence in recent years has demonstrated that the number of obese adolescents has continued to rise. Obese adolescents are more likely to be diagnosed with type 2 diabetes, which causes additional harm. This study aimed to compare the clinical outcomes of bariatric surgery and medical treatment. MethodsWe conducted a multicenter, nonrandomized, retrospective study on 202 obese adolescents with type 2 diabetes who received surgery or medical treatment in three hospitals from 2017 to 2019. We analyzed the effects of surgery and medical treatment in terms of weight loss, glycemic control and the remission of type 2 diabetes. Propensity score matching was conducted to balance the confounding factors. ResultsAmong the 202 adolescents, 109 adolescents underwent surgery, and the remaining 93 adolescents received nonsurgical treatment. Both in the entire cohort and in the propensity-score matching cohort, the mean body mass index (BMI) and total weight in the surgery group notably decreased. Similarly, the effect of surgery on glycemic control (with respect to HBG, HbA1c, HOMA-IR) was superior to that of medical treatment. In the surgery group, the remission rate of diabetes was 76.1% in the entire cohort and 80.5% in the matched group, which was significantly higher than that in the control group (6.5% and 5.7%, respectively). In addition, LRYGB had better effects on weight loss and glycemic control than LSG. ConclusionBariatric surgery is more effective in the control of weight loss and type 2 diabetes than medical treatment. The effects between different types of bariatric surgeries remain to be further investigated, and longer follow-up times are needed.

Bariatric surgery in the management of childhood and adolescence obesity.

Nowadays, childhood obesity is literally a global pandemic health problem. According to current data, pediatric obesity is strongly associated with adult excess weight status as well as the development of certain co morbidities, already present in childhood, including cardiovascular disorders (dyslipidemia, hypertension), endocrine/metabolic (Type 2 diabetes, fatty liver disease, metabolic syndrome), respiratory, gastrointestinal, and musculoskeletal problems. Additionally, children with obesity frequently experience psychosocial issues, such as mood disorders, anxiety, prejudice and low self-esteem. The aim of this article was to evaluate whether or not bariatric surgery is an effective and safe treatment option for childhood obesity. This paper is based on a literature search in Pub Med for articles referring to the medical co morbidities and the results of different types of bariatric surgery for the treatment of childhood obesity (up to 18 years) until December 2021. The following keywords were used as MESH terms: childhood obesity, adolescence obesity, co morbidities and bariatric surgery. The bibliographic references of the studies found in these databases were also reviewed. Although some researchers demonstrate that surgical interventions in adolescents might be a reliable intervention to lose weight in a maintainable way and reverse many of the co morbidities associated with severe obesity, their safety and long-term efficacy are still not clarified. Thus, large long-term prospective studies, with detailed recording of complications and co morbidity resolution are obviously needed in order to determine the role of surgical treatment in childhood obesity.

Molecular remodeling of adipose tissue is associated with metabolic recovery after weight loss surgery

BackgroundBariatric surgery is an effective therapy for individuals with severe obesity to achieve sustainable weight loss and to reduce comorbidities. Examining the molecular signature of subcutaneous adipose tissue (SAT) following different types of bariatric surgery may help in gaining further insight into their distinct metabolic impact.ResultsSubjects undergoing biliopancreatic diversion with duodenal switch (BPD-DS) showed a significantly higher percentage of total weight loss than those undergoing gastric bypass or sleeve gastrectomy (RYGB + SG) (41.7 ± 4.6 vs 28.2 ± 6.8%; p = 0.00005). Individuals losing more weight were also significantly more prone to achieve both type 2 diabetes and dyslipidemia remission (OR = 0.75; 95%CI = 0.51–0.91; p = 0.03). Whole transcriptome and methylome profiling showed that bariatric surgery induced a profound molecular remodeling of SAT at 12 months postoperative, mainly through gene down-regulation and hypermethylation. The extent of changes observed was greater following BPD-DS, with 61.1% and 49.8% of up- and down-regulated genes, as well as 85.7% and 70.4% of hyper- and hypomethylated genes being exclusive to this procedure, and mostly associated with a marked decrease of immune and inflammatory responses. Weight loss was strongly associated with genes being simultaneously differentially expressed and methylated in BPD-DS, with the strongest association being observed for GPD1L (r2 = 0.83; p = 1.4 × 10–6).ConclusionsPresent findings point to the greater SAT molecular remodeling following BPD-DS as potentially linked with higher metabolic remission rates. These results will contribute to a better understanding of the metabolic pathways involved in the response to bariatric surgery and will eventually lead to the development of gene targets for the treatment of obesity.Trial registration ClinicalTrials.gov NCT02390973.

The Effect of Different Types of Bariatric Surgery on Levothyroxine Requirement in Hypothyroid Bariatric Patients.

BackgroundBariatric surgeries are carried out to improve a patient's quality of life, and to reduce respiratory, cardiac, endocrine, and metabolic complications encountered by those with high body mass index (BMI). A complication associated with high hypothyroidism is weight gain, which may lead to obesity. Here, we explore the effect of different bariatric procedures on thyroid function and levothyroxine dosage. MethodsThis is a retrospective review of 887 patients referred to a tertiary bariatric service between 2008 and 2020 and treated for hypothyroidism at the time of referral.The study identified 57 patients on thyroxine replacement. Of these, 22 underwent restrictive bariatric procedures, 16 underwent restrictive/malabsorptive procedures, and 19 did not undergo operative intervention.Comparisons were made among each group throughout the timeline of interest.ResultsOut of 57 patients, 50 (87.7%) were female. The average age for patients was 47.26+/- 8.89 years. The average BMI at baseline was 48.72+/- 8.68 kg/m2. The mean dose of levothyroxine in controls was 115.8+/- 53.5 mcg while that of surgical patients was 149.8+/- 68.4 mcg.There were no statistically significant differences in levothyroxine doses between surgical and control at T0 (baseline), T1 (one-year post-op in surgical patient, or two-year post referral in control patient), T2 (two-year post-op in surgical patient, or three-year post referral in control patient), and T3 (most recent result available). The surgical group was then categorized further into restrictive and restrictive/malabsorptive. When they were compared with the control group, there were no statistically significant differences in doses.A generalized linear mixed model was applied to assess differences in levothyroxine dose with time as a random variable. This was adjusted for age, sex, BMI, T4 level, and hypothyroid cause. Through this assessment, there were several statistically significant differences in levothyroxine dosage between the groups. Control group required on average 28.06 mcg less levothyroxine than the restrictive/malabsorptive group (p=0.015). Also, the restrictive group required on average 23.57 mcg less levothyroxine than the restrictive/malabsorptive group (p=0.033). There were no statistically significant differences observed between the control group and the restrictive group (p=0.67)ConclusionPatients who have bariatric surgery have changes to their anatomy and physiology which may affect both their thyroid hormone homeostasis and levothyroxine pharmacokinetics. Thus, hypothyroid bariatric patients requiring levothyroxine must have their thyroid function monitored regularly. In this study, it was found that hypothyroid patients who underwent restrictive surgery had an overall statistically significant lower levothyroxine requirement to remain euthyroid as compared to the restrictive/malabsorptive group (p=0.033). Additionally, the control group required statistically significantly less levothyroxine than the restrictive/malabsorptive group (p=0.015). These factors may determine the type of surgery chosen by hypothyroid bariatric patients. However, further studies that are randomized, controlled, and multi-center with a higher population are required.

Body composition changes following different types of bariatric surgery: Interpreting discordant findings from different methodological approaches

Body composition changes following different types of bariatric surgery: Interpreting discordant findings from different methodological approaches

Comparative evaluation of different types of bariatric surgery

Introduction. The use of bariatric surgery as a treatment for obesity has increased dramatically over the past few years. Because the results in obese patients with type 2 diabetes were so impressive, the International Diabetes Federation recommended considering bariatric surgery as an acceptable treatment option in patients with a BMI of 30-35 kg / m2 when diabetes cannot be adequately controlled with traditional therapies.
 The aim of the study is to compare the results of bariatric surgery in patients with metabolic syndrome according to the dynamics of body mass index and major orexigenic and anorexigenic hormones.
 Material and Methods. The results of surgical treatment of 19 patients with morbid obesity (5 men and 14 women) aged 44 ± 3.26 years with a body mass index ˃40 kg / m2 were evaluated. The control group consisted of 12 patients with normal body mass index and no manifestations of metabolic syndrome.
 Results. Our study also demonstrated the positive effect of LGAE on hormonal parameters with a decrease in ghrelin and leptin. This helped reduce BMI by 10.12% after 6 months. At the same time there is an increase in adiponectin and resistin.
 Conclusions. LGAE in patients with ghrelin-associated obesity is possible as an alternative intervention, given its good tolerability. Or, as the first preparatory stage of comprehensive surgical treatment in obese patients who are not good candidates for standard bariatric surgery.

Changes in serum albumin and liver enzymes following three different types of bariatric surgery: six-month follow-up. A retrospective cohort study.

Few reports have examined the effects of Roux-en-Y gastric bypass (RYGB), one-anastomosis gastric bypass (OAGB) and sleeve gastrectomy (SG) on changes to serum albumin (Alb) and liver enzyme levels. To compare short-term post-surgery changes in serum Alb, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALKP) levels. Body composition changes were also measured and compared among three groups. Retrospective cohort study conducted in Tehran, Iran. 151 OAGB, RYGB and SG patients referred to the obesity clinic of Hazrat-e Rasool General Hospital, Tehran, Iran, were evaluated. Physical characteristics and biochemical parameters were measured pre-surgery and then after three and six months. Through repeated measurements to determine intragroup changes, significant changes in serum AST (P = 0.003) and ALT (P < 0.001) were observed in follow-ups. However, Alb levels did not change (P = 0.413). Body fat, fat-free mass and muscle mass decreased significantly in each group (P < 0.05). In a univariate general linear model for determining intergroup changes, SG showed greater decreases in ALT and AST at three and six months (P < 0.05) and in ALKP at six months (P = 0.037), compared with OAGB. There were no significant differences in Alb levels. Also, RYGB had a greater effect on reducing fat percentage (three months, P = 0.011; six months, P = 0.059) and fat mass (three months, P = 0.042) than OAGB. SG and RYGB may be superior to OAGB in reducing liver enzymes and body fat, respectively. However, Alb levels showed no significant differences.

Effect of Bariatric Surgery on Metabolic Diseases and Underlying Mechanisms.

Obesity is a highly prevalent public health concern, attributed to multifactorial causes and limited in treatment options. Several comorbidities are closely associated with obesity such as the development of type 2 diabetes mellitus (T2DM), cardiovascular and cerebrovascular diseases, and nonalcoholic fatty liver disease (NAFLD). Bariatric surgery, which can be delivered in multiple forms, has been remarked as an effective treatment to decrease the prevalence of obesity and its associated comorbidities. The different types of bariatric surgery create a variety of new pathways for food to metabolize in the body and truncate the stomach’s caliber. As a result, only a small quantity of food is tolerated, and the body mass index noticeably decreases. This review describes the improvements of obesity and its comorbidities following bariatric surgery and their mechanism of improvement. Additionally, endocrine function improvements after bariatric surgery, which contributes to the patients’ health improvement, are described, including the role of glucagon-like peptide-1 (GLP-1), fibroblast growth factors 19 and 21 (FGF-19, FGF-21), and pancreatic peptide YY (PYY). Lastly, some of the complications of bariatric surgery, including osteoporosis, iron deficiency/anemia, and diarrhea, as well as their potential mechanisms, are described.

Impact of bariatric surgery on non-alcoholic fatty liver disease: an integrative review

The present study aims to demonstrate the results of the impact of bariatric surgery on non-alcoholic fatty liver disease through secondary sources available in the literature. A literature review was carried out with the descriptors "Non-alcoholic Fatty Liver Disease" OR "NAFLD" AND "Bariatric Surgery"; “Doença Hepática Gordurosa não Alcoólica” OR “DHGNA” AND “Cirurgia Bariátrica” in the databases: Latin American and Caribbean Health Sciences Literature, through the Virtual Health Library, and Medical Literature Analysis and Retrieval System Online (Medline), through PubMed. Cohort-type studies addressing the effects of bariatric surgery on non-alcoholic fatty liver disease published in the last 5 years were included in the review. Thirty-one studies were identified, of which 10 were excluded for not performing postoperative evaluation and 8 were excluded for not containing the methodological criteria, totaling 13 studies. The current literature presents data suggestive of the association between bariatric surgery and the regression of non-alcoholic fatty liver disease, however, the studies observed present wide variations in methodological applications and samples with heterogeneous profiles, which makes it difficult to generalize the results. More studies are needed so that it is possible to document with greater evidence and reproducibility the action of different types of bariatric surgery on the rate of this liver disease regression.