Obesity is a pathology whose incidence is increasing throughout the world. There are many pathologies associated with obesity. In recent years, the influence of the microbiota on both health and pathological states has been known. There is growing information related to changes in the microbiome and obesity, as well as its associated pathologies. Changes associated with age, exercise, and weight changes have been described. In addition, metabolic changes associated with the microbiota, bariatric surgery, and fecal matter transplantation are described. In this review, we summarize the biology and physiology of microbiota in obese patients, its role in the pathophysiology of several disorders associated, and the emerging therapeutic applications of prebiotics, probiotics, and fecal microbiota transplantation.
Obesity is a worldwide epidemic that leads to several non-communicable illnesses, including chronic kidney disease (CKD). Diet and lifestyle modifications have shown a limited impact in the treatment of obesity. Because the group of end-stage renal disease (ESRD) patients examined in this study had limited access to kidney transplantation (KT), patients with obesity were thought to be at an increased risk of intraoperative and postoperative KT complications. Although bariatric surgery (BS) is now recognized as the gold standard treatment for morbid obesity, its role in ESRD or kidney transplant patients remains unknown. It is critical to know the correlation between weight loss and complications before and after KT, the impact of the overall graft, and patients’ survival. Hence, this narrative review aims to present updated reports addressing when to perform surgery (before or after a KT), which surgical procedure to perform, and again, if strategies to avoid weight regain must be specific for these patients. It also analyzes the metabolic alterations produced by BS and studies its cost-effectiveness pre- and post-transplantation. Due to the better outcomes found in KT recipients, the authors consider it more convenient to perform BS before KT. However, more multicenter trials are required to provide a solid foundation for these recommendations in ERSD patients with obesity.
Algunos trabajadores mantienen estilos de vida no saludables que los hace propensos a tener un alto riesgo de diabetes tipo 2 (DT2). El presente estudio tuvo como objetivo evaluar el riesgo de DT2 (RDT2) en personal administrativo y docente de una universidad ecuatoriana y factores asociados. Estudio de corte transversal que evaluó el RDT2 según FINDRISC. Se consideró RDT2 alto si la puntuación ≥12 puntos. Se analizaron aspectos sociodemográficos, hábitos nocivos y saludables; se midieron el índice de masa corporal (IMC), el perímetro abdominal (PA) y la tensión arterial (TA). Se evaluaron las razones de prevalencia bruta (RPB) y ajustada (RPA) para identificar factores asociados con RDT2. De 311 participantes, edad media de 41,02 años (DE 10,1), 58,2% mujeres y 41,8% hombres. La prevalencia de RDT2 elevada fue mayor en mujeres respecto a varones (38,1% frente a 32,3%) y aumentó en mayores de 40 años [RPA 1.55 (1.11-2.15)], personas casadas [RPA 1.49 (1.07-2.05)], aquellos con actividad física moderada o menor [RPA 1.55 (1.11-2.15)], y en aquellos con PA elevado [RPA 2,41 (1,33 - 4,36)]. La edad, la baja actividad física y el PA, fueron factores asociados con una mayor prevalencia de RDT2. Se deben promover estilos de vida saludables, para incrementar la actividad física y disminuir el PA en trabajadores, para reducir el riesgo de DT2. Palabras claves: Diabetes Mellitus tipo 2, Estilos de Vida, Factores de Riesgo, Salud Laboral
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