Obesos diabéticos tipo 2 submetidos à derivação gástrica em Y-de-Roux: análise de resultados e influência nas complicações

Zeve, Jorge Luiz de Mattos; Tomaz, Carlos; Nassif, Paulo Afonso Nunes; Lima, João Henrique Felício de; Sansana, Luciana Regina Zeve; Zeve, Christiana Haddad

doi:10.1590/s0102-67202013000600011

Cited by 13 publications

(6 citation statements)

References 26 publications

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“…Overall, serum leptin levels mirrored the change in the epididymal fat pad weight. This was expected since leptin is mainly produced by adipose tissue and its circulating levels correlate with the amount of body fat [ 33 ]. Serum insulin levels appeared lower in diabetic rats compared to control or diet induced obese rats but the difference was not significant.…”

Section: Resultsmentioning

confidence: 99%

Rat Models of Diet-Induced Obesity and High Fat/Low Dose Streptozotocin Type 2 Diabetes: Effect of Reversal of High Fat Diet Compared to Treatment with Enalapril or Menhaden Oil on Glucose Utilization and Neuropathic Endpoints

Holmes

Coppey

Davidson

et al. 2015

Journal of Diabetes Research

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We examined whether reversal of high fat diet, stimulating weight loss, compared to two treatments previously shown to have beneficial effects, could improve glucose utilization and peripheral neuropathy in animal models of obesity and type 2 diabetes. Rats were fed a high fat diet and treated with a low dose of streptozotocin to create models of diet induced obesity or type 2 diabetes, respectively. Afterwards, rats were transferred to a normal diet or treated with enalapril or dietary enrichment with menhaden oil for 12 weeks. Obesity and to a greater extent type 2 diabetes were associated with impaired glucose utilization and peripheral neuropathy. Placing obese rats on a normal diet improved glucose utilization. Steatosis but not peripheral neuropathy was improved after placing obese or diabetic rats on a normal diet. Treating obese and diabetic rats with enalapril or a menhaden oil enriched diet generally improved peripheral neuropathy endpoints. In summary, dietary improvement with weight loss in obese or type 2 diabetic rats was not sufficient to correct peripheral neuropathy. These results further stress the need for discovery of a comprehensive treatment for peripheral neuropathy.

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Section: Resultsmentioning

confidence: 99%

Rat Models of Diet-Induced Obesity and High Fat/Low Dose Streptozotocin Type 2 Diabetes: Effect of Reversal of High Fat Diet Compared to Treatment with Enalapril or Menhaden Oil on Glucose Utilization and Neuropathic Endpoints

Holmes

Coppey

Davidson

et al. 2015

Journal of Diabetes Research

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“…120 Roux-en-Y Gastric Bypass surgery also improves polyneuropathy one year post-procedure. 121 These surgical intervention studies support the pathogenic role of obesity in both the CNS and PNS, but are not the treatment of choice due to the high prevalence of obesity worldwide. Performing invasive surgical procedures in a large population is also not practical, so feasible alternatives focused on lifestyle intervention are urgently needed.…”

Section: Neurological Benefits Of Targeting Obesitymentioning

confidence: 94%

Neurological consequences of obesity

O’Brien

Hinder

Callaghan

et al. 2017

The Lancet Neurology

349

230

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Obesity, primarily a consequence of poor dietary choices and an increased sedentary lifestyle, has become a global pandemic that brings with it enormous medical, social, and economic challenges. Not only does obesity increase the risk of cardiovascular disease and certain cancers, but it is also recognized as a key driver of other metabolic syndrome (MetS) components. These components include insulin resistance, hyperglycemia with prediabetes or type 2 diabetes, dyslipidemia, and hypertension, and are underlying contributors to systemic metabolic dysfunction. More recently, obesity and diet-induced metabolic dysfunction have been identified as risk factors for the development of a wide variety of neurological disorders in both the central and peripheral nervous systems. An abundance of literature has shown that obesity is associated with mild cognitive impairment and altered hippocampal structure and function, and there is a robust correlation between obesity and Alzheimer’s type dementia. Similarly, many reports show that both the autonomic and somatic components of the peripheral nervous system are impacted by obesity. The autonomic nervous system, under control of the hypothalamus, displays altered catabolic and anabolic processes in obese individuals attributed to sympathetic-parasympathetic imbalances. A close association also exists between obesity and polyneuropathy, a complication most commonly found in prediabetic and diabetic patients, and is likely secondary to a combination of obesity-induced dyslipidemia with hyperglycemia. This review will outline the pathophysiological development of obesity and dyslipidemia, discuss the adverse impact of these conditions on the nervous system, and provide evidence for lipotoxicity and metabolic inflammation as the drivers underlying the neurological consequences of obesity. In addition, this review will examine the benefits of lifestyle and surgical interventions in obesity-induced neurological disorders.

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“…Em contrapartida, a cirurgia bariátrica vem se tornando uma alternativa para a redução de peso naqueles com IMC >35 kg/m2 com comorbidades ou IMC e"40 kg/m 2 . Diversos estudos têm mostrado resultados promissores no controle e melhora da glicemia em grandes obesos submetidos à cirurgia para redução de peso 2,7-10, [14][15][16][17] .…”

Section: Discussionunclassified

“…A glicemia média pré operatória foi de 132 mg/dl diminuindo para 91,6 mg/dl com dois meses de pós operatório. Semelhante aconteceu com a HbA1c a qual reduziu de 7% para 5% após 60 dias da intervenção cirúrgica 17 .…”

Section: Discussionunclassified

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Avaliação Do Controle Glicêmico E Ponderal Em Grandes Obesos Diabéticos: Um Estudo Comparativo Da Intervenção Clínica E Cirúrgica

Silva

Martins

Oliveira³

et al. 2017

Rev. Cient. Fac. Med Campos

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O Diabetes Mellitus do tipo 2 é um transtorno metabólico caracterizado por hiperglicemia crônica de elevada morbimortalidade. O objetivo do estudo foi comparar o controle glicêmico do Diabetes Mellitus do tipo 2 por meio da intervenção do tratamento clínico e da cirurgia bariátrica, em 20 pacientes, de ambos os sexos e idade na faixa entre 20 a 65 anos, com IMC ≥ 35 kg/m2, em Campos dos Goytacazes, RJ, em 2016. Para isso, foram analisadas a resposta ao controle glicêmico, laboratorialmente, com seguimento mínimo de 3 meses. Resultados: Do total (n=20) de ambos os grupos, observou-se que a maioria são mulheres (65%) e a maioria dos pacientes situaram-se entre 24 a 65 anos. Em relação à avaliação da glicemia de jejum, todos os pacientes do grupo cirúrgico conseguiram reduzir o nível glicêmico para abaixo de 126 mg/dl na pós intervenção, em contrapartida aos 60% no grupo clínico. Observou-se que 88,9% dos pacientes do grupo cirúrgico tiveram uma melhora dos níveis de HbA1c (<7%), em contrapartida, 50% dos pacientes do grupo clínico mantiveram valores acima do ideal (≥7%) após o retorno de 3 meses. Observou-se uma redução do IMC do grupo cirúrgico (média IMC= 35,2 kg/m2 ± 1,1), seguindo uma média de IMC de 37,7kg/m2 ± 3,8 do grupo clínico após retorno. O grupo cirúrgico obteve melhor controle ponderal e da glicemia na pós-intervenção do que o grupo clínico, ao observar os parâmetros de: glicemia em jejum, HbA1C e IMC.

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Obesos diabéticos tipo 2 submetidos à derivação gástrica em Y-de-Roux: análise de resultados e influência nas complicações

Abstract: Gastric bypass with Roux-en-Y derivation is a safe procedure, with good results in control of diabetes type 2 in obese patients with BMI above 35 kg/m2.

Cited by 13 publications

References 26 publications

Rat Models of Diet-Induced Obesity and High Fat/Low Dose Streptozotocin Type 2 Diabetes: Effect of Reversal of High Fat Diet Compared to Treatment with Enalapril or Menhaden Oil on Glucose Utilization and Neuropathic Endpoints

Rat Models of Diet-Induced Obesity and High Fat/Low Dose Streptozotocin Type 2 Diabetes: Effect of Reversal of High Fat Diet Compared to Treatment with Enalapril or Menhaden Oil on Glucose Utilization and Neuropathic Endpoints

Neurological consequences of obesity

Avaliação Do Controle Glicêmico E Ponderal Em Grandes Obesos Diabéticos: Um Estudo Comparativo Da Intervenção Clínica E Cirúrgica

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