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Nutrients Jan 2023Bariatric surgery (BS) is usually considered when other weight-loss treatments have failed, and remains an effective long-term treatment for severe obesity and its...
Bariatric surgery (BS) is usually considered when other weight-loss treatments have failed, and remains an effective long-term treatment for severe obesity and its related medical complications [...].
Topics: Humans; Obesity, Morbid; Obesity; Bariatric Surgery; Weight Loss
PubMed: 36771222
DOI: 10.3390/nu15030515 -
Osteoarthritis and Cartilage Oct 2021
Topics: Bariatric Surgery; Data Interpretation, Statistical; Humans; Obesity, Morbid; Osteoarthritis; Pain Management
PubMed: 34339823
DOI: 10.1016/j.joca.2021.07.004 -
Frontiers in Endocrinology 2020An association between hypothyroidism and the risk of Non-alcoholic Fatty Liver Disease (NAFLD) has been suggested. This association remains to be elucidated in patients...
BACKGROUND
An association between hypothyroidism and the risk of Non-alcoholic Fatty Liver Disease (NAFLD) has been suggested. This association remains to be elucidated in patients with morbid obesity.
AIM
To evaluate the association between thyroid function and parameters of liver function and hepatic scores in patients with morbid obesity.
METHODS
Patients with morbid obesity followed in our center between January 2010 and July 2018 were included. The ones without evaluation of liver and thyroid functions were excluded. (FLI) and BARD scores were used as predictors of hepatic steatosis and fibrosis, respectively.
RESULTS
We observed a positive association between TSH and both BARD (OR 1.14; p = 0.035) and FLI (OR 1.19; p = 0.010) in the unadjusted analysis. We found a negative association between free triiodothyronine levels and BARD (OR 0.70; p<0.01) and a positive association between free triiodothyronine levels and FLI (OR 1.48; p = 0.022). Concerning liver function, we found a positive association between total bilirubin and free thyroxine levels (β = 0.18 [0.02 to 0.35]; p = 0.033) and a negative association between total bilirubin and free triiodothyronine levels (β = -0.07 [-0.14 to -0.002]; p = 0.042).
CONCLUSION
Higher levels of TSH and free triiodothyronine may be associated with a higher risk of NAFLD, particularly steatosis, in patients with morbid obesity.
Topics: Adult; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Non-alcoholic Fatty Liver Disease; Obesity, Morbid; Thyroid Gland; Thyroid Hormones; Thyrotropin
PubMed: 33193088
DOI: 10.3389/fendo.2020.572128 -
Frontiers in Endocrinology 2022Glycine is a dietary non-essential amino acid that is low in obesity and increases following bariatric surgery. However, the exact mechanism responsible remains unclear...
BACKGROUND
Glycine is a dietary non-essential amino acid that is low in obesity and increases following bariatric surgery. However, the exact mechanism responsible remains unclear and it is unknown whether hypoglycinemia is a cause or consequence of insulin resistance.
OBJECTIVE
Using multiple isotopically labeled tracers, we aimed to determine the underlying kinetic changes responsible for hypoglycinemia in obesity by: 1) Comparing glycine kinetics between participants with morbid obesity (BMI ≥ 32.5 kg/m) to those with healthy weight (BMI < 25 kg/m), and 2) Comparing glycine kinetic changes in participants with morbid obesity after bariatric surgery.
METHODS
[1,2-C] glycine, [2,3,3-H] serine, and [H] phenylalanine were infused to compare the glycine kinetic parameters between 21 participants with morbid obesity and 21 controls with healthy weight. Participants with morbid obesity then underwent bariatric surgery and 17 were re-studied 6 months later. Data were analyzed by non-parametric methods and presented as median (interquartile range).
RESULTS
Compared to controls, participants with morbid obesity had significantly lower plasma glycine concentrations at 163 (153-171) vs. 201 (172-227) µmol/L and significantly reduced glycine synthesis rate at 86.2 (64.5-111) vs.124 (103-159) µmol·kg LBM·h, p < 0.001. Following surgery, body weight and insulin resistance decreased and this was accompanied by significant increases in plasma glycine concentration to 210 (191-243) µmol/L as well as the glycine synthesis rate to 127 (98.3-133) µmol·kg LBM·h, p < 0.001 vs. baseline.
CONCLUSION
Hypoglycinemia in participants with morbid obesity was associated with impaired glycine synthesis. The increase in plasma glycine concentration and glycine synthesis plus the marked improvement in insulin resistance after bariatric surgery suggest that hypoglycinemia may be secondary to impaired glycine synthesis because of obesity-induced insulin resistance.
CLINICAL TRIAL REGISTRATION
[https://tinyurl.com/6wfj7yss], identifier [NCT04660513].
Topics: Adult; Amino Acids; Bariatric Surgery; Glycine; Humans; Insulin Resistance; Obesity, Morbid
PubMed: 35757406
DOI: 10.3389/fendo.2022.900343 -
Pulmonology 2021In the conventional management of the morbidly obese that normalizes the apnea-hypopnea index (AHI), CO2 levels often remain elevated.
BACKGROUND
In the conventional management of the morbidly obese that normalizes the apnea-hypopnea index (AHI), CO2 levels often remain elevated.
METHODS
A retrospective review of morbidly obese patients using volume preset settings up to 1800ml to positive inspiratory pressures (PIPs) of 25-55cm H2O, or pressure control at 25-50cm H2O pressure via noninvasive interfaces up to continuously (CNVS).
RESULTS
Twenty-six patients, mean 55.6±14.8 years of age, weight 108-229kg, mean BMI 56.1 (35.5-77)kg/m, mean AHI 69.0±24.9, depended on up to CNVS for 3 weeks to up to 66 years. There were eleven extubations and seven decannulations to CNVS despite failure to pass spontaneous breathing trials. Thirteen were CNVS dependent for 92.2 patient-years with little to no ventilator free breathing ability (VFBA). Six used NVS from 10 to 23h a day, and others only for sleep. Fifteen patients with cough peak flows (CPF) less than 270L/m had access to mechanical insufflation-exsufflation (MIE) in the peri-extubation/decannulation period and long-term. The daytime end-tidal (Et)CO2 of 14 who were placed on sleep NVS without extubation or decannulation to it decreased from mean EtCO2 61.0±9.3-38.5±3.6mm Hg and AHI normalized to 2.2. Blood gas levels were normal while using NVS/CNVS. Pre-intubation PaCO2 levels, when measured, were as high as 183mm Hg before extubation to CNVS.
CONCLUSIONS
Ventilator unweanable morbidly obese patients can be safely extubated/decannulated and maintained indefinitely using up to CNVS rather than resort to tracheotomies.
Topics: Adult; Carbon Dioxide; Female; Humans; Male; Middle Aged; Obesity, Morbid; Respiration, Artificial; Respiratory Insufficiency; Retrospective Studies; Ventilator Weaning
PubMed: 33446455
DOI: 10.1016/j.pulmoe.2020.12.003 -
Clinical Cardiology Apr 2022Real-world data on atrial fibrillation (AF) ablation outcomes in obese populations have remained scarce, especially the relationship between obesity and in-hospital AF...
BACKGROUND
Real-world data on atrial fibrillation (AF) ablation outcomes in obese populations have remained scarce, especially the relationship between obesity and in-hospital AF ablation outcome.
HYPOTHESIS
Obesity is associated with higher complication rates and higher admission trend for AF ablation.
METHODS
We drew data from the US National Inpatient Sample to identify patients who underwent AF ablation between 2005 and 2018. Sociodemographic and patients' characteristics data were collected, and the trend, incidence of catheter ablation complications and mortality were analyzed, and further stratified by obesity classification.
RESULTS
A total of 153 429 patients who were hospitalized for AF ablation were estimated. Among these, 11 876 obese patients (95% confidence interval [CI]: 11 422-12 330) and 10 635 morbid obese patients (95% CI: 10 200-11 069) were observed. There was a substantial uptrend admission, up to fivefold, for AF ablation in all obese patients from 2005 to 2018 (p < .001). Morbidly obese patients were statistically younger, while coexisting comorbidities were substantially higher than both obese and nonobese patients (p < .01) Both obesity and morbid obesity were significantly associated with an increased risk of total bleeding, and vascular complications (p < .05). Only morbid obesity was significantly associated with an increased risk of ablation-related complications, total infection, and pulmonary complications (p < .01). No difference in-hospital mortality was observed among obese, morbidly obese, and nonobese patients.
CONCLUSION
Our study observed an uptrend in the admission of obese patients undergoing AF ablation from 2005 through 2018. Obesity was associated with higher ablation-related complications, particularly those who were morbidly obese.
Topics: Atrial Fibrillation; Catheter Ablation; Hospitals; Humans; Obesity, Morbid; Postoperative Complications; Risk Factors; Treatment Outcome
PubMed: 35170775
DOI: 10.1002/clc.23795 -
Current Obesity Reports Sep 2017In recent years, the role of the gastrointestinal (GI) tract in energy homeostasis through modulation of the digestion and absorption of carbohydrates and the production... (Review)
Review
PURPOSE OF REVIEW
In recent years, the role of the gastrointestinal (GI) tract in energy homeostasis through modulation of the digestion and absorption of carbohydrates and the production of incretin hormones is well recognized.
RECENT FINDINGS
Bariatric surgery for obesity has been a very effective method in substantially improving weight, and numerous studies have focused on intestinal adaptation after bariatric procedures. A number of structural and functional changes in the GI tract have been reported postsurgery, which could be responsible for the altered hormonal responses. Furthermore, the change in food absorption rate and the intestinal regions exposed to carbohydrates may affect blood glucose response. This review hopes to give new insights into the direct role of gut hormones, by summarising the metabolic effects of bariatric surgery.
Topics: Bariatric Surgery; Gastrointestinal Hormones; Humans; Obesity, Morbid; Weight Loss
PubMed: 28780756
DOI: 10.1007/s13679-017-0276-5 -
Nutricion Hospitalaria Feb 2016
Topics: Adolescent; Adult; Anthropometry; Bariatric Surgery; Blood Pressure; Body Mass Index; Exercise Therapy; Female; Humans; Male; Middle Aged; Obesity, Morbid; Physical Fitness; Quality of Life; Treatment Outcome; Weight Loss; Young Adult
PubMed: 27019243
DOI: 10.20960/nh.v33i1.16 -
Nutricion Hospitalaria Mar 2016
Topics: Adolescent; Adult; Body Mass Index; Exercise Therapy; Female; Humans; Male; Middle Aged; Nutritional Status; Obesity; Obesity, Morbid; Physical Fitness; Young Adult
PubMed: 27238789
DOI: 10.20960/nh.107 -
Journal of Pediatric Nursing 2021Severe obesity, defined as a body mass index (BMI) ≥120th percent of the 95th BMI percentile for age and sex, is the fastest growing subcategory of obesity among...
PURPOSE
Severe obesity, defined as a body mass index (BMI) ≥120th percent of the 95th BMI percentile for age and sex, is the fastest growing subcategory of obesity among youth, yet little is known about how this group understands and incorporates weight management strategies. The aims of this study were to explore how parents and adolescents understand severe obesity and incorporate management into their daily lives and evaluate the applicability of the Family Management Styles Framework (FMSF) to better understand the impact of severe obesity for adolescents.
DESIGN AND METHODS
Directed content analysis grounded in a modified version of the FMSF was used to analyze one-time in-home face-to-face interviews with adolescents aged 12-17 years (N = 14) who received pediatric weight management care and a parent (N = 17).
RESULTS
Both adolescents and parents described the day-to-day management as challenging and impactful to parent-child and sibling relationships. They described the need for sustained support and coaching in meeting daily physical activity requirements and related stories of weight stigma experienced. Further, parents' and adolescents' views were mostly congruent, except in their view of effectiveness of daily routines and how family attitudes and actions did or did not support the adolescent.
CONCLUSIONS
The FMSF was successfully applied to understand family management of adolescents with severe obesity. These adolescents have complex physical and psychological needs impacting effective weight management and family life.
PRACTICE IMPLICATIONS
Technology interventions should be considered to improve physiological and psychological outcomes for youth with severe obesity.
Topics: Adolescent; Body Mass Index; Humans; Obesity, Morbid; Parents; Pediatric Obesity; Social Stigma
PubMed: 34218134
DOI: 10.1016/j.pedn.2021.06.016