Reduction In Excess Body Weight Research Articles

Gender-specific differences in bariatric surgery: epidemiology, treatment and results

This study investigates gender-specific differences in obesity and the treatment by metabolic bariatric surgery (MBS). The database includes 2393 patients (1725 women, 668 men) from for ahigh-volume center for bariatric surgery. Demographic, perioperative and follow-up data were retrospectively analyzed. Men had a significantly higher body mass index (BMI) and more frequent obesity-associated diseases. Despite the higher prevalence of obesity in men, women accounted for 80% of the surgical patients. On average men had longer operation times but with the same complication rates. Postoperatively, both sexes experienced asignificant reduction in excess body weight, which was slightly more pronounced in women. The study particularly emphasizes the need to better motivate men to undergo obesity treatment in order to reduce the health consequences of morbid obesity in this population group.

Mental Health and Body Image and the Reduction of Excess Body Weight in Woman (Polish Sample).

In recent years, excessive body weight has become one of the most serious psychological, biological and social problems. According to forecasts by the World Health Organization, obesity and overweight will continue to increase among both adults and children in the coming years. Poland ranks sixth in Europe in this respect. In 2021, almost 58% of Poles had above-average body weight (overweight or obesity). In Poland, 29% of women are overweight, and 21% of women are obese. Body dissatisfaction, depression, and anxiety disorder are indicated as consequences of high BMI in women. Reducing excess body weight improves psychosocial functioning and changes body assessment. The most lasting effects of weight reduction are achieved by a properly selected diet combined with increased physical activity. This results in a change in lifestyle, changes in the levels of metabolic indicators, and changes in one's body image and mental health. Objective: Our objective was to assess changes in body image and mental health among Polish women and their dependence on the weight reduction method used (type of diet and physical activity). Comparative studies involving 122 women were conducted. These women were selected from 1000 volunteers based on BMI criteria. The effects of diet therapy were compared with the effects of diet therapy combined with physical activity. Research tools: The GHQ-12 scale was used to measure mental health, and the Body Esteem Scale was used to measure body image. The study lasted four years. The results showed changes in body image, general mental health index, and BMI in women who dieted and in those who dieted and exercised. In women using a diet combined with physical activity, greater positive changes in mental condition and stronger positive changes in body image, namely in the assessment of satisfaction with sexual attractiveness, physical condition, and body weight control, were observed compared to women using diet therapy alone.

Vertikaliosios skrandžio rezekcijos dešimties metų rezultatai: sisteminė literatūros apžvalga

Introduction. Sleeve gastrectomy is currently the most popular surgical treatment for obesity worldwide. However, there is still a lack of data on long-term outcomes of this procedure. The objective of this study was to review and analyze the scientific literature and evaluate the long-term (10 years and beyond) results of sleeve gastrectomy for the surgical treatment of obesity. Methods. A literature search was conducted using the PubMed search engine, resulting in 1 443 publications on the long-term results of sleeve gastrectomy for obesity. After applying search criteria and selecting articles by title and abstract, 7 results were included in the systematic review. Results. The included studies involved 2 399 patients after sleeve gastrectomy, with an average age of 41.8 years and 1 577 (65.7%) of all patients being women. The mean preoperative body mass index of the patients in the selected publications was 45.1 kg/m2. Long-term (10 years and beyond) weight loss outcomes were assessed in terms of excess body weight loss. Among the studies, the average excess body weight loss achieved was 54.2%, with a maximum of 70.5% and a minimum of 36%. Arterial hypertension remission was achieved in 23.6%, obstructive sleep apnea remission was achieved in 62.2%, type II diabetes remission was achieved in 54.4%, and dyslipidemia remission was achieved in 42.5% of patients. Conclusion. Sleeve gastrectomy provides a stable reduction in excess body weight and control of comorbidities over 10 years. However, more data on the long-term results of sleeve gastrectomy are needed to compare it with other surgical approaches in the treatment of obesity.

Remotely Supervised Weight Loss and Exercise Training to Improve Rheumatoid Arthritis Cardiovascular Risk: Rationale and Design of the Supervised Weight Loss Plus Exercise Training-Rheumatoid Arthritis Trial.

Patients with rheumatoid arthritis (RA) remain at an increased risk for cardiovascular disease (CVD) and mortality. RA CVD results from a combination of traditional risk factors and RA-related systemic inflammation. One hypothetical means of improving overall RA CVD risk is through reduction of excess body weight and increased physical activity. Together, weight loss and physical activity can improve traditional cardiometabolic health through fat mass loss, while also improving skeletal muscle health. Additionally, disease-related CVD risk may improve as both fat mass loss and exercise reduce systemic inflammation. To explore this hypothesis, 26 older persons with RA and overweight/obesity will be randomized to 16 weeks of a usual care control arm or to a remotely Supervised Weight Loss Plus Exercise Training (SWET) program. A caloric restriction diet (targeting 7% weight loss) will occur via a dietitian-led intervention, with weekly weigh-ins and group support sessions. Exercise training will consist of both aerobic training (150 minutes/week moderate-to-vigorous exercise) and resistance training (twice weekly). The SWET remote program will be delivered via a combination of video conference, the study YouTube channel, and study mobile applications. The primary cardiometabolic outcome is the metabolic syndrome Z score, calculated from blood pressure, waist circumference, high-density lipoprotein cholesterol, triglycerides, and glucose. RA-specific CVD risk will be assessed with measures of systemic inflammation, disease activity, patient-reported outcomes, and immune cell function. The SWET-RA trial will be the first to assess whether a remotely supervised, combined lifestyle intervention improves cardiometabolic health in an at-risk population of older individuals with RA and overweight/obesity.

Метод лазерной допплеровской флоуметрии в оценке влияния лираглутида на микроциркуляцию у крыс с диет-индуцированным ожирением

The state of the microcirculatory bed in rats with obesity caused by the "cafeteria diet" was studied using laser Doppler flowmetry during therapy with liraglutide. It has been shown that obesity causes a decrease in the perfusion index and normalized amplitudes of endothelial and neurogenic oscillations on the skin of the dorsal foot of experimental animals. Therapy with liraglutide contributed to the reduction of excess body weight and the Lee index, which resulted in the restoration of disturbed microcirculation of the skin of the dorsal foot of rats, as well as the normalization of the functional activity of target organs.

Role of 3D-CT gastric volumetric study in post-sleeve gastrectomy

BackgroundGastric pouch volumetry after sleeve gastrectomy reflects successful surgery. We aimed to assess the impact of gastric pouch volume after sleeve gastrectomy on weight loss.MethodThe study was performed for 30 patients (22 females and 8 males) who underwent sleeve gastrectomy. Their ages ranged from 18 to 47 years. All patients underwent (multi-slice CT) MSCT examination at 12 months after surgery with oral administration of effervescent emulsion. Post-processing in multi-planar reconstruction and 3D reconstruction was performed to all cases. Gastric pouch volume was measured and correlated with body weight, body mass index (BMI), % reduction in excess body weight and ∆weight at 1 year.ResultsA significant positive association was found among gastric volume pouch and weight loss (P = 0.04), BMI reduction (P value < 0.0001) and ∆weight (P value = 0.013). A significant inverse association was found among gastric pouch volume and % reduction in excess body weight (P value = 0.013).ConclusionMSCT gastric volumetry is the gold standard imaging method for assessment of the gastric pouch volume after sleeve gastrectomy. Significant positive association was found among gastric volume pouch and weight loss, BMI reduction and ∆weight at 1 year, i.e., in spite of large gastric pouch volume at 1 year, there is adequate weight loss, BMI reduction and ∆weight. Yet, significant inverse association was found among gastric pouch volume and % reduction in excess body weight.

Dietary supplements in therapy to support weight reduction in obese patients.

Obesity is a pandemic disease that poses a serious problem for the entire world population. Preventative and non-pharmacological treatments for obesity include changing eating habits and increasing physical activity. The use of certain dietary supplements also brings beneficial results in the process of reducing excess body weight. There are many options for the treatment of obesity available on the pharmaceutical market. This study aims to review the latest publications on selected dietary supplements in the treatment of excess body weight. Dietary supplements which support a reduction in excess body weight include capsaicin, bitter orange, white bean seeds, green coffee, berberine, and single and multi-strain probiotics. Some of these supplements have additional health benefits. Bitter orange has antioxidant and anti-ulcer properties. Berberine improves lipid metabolism and reduces blood glucose levels. Capsaicin has found application in the treatment of neurodegenerative diseases. Supplements that do not significantly reduce body weight are chitosan and vitamin D. Chitosan can reduce blood pressure, while vitamin D improves the sensitivity of tissue to insulin. An increase in body mass index (BMI) is associated with an increased risk of many diseases, including cardiovascular disease, diabetes mellitus, musculoskeletal disorders, and certain cancers. Dietary supplements with beneficial effects which support a reduction in excess body weight can be used in the treatment of both obesity and its complications.

6-10-14 for Health - as an example of an interdisciplinary model of care for a patient with obesity

Abstract Issue Overweight and obesity are public health challenges of growing importance in Poland. The fastest increase has been observed in children and adolescents. Some studies show that 22% of elementary school children are currently (2013) overweight or have obesity (IZZ), compared with no more than 15% in 1990 (WHO Europe, 2012). Description of the problem The “6-10-14 for Health” is the first comprehensive health programme implemented in Poland, focused on long-term health behaviour change both among children with obesity and their families. Screening tests are carried out at Gdańsk schools. Children who are diagnosed with excess body weight are invited to the second level of programme. Target groups are children in Gdansk, aged 6, 9-11 and 14 years, their parents and the school environment. Timeline: 2011-2021 Results effects: Approximately 400-450 new patients join the programme every year. Programme participants receive annual care from an interdisciplinary team of specialists including a paediatrician, dietitian, specialist in physical activity and a psychologist. The effect of one year's participation in the programme is the reduction of excess body weight in 75% of participants. More then 2000 patients have complieted the Programme. The programme is accredited by the European Association for the Study of Obesity and is funded by the City of Gdańsk. changes: Further implementation of the Programme depends on providing funds from the City of Gdańsk. However, it seems that the 6-10-14 for Health is one of the city's health priorities. The challenge in the field of weight reduction programs is to provide care that will not lead to stigmatization of patients Lessons The work on designing the model has already resulted in creation of network of specialists from different backgrounds and allowed sharing different scopes, how to use limited resources for the benefit of children and adolescens. Key messages The proposed care model is fully possible to implement in the care system. So far, sharing knowledge and experience, the program has been implemented in several other local governments. In the era of the COVID19 pandemic, all activities aimed at the prevention and early treatment of obesity become even more important.

Rationale and design of a type 2 diabetes prevention intervention for at-risk mothers and children at a Federally Qualified Healthcare Center: EPIC El Rio Families Study Protocol

BackgroundExposure to gestational diabetes mellitus (GDM) is associated with increased risk for type 2 diabetes (T2DM) in mothers, and poor cardiovascular health among offspring. Identifying effective methods to mitigate T2DM risk has the potential to improve health outcomes for mothers with a history of GDM and their children. The goal of the EPIC El Rio Families Study is to implement and evaluate the effects of a 13-week behavioral lifestyle intervention on T2DM risk factors in at-risk mothers and their 8- to 12-year-old children. We describe herein the rationale for our specific approach, the adaption of the DPP-based curriculum for delivery to patients of a Federally Qualified Health Center (FQHC), and the study design and methodology.MethodsThe effects of the intervention on reduction in excess body weight (primary outcome), hemoglobin A1c, blood pressure, and changes in lifestyle behaviors associated with weight trajectory and T2DM risk in mother-child dyads will be evaluated during a 13-week, group randomized trial wherein 60 mothers and their children will be recruited to the intervention or wait-listed control conditions at one of two FQHC locations. Intervention participants (n = 30) will begin the group program immediately, whereas the wait-listed controls (n = 30) will receive a booklet describing self-guided strategies for behavior change. Associated program delivery costs, acceptability of the program to participants and FQHC staff, and potential for long-term sustainability will also be evaluated.DiscussionSuccessful completion in our aims will produce a scalable program with high potential for replication and dissemination, and estimated intervention effects to inform T2DM prevention efforts on families who use the FQHC system. The results from this study will be critical in developing a T2DM prevention model that can be implemented and scaled across FQHCs serving populations disproportionately burdened by T2DM.Trial registrationClinicalTrials.gov NCT03781102; Date of registration: 19 December 2018.

Management of patients after ischemic stroke

Rehabilitation and secondary prevention of ischemic stroke (IS) is the basis for the management of patients with ischemic stroke. The important role of non-drug methods of secondary prevention of IS should be noted: cessation of smoking and alcohol abuse, regular physical activity, proper nutrition, reduction of excess body weight. The normalization of blood pressure is one of the most effective areas of IS prevention. It is based on the regular intake of antihypertensive drugs in most cases. After noncardioembolic IS, antiplatelet agents are required: acetylsalicylic acid (ASA), clopidogrel, or a combination of dipyridamole and ASA. The possibility of taking a combination of clopidogrel and ASA for 21 days after IS with a subsequent switch to monotherapy with ASA or clopidogrel is discussed in patients with non-disabling IS. After cardiomoembolic IS, warfarin is required under the control of an international normalized ratio or with nonvalvular atrial fibrillation of new oral anticoagulants: apixaban, dabigatran or rivaroxaban. Most patients after IS require statins, and the doses are selected individually. Carotid endarterectomy is most effective in severe stenosis (narrowing of 70–99% of the diameter) of the internal carotid artery on the side of the involved hemisphere during the first 3–7 days after non-disabling IS. The data of multicenter placebo-controlled and open observational studies on the use of the metabolic drug Cytoflavin, which is widely used in our country in the rehabilitation of patients with IS, are presented.

The COVID-19 Pandemic Lockdowns and Changes in Body Weight among Polish Women. A Cross-Sectional Online Survey PLifeCOVID-19 Study

There is limited information on the relationships between restrictions linked to COVID-19 and changes in body weight. The aim of the study was to identify the body weight changes and their determinants in the nutritional and socio-demographic context during the COVID-19 pandemic in Polish women. During lockdown in Poland, 34% of women gained weight, while 18% of women reduced weight. As many as 44% of women with obesity before the pandemic increased their body weight, and 74% of women that were underweight reduced their body weight. In a group with weight gain, women increased their body weight by 2.8 kg on average and around 65% of them increased their total food intake. Unhealthy dietary changes and the negative lifestyle changes that comprised of an increase in screen time and a decrease in physical activity were found as key factors associated with weight gain. A higher risk of weight gain was associated with being obese before the pandemic or living in a macroeconomic region &gt;50% of EU-28 GDP, while those younger in age and carrying out remote work had a higher chance of weight loss. Concluding, the specific conditions during lockdown worsened the nutritional status, which may increase the risk of complicatedness and mortality from COVID-19. It seems advisable to create dietary and lifestyle recommendations tailored to the individual needs of women who are underweight or have excessive body weight. More attention should be paid also to environmental impacts. Both, the reduction of excessive body weight and the maintenance of a normal weight should be based on the principle to eat and live sustainably and healthily.

Influence of bariatric surgery induced weight loss on oxidative DNA damage

Obesity is associated with elevated cancer risk, which may be represented by elevated genomic damage. Oxidative stress plays a key role in obesity related detrimental health consequences including DNA oxidation damage. The elevated cancer risk in obesity may be a consequence. Weight loss has been shown to reduce genomic damage, but the role of oxidative stress in that has not been clarified.The aim of this study is therefore to investigate the influence of bariatric surgery induced weight loss on DNA oxidation damage in morbidly obese subjects. For this aim, we used cryopreserved peripheral blood mononuclear cells in the FPG comet assay. Advanced protein oxidation products and 3-nitrotyrosine were measured as oxidative and nitrative protein stress markers. Furthermore, expression of oxidative stress related proteins HSP70 and Nrf2 as well as mitochondrial enzyme citrate synthase and NADPH oxidase subunit p22 phox were analysed.Our findings revealed significantly reduced DNA strand breaks, but DNA base oxidation was not reduced. We observed significant reduction in plasma AOPPs and 3-nitrotyrosine, which indicated an improvement in oxidative/nitrative stress. However, expression of HSP70 and Nrf2 were not altered after weight loss. In addition, expression of citrate synthase and p22 phox were also unaltered.Overall, bariatric surgery induced significant reduction in excess body weight and improved the patients’ health status, including reduced DNA strand breaks and slightly improved antioxidant status in some of the investigated endpoints, while cellular ROS formation and DNA oxidation damage stayed unaltered. This complex situation may be due to combined beneficial effects of weight loss and burdening of the body with fat breakdown products. In the future, collecting samples two years after surgery, when patients have been in a weight plateau for some time, might be a promising approach.

The Causes of Gastroesophageal Reflux after Laparoscopic Sleeve Gastrectomy: Quantitative Assessment of the Structure and Function of the Esophagogastric Junction by Magnetic Resonance Imaging and High-Resolution Manometry.

The incidence of de novo gastroesophageal reflux disease (GERD) after LSG is substantial. However, an objective correlation with the structural gastric and EGJ changes has not been demonstrated yet. We aimed to prospectively evaluate the effects of laparoscopic sleeve gastrectomy (LSG) on the structure and function of the esophagogastric junction (EGJ) and stomach. Investigations were performed before and after > 50% reduction in excess body weight (6-12months after LSG). Subjects with GERD at baseline were excluded. Magnetic Resonance Imaging (MRI), high-resolution manometry (HRM), and ambulatory pH-impedance measurements were used to assess the structure and function of the EGJ and stomach before and after LSG. From 35 patients screened, 23 (66%) completed the study (age 36 ± 10years, BMI 42 ± 5kg/m2). Mean excess weight loss was 59 ± 18% after 7.1 ± 1.7-month follow-up. Esophageal acid exposure (2.4 (1.5-3.2) to 5.1 (2.8-7.3); p= 0.040 (normal < 4.0%)) and reflux events increased after surgery (57 ± 24 to 84 ± 38; p= 0.006 (normal < 80/day)). Esophageal motility was not altered by surgery; however, intrabdominal EGJ length and pressure were reduced (both p< 0.001); whereas the esophagogastric insertion angle (35° ± 11° to 51° ± 16°; p= 0.0004 (normal < 60°)) and esophageal opening diameter (16.9 ± 2.8mm to 18.0 ± 3.7mm; p= 0.029) were increased. The increase in reflux events correlated with changes in EGJ insertion angle (p= 0.010). Patients with > 80% reduction in gastric capacity (TGV) had the highest prevalence of symptomatic GERD. LSG has multiple effects on the EGJ and stomach that facilitate reflux. In particular, EGJ disruption as indicated by increased (more obtuse) esophagogastric insertion angle and small gastric capacity were associated with the risk of GERD after LSG. clinicaltrials.gov: NCT01980420.

Estimates of the current and future burden of cancer attributable to excess body weight and abdominal adiposity in Canada

The increasing prevalence of obesity among Canadians has important implications for newly diagnosed cases of cancer given that excess body weight and abdominal adiposity are known to increase the risk of several cancers. The purpose of this analysis was to estimate the current attributable and future avoidable burden of cancer related to excess body weight and abdominal adiposity among Canadian adults. We estimated the population attributable risk (PAR) for all cancers associated with excess body weight and abdominal adiposity using contemporary cancer incidence, relative risk and exposure prevalence data for body mass index (BMI), waist circumference and waist-to-hip-ratio. Using the partial impact fraction (PIF), we also estimated the future avoidable burden of cancer from 2015 to 2042 in Canada, and by province, through various hypothetical intervention scenarios. In 2003, approximately half (50.5%) of the Canadian population was estimated to be overweight (BMI 25.0–29.9) or obese (BMI ≥30.0), 56.5% to have excess abdominal adiposity and 56.8% with a high waist-to-hip ratio. In 2015, the estimated PARs of all incident cancers associated with excess body weight, excess abdominal adiposity and high waist-to-hip ratio were 7.2%, 8.9% and 10.0%, respectively. If the population BMI could revert to its 1994 distribution, 72,157 associated cancer cases could be prevented cumulatively by 2042. A reduction in excess body weight and abdominal adiposity has the potential to decrease the future cancer burden in Canada substantially, and hence efforts to reverse increasing trends in obesity should be prioritized.

Effects of Laparoscopic Sleeve Gastrectomy on Hypertensive Morbidly Obese Patients

Background: bariatric surgery is the standard way for obtaining a sustainable weight reduction in morbidly obese patients and it is a beneficial in lowering hypertension (both on the short and long terms)and improving other metabolic parameters. LSG is a relatively safe, simple and effective procedure which gained more popularity and became the most commonly performed bariatric operation. Aim: this prospective, randomized study designed to evaluate the outcomes of laparoscopic sleeve gastrectomy (LSG) on hypertensive morbidly obese patients. Patients and Methods: this prospective, randomized study was performed between January 2015 and December 2018 on 50 morbidly obese patients for whom a laparoscopic sleeve gastrectomy for treating morbid obesity was done in the department of general surgery, Al-Azhar University Hospital, Damietta. Results: the comorbidities among the 50 patients included hypertension (40), dyslipidemia (20), sleep apnea (18) and diabetes mellitus (15). These preoperative comorbidities significantly improved within 6 months after LSG and at the end of follow-up period which was one year after operation, nearly all comorbidities were resolved or improved.There was also a significant short-term effect on obesity and hypertension following surgical treatment and the decrease of blood pressure occured prior to significant reduction of weight. Conclusions: laparoscopic sleeve gastrectomy can improve and resolve elevated blood pressure in morbidly obese patients not only on the long term but also on the short term. It is a relatively safe and effective method not only for reduction of excessive body weight but also for improving and resolving many other comorbidities of morbid obesity.

Endotoxemia And Intestinal Barrier Disorders Associated With Overweight And Obesity

Abstract According to the World Health Organization (WHO), the widespread problem of overweight and obesity is the fifth most important risk factor for deaths in the world. The most frequently mentioned are the genetic and environmental factors that lead to the absorption of excess energy from food and to accumulate it in the form of spare adipose tissue. Another important fact is that even the use of a low-energy diet does not support the effective reduction of excessive body weight. It turns out that the cause may be intestinal microbiota, the composition of which changes in people with overweight and obesity. The intestinal microbiota dysbiosis is additionally perceived by many researchers as the cause of the development of metabolic diseases, including obesity or type 2 diabetes. On the other hand, Gram-negative bacteria constituting a component of the intestinal ecosystem are the source of lipopolysaccharide (LPS), responsible for the development of systemic inflammation and endotoxemia. Based on a literature review related to the subject, it can be concluded that intestinal microbiota disorders, intestinal barrier damage and increased LPS levels in patients adversely affect the obesity and components of the metabolic syndrome and hinder the treatment of these diseases. 1. Introduction. 2. Intestinal barrier function. 3. Intestinal barrier disorders and endotoxemia. 4. Summary

The influence of modifications in the intestinal microbiota composition on changes in anthropometric parameters in people with excessive body weight

Obesity is a chronic disease, which is often accompanied by disorders of the carbohydrates and lipid metabolism, as well as metabolic complications concerning the circulatory system. It is a disorder of homeostasis of energy transformation, caused by excessive supply of energy contained in food which exceeds the needs of the body, consequently leading to increased storage of excess kilocalories in the form of adipose tissue. The incidence of obesity in the world has more than doubled between 1980 and 2014 and currently affects more than 600 million people. This is primarily due to increased food availability, a sedentary lifestyle, as well as a high-fat and high-carbohydrate diet. These facts are a consequence of socio-economic changes which took place in recent decades. One of the factors that can play an important role in the prevention of obesity or reduction of excessive body weight is the modification of intestinal microbiota composition. Recent studies have shown that a diverse, properly functioning microbiota secures the adequate use of energy supplied with food and suitable storage in the body. Probiotic bacteria can contribute to weight loss in two ways. First of all, microbiota of people characterized by the correct quantitative and qualitative composition is much more energy-efficient and contributes to the increased excretion of undigested food residues as compared to the microbiome of people diagnosed with intestinal dysbiosis. Weight reduction due to taking probiotics may also be related to its effect on the regulation of carbohydrate and lipid metabolism in the organism. This article reviews the current clinical studies on the potential relationship between intestinal microbiota and changes in anthropometric parameters concerning people with excessive body weight.

Sleeve gastrectomy in patients with obesity

Background. Obesity is one of the most common chronic diseases in the world, described by the World Health Organization as "a non-infectious epidemic of the late XX - early XXI century." One of the ways to solve this problem was the rapid development of so-called weight correction surgery - bariatric surgery. One of the most progressive and effective techniques of the modern era has been the sleeve gastrectomy. Objective. To study the immediate and long-term results of open and laparoscopic sleeve gastrectomy in Ukraine in patients with obesity. Methods. Analysis of surgical treatment of 117 patients with obesity, who underwent sleeve-gastrectomy (from a laparoscopic approach – 59 (50,4%) patients, from a supramedian laparotomic approach – 58 (49,6%) patients) was performed. Results. The performance of sleeve gastrectomy provided an effective loss of excess body weight. Mean EBWL 2 years after surgery was 68.9 ± 7.6%. Complete compensation of arterial hypertension, dyslipidemia and type 2 diabetes was achieved in 60 (72.3%), 51 (68.9%) and 17 (65.4%) patients, respectively. In the remaining patients, there was a significant regression of the severity of the concomitant diseases with the possibility of effective control of the blood pressure level due to monotherapy, improvement of the lipidogram indices. Partial remission of type 2 diabetes was recorded in 9 (34.5%) patients. Conclusion. Sleeve gastrectomy is an effective and safe technique for the surgical treatment of obesity, which provides a significant reduction in excess body weight and a regression of concomitant obesity-associated diseases and metabolic disorders.

Multi-omic network-based interrogation of rat liver metabolism following gastric bypass surgery featuring SWATH proteomics.

Morbidly obese patients often elect for Roux-en-Y gastric bypass (RYGB), a form of bariatric surgery that triggers a remarkable 30% reduction in excess body weight and reversal of insulin resistance for those who are type II diabetic. A more complete understanding of the underlying molecular mechanisms that drive the complex metabolic reprogramming post-RYGB could lead to innovative non-invasive therapeutics that mimic the beneficial effects of the surgery, namely weight loss, achievement of glycemic control, or reversal of non-alcoholic steatohepatitis (NASH). To facilitate these discoveries, we hereby demonstrate the first multi-omic interrogation of a rodent RYGB model to reveal tissue-specific pathway modules implicated in the control of body weight regulation and energy homeostasis. In this study, we focus on and evaluate liver metabolism three months following RYGB in rats using both SWATH proteomics, a burgeoning label free approach using high resolution mass spectrometry to quantify protein levels in biological samples, as well as MRM metabolomics. The SWATH analysis enabled the quantification of 1378 proteins in liver tissue extracts, of which we report the significant down-regulation of Thrsp and Acot13 in RYGB as putative targets of lipid metabolism for weight loss. Furthermore, we develop a computational graph-based metabolic network module detection algorithm for the discovery of non-canonical pathways, or sub-networks, enriched with significantly elevated or depleted metabolites and proteins in RYGB-treated rat livers. The analysis revealed a network connection between the depleted protein Baat and the depleted metabolite taurine, corroborating the clinical observation that taurine-conjugated bile acid levels are perturbed post-RYGB.

The Association of Weight Loss and Cardiometabolic Outcomes in Obese Children: Systematic Review and Meta-regression.

Excess body weight in children is associated with multiple immediate and long-term medical comorbidities. We aimed to identify the degree of reduction in excess body weight associated with cardiometabolic changes (lipid panel, liver function tests, systolic blood pressure (SBP), diastolic blood pressure, glycosylated hemoglobin, and fasting blood glucose) in overweight and obese children. We conducted a comprehensive search of MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and Scopus through February 12, 2015. We included randomized controlled trials and cohort studies that evaluated interventions to treat pediatric obesity (medication, surgery, lifestyle, and community-based interventions) with ≥ a 6-month follow-up. We used a random effects meta-regression approach to assess the association between body mass index (BMI)/weight and cardiometabolic changes. We included 42 studies (37 randomized controlled trials and five cohorts) enrolling 3807 children (mean age, 12.2 years; weight, 74.7 kg; and BMI, 31.7 kg/m2). Studies had overall moderate to low risk of bias. A 1-mm Hg decrease in SBP was significantly associated with a decrease of 0.16 kg/m2 (P = .04) in BMI. A 1-mg/dL increase in HDL was significantly associated with a 0.74-kg decrease in weight (P = .02). A 1-mg/dL decrease in triglycerides was significantly associated with a 0.1-kg decrease in weight (P = .03). The remaining associations were not statistically significant. Weight reduction in children is associated with significant changes in several cardiometabolic outcomes, particularly HDL, SBP, and triglycerides. The magnitude of improvement may help in setting expectations and may inform shared decision-making and counseling.