Cardiovascular Risk Profile in Mediterranean Patients Submitted to Bariatric Surgery and Intensive Lifestyle Intervention: Impact of Both Interventions After 1 Year of Follow-Up

Sanchís, Pilar; Francés, Carla; Nicolau, Joana; Rivera, Rosmeri; Fortuny, Regina; Julian, Xavier; Pascual, Salvador; Gómez, L.; Rodrı́guez, Irene; Olivares, Josefina; Ayala, Luisa; Masmiquel, Luis

doi:10.1007/s11695-014-1321-z

Cited by 14 publications

(7 citation statements)

References 46 publications

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“…Considerable improvement of all lipid sub-fractions was observed during follow-up in our study, in line with other investigations[20,25,26]. The Swedish obese subject (SOS) study indicated that the incidence rate of hypertriglyceridemia was significantly lower in the surgically treated group than in the control group after two years[27].…”

Section: Discussionsupporting

confidence: 92%

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Effect of bariatric surgery on adiposity and metabolic profiles: A prospective cohort study in Middle-Eastern patients

Mazidi

Rezaie

Jangjoo

et al. 2017

WJD

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AIMTo investigate changes in adiposity and cardio-metabolic risk profile following Roux-en-Y gastric bypass in patients of Middle Eastern ethnicity with severe obesity.METHODSThis prospective cohort study involved 92 patients who met the indications of bariatric surgery. Post-procedure markers of obesity and cardiometabolic profile were monitored regularly for a year.RESULTSMean body mass index decreased by 29.5% from 41.9 to 29.5 kg/m2 between baseline and 12-mo follow-up, while mean fat mass decreased by 45.9% from 64.2 kg to 34.7 kg. An improvement was also observed in the gluco-metabolic profile with both fasting glucose and HbA1c substantially decreasing (P < 0.001).CONCLUSIONThe present study shows the short to medium term (1 year) health benefits of bariatric surgery for patients of Middle Eastern ethnicity.

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Section: Discussionsupporting

confidence: 92%

“…Consistent with our results, several studies have previously reported the beneficial effects of bariatric surgery on adiposity and cardio-metabolic profiles[18-20]. A prospective study conducted on 1156 severely obese participants in Utah reported that patients lost 27.7% of their initial body weight six years after RYGB surgery[21].…”

Section: Discussionsupporting

confidence: 91%

Effect of bariatric surgery on adiposity and metabolic profiles: A prospective cohort study in Middle-Eastern patients

Mazidi

Rezaie

Jangjoo

et al. 2017

WJD

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“…Additional searches of ClinicalTrials.gov and the reference list of included publications did not yield any further studies not included in the initial search. Of the 12 studies, 318 26 27 compared clinical outcomes in patients with HF undergoing bariatric surgery, 418 26 28 29 investigated heart function and morphology changes in patients with prevalent HF and 730–36 assessed incident HF in obese patients without HF prior to surgery.…”

Section: Resultsmentioning

confidence: 98%

Bariatric surgery among patients with heart failure: a systematic review and meta-analysis

et al. 2018

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BackgroundBariatric surgery reduces cardiovascular risk in obese patients. Heart failure (HF) is associated with an increased perioperative risk following bariatric surgery. This systematic review aimed to assemble the evidence on bariatric surgery in patients with known HF and the potential effect of bariatric surgery on incident HF in obese patients without prevalent HF.MethodsWe performed a comprehensive literature search up to 30 September 2017 and included studies comparing bariatric surgery to non-surgical treatment in patients with known presurgical HF. To assess whether bariatric surgery has any effect on incident HF, we also assembled studies looking at new-onset HF among patients without HF prior to surgery.ResultsWe found five observational studies (0 randomised trials) comparing bariatric surgery with non-surgical treatment in patients with a diagnosis of HF prior to surgery. A review of the available studies (n=676 patients) suggested reduced admission rates for HF exacerbation and increased left ventricular ejection fraction after bariatric surgery. No meta-analysis was possible due to the heterogeneous nature of these studies. Seven studies (one randomised trial) reported data on new-onset HF in obese patients without HF prior to bariatric surgery (n=111 127 patients). When comparing surgical to non-surgical treatment groups, the pooled univariable and multivariable HRs for incident HF were 0.28 (95% CI 0.13 to 0.55) and 0.44 (95% CI 0.36 to 0.55), respectively.ConclusionIn this systematic review, no randomised trial assessed the benefits and risks of bariatric surgery in obese patients with concomitant HF. Available studies do, however, show that surgery might prevent incident HF.

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“…Obesity and its associated co-morbidities are international public health concerns. As the prevalence of obesity has increased over the past decade, it has become clear that bariatric surgery can be more effective than diet and lifestyle interventions for weight loss and remediation of obesity-related morbidities [1–4] . Roux-en-Y gastric bypass (RYGB) is the most commonly performed bariatric surgery worldwide and involves physical reconstruction of the gastrointestinal tract [5] .…”

Section: Introductionmentioning

confidence: 99%

Activation of natriuretic peptides and the sympathetic nervous system following Roux-en-Y gastric bypass is associated with gonadal adipose tissues browning

Neinast

Frank

Zechner

et al. 2015

Molecular Metabolism

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ObjectiveRoux-en-Y gastric bypass (RYGB) is an effective method of weight loss and remediation of type-2 diabetes; however, the mechanisms leading to these improvements are unclear. Additionally, adipocytes within white adipose tissue (WAT) depots can manifest characteristics of brown adipocytes. These ‘BRITE/beige’ adipocytes express uncoupling protein 1 (UCP1) and are associated with improvements in glucose homeostasis and protection from obesity. Interestingly, atrial and B-type natriuretic peptides (NPs) promote BRITE/beige adipocyte enrichment of WAT depots, an effect known as “browning.” Here, we investigate the effect of RYGB surgery on NP, NP receptors, and browning in the gonadal adipose tissues of female mice. We propose that such changes may lead to improvements in metabolic homeostasis commonly observed following RYGB.MethodsWild type, female, C57/Bl6 mice were fed a 60% fat diet ad libitum for six months. Mice were divided into three groups: Sham operated (SO), Roux-en-Y gastric bypass (RYGB), and Weight matched, sham operated (WM-SO). Mice were sacrificed six weeks following surgery and evaluated for differences in body weight, glucose homeostasis, adipocyte morphology, and adipose tissue gene expression.ResultsRYGB and calorie restriction induced similar weight loss and improved glucose metabolism without decreasing food intake. β3-adrenergic receptor expression increased in gonadal adipose tissue, in addition to Nppb (BNP), and NP receptors, Npr1, and Npr2. The ratio of Npr1:Npr3 and Npr2:Npr3 increased in RYGB, but not WM-SO groups. Ucp1 protein and mRNA, as well as additional markers of BRITE/beige adipose tissue and lipolytic genes increased in RYGB mice to a greater extent than calorie-restricted mice.ConclusionsUpregulation of Nppb, Npr1, Npr2, and β3-adrenergic receptors in gonadal adipose tissue following RYGB was associated with increased markers of browning. This browning of gonadal adipose tissue may underpin the positive effect of RYGB on metabolic parameters and may in part be mediated through upregulation of natriuretic peptides.

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Cardiovascular Risk Profile in Mediterranean Patients Submitted to Bariatric Surgery and Intensive Lifestyle Intervention: Impact of Both Interventions After 1 Year of Follow-Up

Cited by 14 publications

References 46 publications

Effect of bariatric surgery on adiposity and metabolic profiles: A prospective cohort study in Middle-Eastern patients

Effect of bariatric surgery on adiposity and metabolic profiles: A prospective cohort study in Middle-Eastern patients

Bariatric surgery among patients with heart failure: a systematic review and meta-analysis

Activation of natriuretic peptides and the sympathetic nervous system following Roux-en-Y gastric bypass is associated with gonadal adipose tissues browning

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