Percentage of excess BMI lost correlates better with improvement of metabolic syndrome after Roux-en-Y gastric bypass in morbidly obese subjects: anthropometric indexes and gastric bypass

Rossi, Marçal; Neto, Ary Serpa; Rossi, Felipe Martin Bianco; Amarante, Rodrigo Dal Moro; Alcântara, Geraldo Chaves; Silva, Renato Barretto Ferreira da; Regina, Paulo Fernando

doi:10.1016/j.soard.2008.08.002

Cited by 22 publications

(11 citation statements)

References 38 publications

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“…Our data showed that the %EBMIL and BMI were the best parameters for predicting MS remission, suggesting that in contrast to what is observed regarding diabetes, weight loss is a major determinant of MS remission in the clinical setting, as supported by previous studies [21]. The %EBMIL has been shown to be the best parameter to predict MS improvement in obese subjects after Roux-en-Y gastric bypass [45], while the resolution of MS was demonstrated to be independent of preoperative BMI [46]. …”

Section: Discussionsupporting

confidence: 73%

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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Section: Discussionsupporting

confidence: 73%

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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“…Most publications have concentrated on the gastric bypass [11][12][13][14][15]. Batsis et al [24] compared gastric bypass with medical management of the metabolic syndrome and found a significant difference at 12 months in favor of surgery (87% to 29% at 12 months), while medical management showed much less efficacy (85% to 75% at 12 months).…”

Section: Discussionmentioning

confidence: 99%

“…The efficacy of sleeve gastrectomy for weight loss has been shown [10]. Several articles have documented the efficacy of malabsorptive procedures with regard to metabolic comorbidities [11][12][13][14][15]. However, reports on the metabolic effects of sleeve gastrectomy are rare.…”

Section: Introductionmentioning

confidence: 99%

Efficiency of laparoscopic sleeve gastrectomy on metabolic syndrome disorders: Two years results

Péquignot¹,

Dhahri²,

Verhaeghe³

et al. 2012

Journal of Visceral Surgery

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“…Obesity is also associated with co-morbidities such as cardiovascular diseases, type 2 diabetes, sleep apnea, arthritis and cancers; the remission of many of which have been reported in patients after Roux-en-Y gastric bypass in morbidly obese subjects [1]. Consequently, the reduction of obesity-related morbidities is as important as the success of weight loss.…”

Section: Introductionmentioning

confidence: 99%

Consequences of Exchanging Carbohydrates for Proteins in the Cholesterol Metabolism of Mice Fed a High-fat Diet

et al. 2012

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Consumption of low-carbohydrate, high-protein, high-fat diets lead to rapid weight loss but the cardioprotective effects of these diets have been questioned. We examined the impact of high-protein and high-fat diets on cholesterol metabolism by comparing the plasma cholesterol and the expression of cholesterol biosynthesis genes in the liver of mice fed a high-fat (HF) diet that has a high (H) or a low (L) protein-to-carbohydrate (P/C) ratio. H-P/C-HF feeding, compared with L-P/C-HF feeding, decreased plasma total cholesterol and increased HDL cholesterol concentrations at 4-wk. Interestingly, the expression of genes involved in hepatic steroid biosynthesis responded to an increased dietary P/C ratio by first down-regulation (2-d) followed by later up-regulation at 4-wk, and the temporal gene expression patterns were connected to the putative activity of SREBF1 and 2. In contrast, Cyp7a1, the gene responsible for the conversion of cholesterol to bile acids, was consistently up-regulated in the H-P/C-HF liver regardless of feeding duration. Over expression of Cyp7a1 after 2-d and 4-wk H-P/C-HF feeding was connected to two unique sets of transcription regulators. At both time points, up-regulation of the Cyp7a1 gene could be explained by enhanced activations and reduced suppressions of multiple transcription regulators. In conclusion, we demonstrated that the hypocholesterolemic effect of H-P/C-HF feeding coincided with orchestrated changes of gene expressions in lipid metabolic pathways in the liver of mice. Based on these results, we hypothesize that the cholesterol lowering effect of high-protein feeding is associated with enhanced bile acid production but clinical validation is warranted. (246 words)

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Percentage of excess BMI lost correlates better with improvement of metabolic syndrome after Roux-en-Y gastric bypass in morbidly obese subjects: anthropometric indexes and gastric bypass

Cited by 22 publications

References 38 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

Efficiency of laparoscopic sleeve gastrectomy on metabolic syndrome disorders: Two years results

Consequences of Exchanging Carbohydrates for Proteins in the Cholesterol Metabolism of Mice Fed a High-fat Diet

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