MANAGEMENT OF ENDOCRINE DISEASE: Metabolic effects of bariatric surgery

Corcelles, Ricard; Daigle, Christopher R.; Schauer, Philip R.

doi:10.1530/eje-15-0533

Cited by 30 publications

(12 citation statements)

References 89 publications

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“…The theoretical concerns regarding whether there is an effect of GH treatment on neoplasia were addressed in recently published position papers (20, 21, 22). These concerns may also apply to LAGH.…”

Section: Safety Considerations Unique To Laghmentioning

confidence: 99%

Growth Hormone Research Society perspective on the development of long-acting growth hormone preparations

Christiansen

Backeljauw

Bidlingmaier

et al. 2016

European Journal of Endocrinology

112

147

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ObjectiveThe Growth Hormone (GH) Research Society (GRS) convened a workshop to address important issues regarding trial design, efficacy, and safety of long-acting growth hormone preparations (LAGH).ParticipantsA closed meeting of 55 international scientists with expertise in GH, including pediatric and adult endocrinologists, basic scientists, regulatory scientists, and participants from the pharmaceutical industry.EvidenceCurrent literature was reviewed for gaps in knowledge. Expert opinion was used to suggest studies required to address potential safety and efficacy issues.Consensus processFollowing plenary presentations summarizing the literature, breakout groups discussed questions framed by the planning committee. Attendees reconvened after each breakout session to share group reports. A writing team compiled the breakout session reports into a draft document that was discussed and revised in an open forum on the concluding day. This was edited further and then circulated to attendees from academic institutions for review after the meeting. Participants from pharmaceutical companies did not participate in the planning, writing, or in the discussions and text revision on the final day of the workshop. Scientists from industry and regulatory agencies reviewed the manuscript to identify any factual errors.ConclusionsLAGH compounds may represent an advance over daily GH injections because of increased convenience and differing phamacodynamic properties, providing the potential for improved adherence and outcomes. Better methods to assess adherence must be developed and validated. Long-term surveillance registries that include assessment of efficacy, cost-benefit, disease burden, quality of life, and safety are essential for understanding the impact of sustained exposure to LAGH preparations.

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Section: Safety Considerations Unique To Laghmentioning

confidence: 99%

Growth Hormone Research Society perspective on the development of long-acting growth hormone preparations

Christiansen

Backeljauw

Bidlingmaier

et al. 2016

European Journal of Endocrinology

112

147

View full text Add to dashboard Cite

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“…Surgical restructuring of the gut referred to as “bariatric” or “metabolic” surgery includes a number of approaches that were originally focused on weight loss and were designed to either reduce the nutrient load or limit absorption by the small intestine. While these procedures restructure the gut in various ways, all of them result in comorbid disease remission including T2DM[ 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 ] and MetS,[ 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 ] even if at a variable rate and durability[ 29 35 38 40 48 60 61 62 63 64 65 66 67 68 69 70 71 ] though remission has been reported in a number of publications to be durable[ 34 36 38 72 73 ] and immediate prior to significant weight loss. [ 74 75 76 77 78 79 ]…”

Section: Bariatric Surgery Impact On Hepatic Omentioning

confidence: 99%

Metabolic syndrome and the hepatorenal reflex

Wider

2016

Surg Neurol Int

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Insufficient hepatic O2 in animal and human studies has been shown to elicit a hepatorenal reflex in response to increased hepatic adenosine, resulting in stimulation of renal as well as muscle sympathetic nerve activity and activating the renin angiotensin system. Low hepatic ATP, hyperuricemia, and hepatic lipid accumulation reported in metabolic syndrome (MetS) patients may reflect insufficient hepatic O2 delivery, potentially accounting for the sympathetic overdrive associated with MetS. This theoretical concept is supported by experimental results in animals fed a high fructose diet to induce MetS. Hepatic fructose metabolism rapidly consumes ATP resulting in increased adenosine production and hyperuricemia as well as elevated renin release and sympathetic activity. This review makes the case for the hepatorenal reflex causing sympathetic overdrive and metabolic syndrome in response to exaggerated splanchnic oxygen consumption from excessive eating. This is strongly reinforced by the fact that MetS is cured in a matter of days in a significant percentage of patients by diet, bariatric surgery, or endoluminal sleeve, all of which would decrease splanchnic oxygen demand by limiting nutrient contact with the mucosa and reducing the nutrient load due to the loss of appetite or dietary restriction.

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“…Numerous other factors have been implicated as potential contributors to the metabolic improvement observed after bariatric surgery, including other intestinal gut hormones (GLP-2, PYY), ghrelin (an anorexic hormone secreted by the gastric fundus), adipokines, the increased energy expenditure following surgery, changes in the gut microbiome, and bile acid metabolism (31).…”

Section: Discussionmentioning

confidence: 99%