Predictors for Weight Loss Failure Following Roux-en-Y Gastric Bypass

Cazzo, Everton; Silva, Flávio Pinto da; Pareja, José Carlos; Chaim, Élinton Adami

doi:10.1590/s0004-28032014000400011

Cited by 26 publications

(20 citation statements)

References 23 publications

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“…Although these hormones have been identified in the early 1970s, they really rose to prominence after the growth of bariatric surgery and the observation of the critical impact of these procedures on their release and, consequently, on the glucose homeostasis and improvement of metabolic syndrome and its clinical features (16)(17)(18)(19)(20)(21)(22)(28)(29)(30)(31)(32)(33)(34) . In this study, we observed that the GLP-1 levels did not differ among non-diabetic individuals with morbid obesity, diabetic individuals with mild obesity and healthy controls.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Levels of C-Reactive Protein, GLP-1 and GLP-2 Among Individuals With Diabetes, Morbid Obesity and Healthy Controls: An Exploratory Study

Cazzo

Pareja

Chaim

et al. 2018

Arq. Gastroenterol.

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-Background -The glucagon-like peptides 1 and 2 (GLP-1/GLP-2) are gut hormones that may directly affect the glucose homeostasis and their activity seems to be significantly affected by chronic inflammation. Objective -To evaluate the postprandial levels of glucagon-like peptides 1 and 2 (GLP-1/GLP-2), C-reactive protein (CRP), and the postprandial glucose and insulin levels among individuals with obesity, type 2 diabetes, and healthy controls. Methods -An exploratory cross-sectional study, which involved individuals awaiting for bariatric/metabolic surgery and healthy controls. Postprandial levels of GLP-1, GLP-2, glucose, and insulin were obtained after a standard meal tolerance test. Inflammation was assessed by means of CRP. Results -There were 30 individuals enrolled in the study, divided into three groups: non-diabetic with morbid obesity (NDO; n=11 individuals), diabetic with mild obesity (T2D; n=12 individuals), and healthy controls (C; n=7 individuals). The mean CRP levels were significantly higher in the NDO group (6.6±4.7 mg/dL) than in the T2D (3.3±2.2 mg/dL) and C groups (2.5±3.2 mg/dL) (P=0.038). The GLP-1 levels following standard meal tolerance test and the area under the curve of GLP-1 did not differ among the three groups. The GLP-2 levels were significantly lower in the NDO and T2D than in the C group following standard meal tolerance test at all the times evaluated. The area under the curve of the GLP-2 was significantly lower in the NDO and T2D groups than in the C group (P=0.05 and P=0.01, respectively). Conclusion -GLP-2 levels were impaired in the individuals with obesity and diabetes. This mechanism seems to be enrolled in preventing the worsening of the glucose homeostasis in these individuals. HEADINGS -Glucagon-like peptide 1. Glucagon-like peptide 2. Diabetes mellitus. Obesity. Insulin resistance. Incretins.

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Section: Discussionmentioning

confidence: 99%

Comparison of the Levels of C-Reactive Protein, GLP-1 and GLP-2 Among Individuals With Diabetes, Morbid Obesity and Healthy Controls: An Exploratory Study

Cazzo

Pareja

Chaim

et al. 2018

Arq. Gastroenterol.

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“…Another study reached the same conclusion when comparing weight loss between patients with and without T2DM, enrolled in a weight loss programme that included use of appetite suppressants, structured diet, exercise and behavioural modification . In addition, studies comparing groups of patients according to the magnitude of weight loss after bariatric surgery observed an association between the presence of T2DM and less weight loss . In these studies, the follow‐up period ranged from 1 to 4 years, and in two of them there was no significant difference in weight loss between patients with and without T2DM at 12 months of follow‐up, but only after that period .…”

Section: Discussionmentioning

confidence: 81%

“…Although patients with both obesity and T2DM benefit most from weight loss, some studies using different treatment modalities have suggested that these patients have greater difficulty in losing weight when compared to patients without T2DM . Few studies have evaluated patients undergoing bariatric surgery, and their results were conflicting . In this context, the objective of the present study was to compare weight loss 12 months after gastric bypass surgery, as well as variations in related biochemical parameters, between patients with and without T2DM.…”

Section: Introductionmentioning

confidence: 98%

“…[10][11][12] Few studies have evaluated patients undergoing bariatric surgery, and their results were conflicting. [13][14][15][16][17][18] In this context, the objective of the present study was to compare weight loss 12 months after gastric bypass surgery, as well as variations in related biochemical parameters, between patients with and without T2DM.…”

Section: Introductionmentioning

confidence: 99%

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Bariatric surgery‐induced weight loss in patients with and without type 2 diabetes mellitus

et al. 2020

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Summary Surgical treatment of obesity leads to weight loss and metabolic improvement, but it is unclear if the response differs between patients with and without type 2 diabetes. Retrospective cohort study comparing weight loss and metabolic outcomes between patients with and without type 2 diabetes, matched for body mass index (BMI), gender and age, 12 months after Roux‐en‐Y gastric bypass. Forty‐eight patients with type 2 diabetes (D) and 48 without type 2 diabetes (ND) were evaluated, 87.5% female, mean age 42.2 ± 0.9 years. The mean baseline weight and BMI of the D and ND groups were, respectively, 120.3 ± 21.6 vs 123.7 ± 20.8 kg (P = .45) and 47.2 ± 7.5 vs 47.2 ± 6.9 kg/m2 (P = .70). After 12 months, there was no significant difference in weight (40.4 ± 16.9 vs 44.1 ± 12.2 kg, P = .28) and BMI (15.8 ± 6.5 vs 16.9 ± 4.5 kg/m2, P = .26) variation between groups. The parameters that presented significant variation were (D vs ND): fasting blood glucose (41.6 ± 43.0 vs 12.7 ± 17.2 mg/dL, P < .01), HbA1c (1.8 ± 1.6 vs 0.6 ± 0.7%; P < .01), triglycerides (91.1 ± 100.4 vs 54.2 ± 43.8 mg/dL; P = .04), low‐density lipoprotein (27.2 ± 41.5 vs 37.5 ± 24.2 mg/dL; P < .01) and gamma glutamyl transferase (46.5 ± 55.3 vs 17.7 ± 11.9 UI/L; P = .04). Weight loss 12 months after a gastric bypass was similar in patients with and without type 2 diabetes, the greater metabolic benefits appearing in patients with type 2 diabetes as they had more pronounced changes at baseline.

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“…Despite the great amelioration of outcomes observed in the last decades, surgical risk, although low, is still significant, especially in some specific groups of patients (i.e. elderly, severe chronic disease carriers etc) (6,24) . In Brazil's public health system, we struggle against specific factors that are not so prominent in other countries.…”

Section: Discussionmentioning

confidence: 99%

Preoperative multidisciplinary program for bariatric surgery: a proposal for the Brazilian Public Health System

Chaim

Pareja

Gestic

et al. 2017

Arq. Gastroenterol.

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-Background -Bariatric surgery has become the gold standard treatment for morbid obesity, but access to surgery remains difficult and low compliance to postoperative follow-up is common. To improve outcomes, enable access and optimize follow-up, we developed a multidisciplinary preoperative approach for bariatric surgery. Objective -To determine the impact of this program in the outcomes of bariatric surgery in the Brazilian public health system. Methods -A prospective evaluation of the individuals who underwent a preoperative multidisciplinary program for bariatric surgery and comparison of their surgical outcomes with those observed in the prospectively collected historical database of the individuals who underwent surgery before the beginning of the program. Results -There were 176 individuals who underwent the multidisciplinary program and 226 who did not. Individuals who underwent the program had significantly lower occurrence of the following variables: hospital stay; wound dehiscence; wound infection; pulmonary complications; anastomotic leaks; pulmonary thromboembolism; sepsis; incisional hernias; eventrations; reoperations; and mortality. Both loss of follow-up and weight loss failure were also significantly lower in the program group. Conclusion -The adoption of a comprehensive preoperative multidisciplinary approach led to significant improvements in the postoperative outcomes and also in the compliance to the postoperative follow-up. It represents a reproducible and potentially beneficial approach within the context of the Brazilian public health system. HEADINGS -Obesity. Bariatric surgery. Gastric bypass. Public health. Preoperative care.

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Predictors for Weight Loss Failure Following Roux-en-Y Gastric Bypass

Cited by 26 publications

References 23 publications

Comparison of the Levels of C-Reactive Protein, GLP-1 and GLP-2 Among Individuals With Diabetes, Morbid Obesity and Healthy Controls: An Exploratory Study

Comparison of the Levels of C-Reactive Protein, GLP-1 and GLP-2 Among Individuals With Diabetes, Morbid Obesity and Healthy Controls: An Exploratory Study

Bariatric surgery‐induced weight loss in patients with and without type 2 diabetes mellitus

Preoperative multidisciplinary program for bariatric surgery: a proposal for the Brazilian Public Health System

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