Efeito da perda ponderal induzida pela cirurgia bariátrica sobre a prevalência de síndrome metabólica

Júnior, Francisco das Chagas Monteiro; Júnior, Wellington Santana da Silva; Filho, Natalino Salgado; Ferreira, Pedro Antônio Muniz; Araújo, Gutenberg Fernandes; Mandarino, Natália Ribeiro; Barbosa, José Bonifácio; Lages, Joyce Santos; Lima, José de Ribamar Medeiros; Monteiro, Carolina Cipriano

doi:10.1590/s0066-782x2009000600007

Cited by 19 publications

(5 citation statements)

References 22 publications

(30 reference statements)

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“…Therefore, the remission rate of MS varies with the criteria used for diagnosis and consequently it is difficult to compare the results between different studies [22,24,39-41]. …”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of MS has been shown to decrease significantly from 83.2% to 98.4% after surgery [22,24,39,40]. In a large controlled study from the Mayo Clinic with a mean follow-up time of 40 months that included 180 patients submitted to LRYGB and 157 patients enrolled in a medical weight-reduction program, showed that prevalence of MS decreased from 87% to 29% in the bariatric surgery group and from 85% to 75% in the non-surgical group, as defined by the American Heart Association [21].…”

Section: Discussionmentioning

confidence: 99%

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Excess body mass index loss predicts metabolic syndrome remission after gastric bypass

Nora

Guimarães

Almeida

et al. 2014

Diabetol Metab Syndr

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BackgroundMetabolic syndrome (MS) is a condition associated with obesity that identifies individuals with increased cardiovascular risk. Gastric bypass improves several MS components, such as glucose, lipid metabolism and hypertension. The aim of this study was to evaluate the effect of long-limb gastric bypass on the remission of MS criteria associated with morbid obesity.MethodsObese patients who met the “harmonized” criteria for MS (n = 153) that underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) with a long biliopancreatic limb were prospectively evaluated with regards to body weight, body mass index (BMI), percentage of excess BMI lost (% EBMIL), fasting glucose, blood pressure and lipid profile up to 36 months after surgery.ResultsBefore surgery, patients had a BMI of 44.3 ± 0.5 kg/m2; 66% were under anti-diabetic treatment; 78.4% were under anti-hypertensive treatment and 44.3% were under anti-dyslipidemic treatment. After a mean follow-up time of 2.4 ± 0.1 years, MS remission rates were 32.7% at 6 months, 69.7% at 12 months, 63.4% at 24 months, and 59.2% at 36 months; when only 32.9%, 43.4% and 15.8% of patients were still under anti-diabetic, anti-hypertensive and anti-dyslipidemic treatment, respectively. The %EBMIL and BMI were the parameters that showed the highest accuracy to predict the MS remission at all-time points after the surgery.ConclusionsLong limb gastric bypass in obese patients results in significant and sustained weight loss which predicts a high remission rate of MS and allows the discontinuation of drug therapy for several metabolic disturbances in most patients.

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“…Therefore, the remission rate of MS varies with the criteria used for diagnosis and consequently it is difficult to compare the results between different studies [22,24,39-41]. …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Excess body mass index loss predicts metabolic syndrome remission after gastric bypass

Nora

Guimarães

Almeida

et al. 2014

Diabetol Metab Syndr

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“…Several gastrointestinal operations and bariatric procedures promote improvement (and even remission) of MetS [ 165 ] and T2D [ 166 ]. In the ensuing years, the concept of “metabolic surgery” or “diabetes surgery” has become widely recognized, and most major worldwide bariatric surgery societies have changed their names to include the word “metabolic” [ 166 , 167 ].…”

Section: Nafld Treatmentmentioning

confidence: 99%

NAFLD as a continuum: from obesity to metabolic syndrome and diabetes

Godoy-Matos

Júnior

Valério

2020

Diabetol Metab Syndr

409

287

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Background: The prevalence of non-alcoholic fatty liver disease (NAFLD) has been increasing rapidly. It is nowadays recognized as the most frequent liver disease, affecting a quarter of global population and regularly coexisting with metabolic disorders such as type 2 diabetes, hypertension, obesity, and cardiovascular disease. In a more simplistic view, NAFLD could be defined as an increase in liver fat content, in the absence of secondary cause of steatosis. In fact, the clinical onset of the disease is a much more complex process, closely related to insulin resistance, limited expandability and dysfunctionality of adipose tissue. A fatty liver is a main driver for a new recognized liver-pancreatic α-cell axis and increased glucagon, contributing to diabetes pathophysiology. Main text: This review will focus on the clinical and pathophysiological connections between NAFLD, insulin resistance and type 2 diabetes. We reviewed non-invasive methods and several scoring systems for estimative of steatosis and fibrosis, proposing a multistep process for NAFLD evaluation. We will also discuss treatment options with a more comprehensive view, focusing on the current available therapies for obesity and/or type 2 diabetes that impact each stage of NAFLD. Conclusion: The proper understanding of NAFLD spectrum-as a continuum from obesity to metabolic syndrome and diabetes-may contribute to the early identification and for establishment of targeted treatment.

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“…In the cohort of 149 patients there was a significant resolution of metabolic syndrome postoperatively on the 180-day follow-up assessment. A later Brazilian study conducted by Júnior et al [74] looked at 35 patients who underwent the RYGB; 27 of these had a diagnosis of metabolic syndrome. When these patients were followed up 34.4 ± 15 months after surgery, not only was a reduction in BMI observed, only 2 patients fulfilled the criteria for metabolic syndrome.…”

Section: Bariatric Surgery and Metabolic Syndromementioning

confidence: 99%

Bariatric Surgery as Potential Treatment for Nonalcoholic Fatty Liver Disease: A Future Treatment by Choice or by Chance?

2013

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Morbid obesity is strongly associated with nonalcoholic fatty liver disease (NAFLD) which is one of the most common causes of chronic liver disease worldwide. The current best treatment of NAFLD and NASH is weight reduction through life style modifications, antiobesity medication, and bariatric surgery. Importantly, bariatric surgery is the best alternative option for weight reduction if lifestyle modifications and pharmacological therapy have not yielded long-term success. Bariatric surgery is an effective treatment option for individuals who are grossly obese and associated with marked decrease in obesity-related morbidity and mortality. The most common performed bariatric surgery is Roux-en-Y gastric bypass (RYGB). The current evidence suggests that bariatric surgery in these patients will decrease the grade of steatosis, hepatic inflammation, and fibrosis. NAFLD per se is not an indication for bariatric surgery. Further research is urgently needed to determine (i) the benefit of bariatric surgery in NAFLD patients at high risk of developing liver cirrhosis (ii) the role of bariatric surgery in modulation of complications of NAFLD like diabetes and cardiovascular disease. The outcomes of the future research will determine whether bariatric surgery will be one of the recommended choice for treatment of the most progressive type of NAFLD.

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Efeito da perda ponderal induzida pela cirurgia bariátrica sobre a prevalência de síndrome metabólica

Abstract: SummaryBackground: Metabolic Syndrome (MS) is often linked to overweight/obesity and can improve after weight loss, such improvement is expected to be proportional to the intensity of weight loss.

Cited by 19 publications

References 22 publications

Excess body mass index loss predicts metabolic syndrome remission after gastric bypass

Excess body mass index loss predicts metabolic syndrome remission after gastric bypass

NAFLD as a continuum: from obesity to metabolic syndrome and diabetes

Bariatric Surgery as Potential Treatment for Nonalcoholic Fatty Liver Disease: A Future Treatment by Choice or by Chance?

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