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1.
Surgeon ; 22(1): e26-e33, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37567846

RESUMO

BACKGROUND AND PURPOSE: Non-alcoholic fatty liver disease (NAFLD) has increasing worldwide prevalence, fuelled by rising obesity rates, and weight reduction is the mainstay of its management. We sought to study the effect of bariatric surgery, the most effective long-term treatment for obesity and associated metabolic disorders, on liver function in people with obesity. METHODS: We performed a retrospective longitudinal cohort study of 511 patients who had undergone bariatric surgery (71 sleeve gastrectomy and 440 gastric bypass) over 60 months of follow-up. Patients were stratified into groups based on their baseline alanine aminotransferase (ALT) into Group A (ALT < 40 U/L) and Group B (ALT > 40 U/L). Postoperative follow-up weight loss, liver function tests, HbA1c, blood pressure and lipid profiles were collected. FINDINGS: Bariatric surgery resulted in nadir total weight loss of 33.1% by 24 months (p < 0.001) with no significant difference between groups. In people with raised baseline ALT (Group B), ALT and gamma glutamyl transferase (GGT) levels decreased significantly by 4 months postoperatively (p < 0.001) and sustained over 60 months of follow-up. There was also significant and sustained reduction in HbA1c, blood pressure, total cholesterol, and non-HDL cholesterol overall with no differences between groups. CONCLUSIONS: Bariatric surgery results in significant weight loss, improves liver function tests and metabolic outcomes in people with obesity. Bariatric surgery could be a therapeutic consideration for patients with NAFLD associated with severe obesity who have otherwise been unresponsive to conservative management.


Assuntos
Cirurgia Bariátrica , Hepatopatia Gordurosa não Alcoólica , Obesidade Mórbida , Humanos , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/cirurgia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Estudos Retrospectivos , Hemoglobinas Glicadas , Estudos Longitudinais , Cirurgia Bariátrica/métodos , Obesidade Mórbida/complicações , Obesidade Mórbida/cirurgia , Alanina Transaminase , Gastrectomia/métodos , Redução de Peso/fisiologia , Colesterol , Resultado do Tratamento
2.
Int J Phytoremediation ; : 1-12, 2024 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-39189076

RESUMO

The article details a feasibility study of removing Brilliant Green (BG), a mutagenic dye from an aqueous solution by adsorption using low-cost coriander seed spent as a by-product in the nutraceutical industry. The study includes an analysis of the parameters that affect the adsorption process. The variables that have been identified include pH, dye concentration, process temperature, adsorbent amount, and particle size of the adsorbent. To obtain information on the adsorption process and to design the mechanism of the adsorption system on experimental equilibrium, 10 isotherm models, namely, Langmuir, Freundlich, Jovanovic, Dubinin-Radushkevich, Sips, Redlich-Peterson, Toth, Vieth-Sladek, Brouers-Sotolongo, and Radke-Prausnitz were applied. It was discovered that the experimental adsorption capacity, qe, was roughly 110 mg g-1. The result has a maximum adsorption of 136.17 mg g-1 as predicted by Dubinin-Radushkevich isotherm. Diffusion film models, Dumwald-Wagner and Weber-Morris models, and pseudo-first- and second-order models, were used to determine the adsorption kinetics. It was realized that the adsorption kinetics data fit into a pseudo-second-order model. Thermodynamic analysis with a reduced enthalpy change suggests a physical process. The values of the thermodynamic parameters ΔG0, ΔH0, and ΔS0 demonstrated an endothermic and nearly spontaneous process of adsorption. The small valuation of ΔH0 specifies that the process is physical. FTIR spectroscopy and SEM imaging were used to confirm that the BG dye had been adsorbing on the adsorbent surface. The study concludes that NICSS is an effective adsorbent to extract BG dye from wastewater solutions, offers insights into numerous dye and adsorbent interaction possibilities and indicates that the process can be scaled to fit into the concept of circular economy.


An attempt has been made to link the concept of circular economy through design and execution of the experiments in the laboratory scale. The following highlights will justify the newer approach adopted by the authors.The experiments are designed by intention to suit the concept of circular economy.The use of NICSS, a nutraceutical industrial spent, which has no feed, fertilizer, or fuel value suits the sustainability concept.The reuse of "waste" from the remediation process replaces the "end-of-life" concept in circular economy.

3.
Int J Mol Sci ; 24(23)2023 11 30.
Artigo em Inglês | MEDLINE | ID: mdl-38069302

RESUMO

Bariatric surgery improves dyslipidaemia and reduces body weight, but it remains unclear how bariatric surgery modulates gene expression in fat cells to influence the proprotein convertase subtilisin/kexin type 9 (PCSK-9) and low-density lipoprotein receptor (LDLR) gene expression. The expression of the PCSK9/LDLR/tumor necrosis factor-alpha (TNFα) gene in adipose tissue was measured in two groups of Zucker Diabetic Sprague Dawley (ZDSD) rats after Roux-en-Y gastric bypass (RYGB) surgery or 'SHAM' operation. There was lower PCSK9 (p = 0.02) and higher LDLR gene expression (p = 0.02) in adipose tissue in rats after RYGB. Weight change did not correlate with PCSK9 gene expression (r = -0.5, p = 0.08) or TNFα gene expression (r = -0.4, p = 0.1). TNFα gene expression was positively correlated with PCSK9 gene expression (r = 0.7, p = 0.001) but not correlated with LDLR expression (r = -0.3, p = 0.3). Circulating triglyceride levels were lower in RYGB compared to the SHAM group (1.1 (0.8-1.4) vs. 1.5 (1.0-4.2), p = 0.038) mmol/L with no difference in cholesterol levels. LDLR gene expression was increased post-bariatric surgery with the potential to reduce the number of circulating LDL particles. PCSK9 gene expression and TNFα gene expression were positively correlated after RYGB in ZDSD rats, suggesting that the modulation of pro-inflammatory pathways in adipose tissue after RYGB may partly relate to PCSK9 and LDLR gene expression.


Assuntos
Cirurgia Bariátrica , Diabetes Mellitus Experimental , Animais , Ratos , Tecido Adiposo/metabolismo , Diabetes Mellitus Experimental/genética , Diabetes Mellitus Experimental/cirurgia , Expressão Gênica , Inflamação/genética , Obesidade/genética , Obesidade/cirurgia , Pró-Proteína Convertase 9/genética , Pró-Proteína Convertases/genética , Ratos Sprague-Dawley , Ratos Zucker , Receptores de LDL/genética , Receptores de LDL/metabolismo , Serina Endopeptidases/metabolismo , Subtilisina/genética , Fator de Necrose Tumoral alfa/genética
4.
Int J Obes (Lond) ; 46(3): 605-612, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34857870

RESUMO

BACKGROUND: The incidence of endometrial cancer is rising in parallel with the obesity epidemic. Obesity increases endometrial cancer risk and weight loss is protective, but the underlying mechanisms are incompletely understood. We hypothesise that the immune microenvironment may influence susceptibility to malignant transformation in the endometrium. The aim of this study was to measure the impact of obesity and weight loss on the immunological landscape of the endometrium. METHODS: We conducted a prospective cohort study of women with class III obesity (body mass index, BMI ≥ 40 kg/m2) undergoing bariatric surgery or medically-supervised low-calorie diet. We collected blood and endometrial samples at baseline, and two and 12 months after weight loss intervention. Serum was analysed for inflammatory markers CRP, IL-6 and TNF-α. Multiplex immunofluorescence was used to simultaneously identify cells positive for immune markers CD68, CD56, CD3, CD8, FOXP3 and PD-1 in formalin-fixed paraffin-embedded endometrial tissue sections. Kruskal-Wallis tests were used to determine whether changes in inflammatory and immune biomarkers were associated with weight loss. RESULTS: Forty-three women with matched serum and tissue samples at all three time points were included in the analysis. Their median age and BMI were 44 years and 52 kg/m2, respectively. Weight loss at 12 months was greater in women who received bariatric surgery (n = 37, median 63.3 kg) than low-calorie diet (n = 6, median 12.8 kg). There were significant reductions in serum CRP (p = 3.62 × 10-6, r = 0.570) and IL-6 (p = 0.0003, r = 0.459), but not TNF-α levels, with weight loss. Tissue immune cell densities were unchanged except for CD8+ cells, which increased significantly with weight loss (p = 0.0097, r = -0.323). Tissue CD3+ cell density correlated negatively with systemic IL-6 levels (p = 0.0376; r = -0.318). CONCLUSION: Weight loss is associated with reduced systemic inflammation and a recruitment of protective immune cell types to the endometrium, supporting the concept that immune surveillance may play a role in endometrial cancer prevention.


Assuntos
Cirurgia Bariátrica , Neoplasias do Endométrio , Endométrio , Biomarcadores , Neoplasias do Endométrio/epidemiologia , Endométrio/imunologia , Feminino , Humanos , Vigilância Imunológica , Interleucina-6/metabolismo , Obesidade/complicações , Obesidade/cirurgia , Estudos Prospectivos , Microambiente Tumoral , Redução de Peso
5.
Ann Neurol ; 90(2): 312-314, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34114256

RESUMO

As of April 22, 2021, around 1.5 million individuals in three districts of Kerala, India had been vaccinated with COVID-19 vaccines. Over 80% of these individuals (1.2 million) received the ChAdOx1-S/nCoV-19 vaccine. In this population, during this period of 4 weeks (mid-March to mid-April 2021), we observed seven cases of Guillain-Barre syndrome (GBS) that occurred within 2 weeks of the first dose of vaccination. All seven patients developed severe GBS. The frequency of GBS was 1.4- to 10-fold higher than that expected in this period for a population of this magnitude. In addition, the frequency of bilateral facial weakness, which typically occurs in <20% of GBS cases, suggests a pattern associated with the vaccination. While the benefits of vaccination substantially outweigh the risk of this relatively rare outcome (5.8 per million), clinicians should be alert to this possible adverse event, as six out of seven patients progressed to areflexic quadriplegia and required mechanical ventilatory support. ANN NEUROL 2021;90:312-314.


Assuntos
Vacinas contra COVID-19/efeitos adversos , Síndrome de Guillain-Barré/induzido quimicamente , Síndrome de Guillain-Barré/diagnóstico , Adulto , Idoso , Vacinas contra COVID-19/administração & dosagem , ChAdOx1 nCoV-19 , Feminino , Síndrome de Guillain-Barré/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Respiração Artificial/tendências , Vacinação/efeitos adversos
6.
Clin Endocrinol (Oxf) ; 97(5): 664-675, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35274331

RESUMO

OBJECTIVE: Thyroid status in the months following radioiodine (RI) treatment for Graves' disease can be unstable. Our objective was to quantify frequency of abnormal thyroid function post-RI and compare effectiveness of common management strategies. DESIGN: Retrospective, multicentre and observational study. PATIENTS: Adult patients with Graves' disease treated with RI with 12 months' follow-up. MEASUREMENTS: Euthyroidism was defined as both serum thyrotropin (thyroid-stimulating hormone [TSH]) and free thyroxine (FT4) within their reference ranges or, when only one was available, it was within its reference range; hypothyroidism as TSH ≥ 10 mU/L, or subnormal FT4 regardless of TSH; hyperthyroidism as TSH below and FT4 above their reference ranges; dysthyroidism as the sum of hypo- and hyperthyroidism; subclinical hypothyroidism as normal FT4 and TSH between the upper limit of normal and <10 mU/L; and subclinical hyperthyroidism as low TSH and normal FT4. RESULTS: Of 812 patients studied post-RI, hypothyroidism occurred in 80.7% and hyperthyroidism in 48.6% of patients. Three principal post-RI management strategies were employed: (a) antithyroid drugs alone, (b) levothyroxine alone, and (c) combination of the two. Differences among these were small. Adherence to national guidelines regarding monitoring thyroid function in the first 6 months was low (21.4%-28.7%). No negative outcomes (new-onset/exacerbation of Graves' orbitopathy, weight gain, and cardiovascular events) were associated with dysthyroidism. There were significant differences in demographics, clinical practice, and thyroid status postradioiodine between centres. CONCLUSIONS: Dysthyroidism in the 12 months post-RI was common. Differences between post-RI strategies were small, suggesting these interventions alone are unlikely to address the high frequency of dysthyroidism.


Assuntos
Doença de Graves , Oftalmopatia de Graves , Hipertireoidismo , Hipotireoidismo , Adulto , Antitireóideos/uso terapêutico , Doença de Graves/radioterapia , Humanos , Hipertireoidismo/radioterapia , Hipotireoidismo/tratamento farmacológico , Radioisótopos do Iodo/uso terapêutico , Estudos Retrospectivos , Tireotropina , Tiroxina/uso terapêutico
7.
Surgeon ; 20(3): 137-141, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33863670

RESUMO

BACKGROUND AND OBJECTIVES: Weight loss is the mainstay of management for women with polycystic ovarian syndrome (PCOS). However, lifestyle and dietary modifications, and gastric banding have generally poor long-term efficacy. We aimed to investigate whether gastric bypass is equally efficacious in women with or without PCOS. METHODS: We performed a matched case-control study of primary Roux-en-Y gastric bypass surgery in women with PCOS (cases, n = 30) compared to women without PCOS (controls, n = 60) matched for baseline age, body mass index (BMI) and presence or absence of type 2 diabetes (T2D). Data shown represent mean values. RESULTS: At 24 months after surgery the 90 participants (age 36.1 years) experienced significant reductions in BMI (53.4 vs. 34.9 kg/m2, p < 0.0001), glycated haemoglobin (HbA1c) in 21 women with T2D (68.2 vs. 38.7 mmol/mol, p < 0.0001) and blood pressure (BP) in 29 women with hypertension (144/91 vs. 129/83 mmHg, p < 0.01), while obstructive sleep apnoea (OSA) resolved in 88.0% of the 25 affected patients. Women with PCOS compared to women without PCOS achieved equivalent reductions in percentage total weight loss (32.6% vs. 32.6% at 12 months and 34.8% vs. 36.1% at 24 months) and HbA1c (T2D subgroup; 38.3 vs. 41.6 mmol/mol at 12 months and 37.0 vs. 39.6 mmol/mol at 24 months) and comparable improvement in BP (hypertension subgroup) and resolution of OSA (87.5% vs. 88.2% at 24 months). CONCLUSION: In women with PCOS with morbid obesity, gastric bypass resulted in significant weight loss and metabolic outcomes similar to women without PCOS.


Assuntos
Diabetes Mellitus Tipo 2 , Derivação Gástrica , Hipertensão , Laparoscopia , Obesidade Mórbida , Síndrome do Ovário Policístico , Apneia Obstrutiva do Sono , Adulto , Índice de Massa Corporal , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/cirurgia , Feminino , Derivação Gástrica/métodos , Hemoglobinas Glicadas , Humanos , Hipertensão/cirurgia , Obesidade Mórbida/complicações , Obesidade Mórbida/cirurgia , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/cirurgia , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/cirurgia , Resultado do Tratamento , Redução de Peso
8.
Curr Opin Lipidol ; 32(4): 231-243, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34116544

RESUMO

PURPOSE OF REVIEW: Coronavirus Disease 2019 (COVID19) has caused significant global morbidity and mortality, especially in persons with underlying cardiovascular disease. There have been concerns that lipid-lowering therapy (LLT) increases angiotensin-converting enzyme 2 levels. Conversely, pleiotropic effects of statins can theoretically protect against severe COVID19 infection, supporting evidence from other respiratory illnesses in which statin use probably confers benefit. RECENT FINDINGS: There is an abundance of studies that show that statins are safe and potentially protect against severe COVID19 infection (critical illness and death), even when adjustment for potential confounders is undertaken. However, the evidence is limited to retrospective cohorts. The benefit for patients with diabetes is less clear. There is a paucity of evidence for other LLT agents. Available clinical guidelines recommend the ongoing use of LLT in patients with COVID19 (unless specifically contra-indicated) and the data from available studies support these. SUMMARY: In patients with COVID19 infection, LLT should be continued. However, the current findings need substantiating in larger prospective clinical studies with specific examination of the possible mechanisms by which LLT confers benefit from COVID19.


Assuntos
Aterosclerose/tratamento farmacológico , Tratamento Farmacológico da COVID-19 , Doenças Cardiovasculares/tratamento farmacológico , Dislipidemias/tratamento farmacológico , Aterosclerose/complicações , Aterosclerose/epidemiologia , Aterosclerose/virologia , COVID-19/complicações , COVID-19/epidemiologia , COVID-19/virologia , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/virologia , LDL-Colesterol/efeitos dos fármacos , Dislipidemias/complicações , Dislipidemias/epidemiologia , Dislipidemias/virologia , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipolipemiantes/uso terapêutico , SARS-CoV-2/patogenicidade
9.
J Lipid Res ; 62: 100043, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33093236

RESUMO

Roux-en-Y gastric bypass (RYGB) is one of the most commonly performed weight-loss procedures, but how severe obesity and RYGB affect circulating HDL-associated microRNAs (miRNAs) remains unclear. Here, we aim to investigate how HDL-associated miRNAs are regulated in severe obesity and how weight loss after RYGB surgery affects HDL-miRNAs. Plasma HDLs were isolated from patients with severe obesity (n = 53) before and 6 and 12 months after RYGB by immunoprecipitation using goat anti-human apoA-I microbeads. HDLs were also isolated from 18 healthy participants. miRNAs were extracted from isolated HDL and levels of miR-24, miR-126, miR-222, and miR-223 were determined by TaqMan miRNA assays. We found that HDL-associated miR-126, miR-222, and miR-223 levels, but not miR-24 levels, were significantly higher in patients with severe obesity when compared with healthy controls. There were significant increases in HDL-associated miR-24, miR-222, and miR-223 at 12 months after RYGB. Additionally, cholesterol efflux capacity and paraoxonase activity were increased and intercellular adhesion molecule-1 (ICAM-1) levels decreased. The increases in HDL-associated miR-24 and miR-223 were positively correlated with an increase in cholesterol efflux capacity (r = 0.326, P = 0.027 and r = 0.349, P = 0.017, respectively). An inverse correlation was observed between HDL-associated miR-223 and ICAM-1 at baseline. Together, these findings show that HDL-associated miRNAs are differentially regulated in healthy participants versus patients with severe obesity and are altered after RYGB. These findings provide insights into how miRNAs are regulated in obesity before and after weight reduction and may lead to the development of novel treatment strategies for obesity and related metabolic disorders.


Assuntos
Derivação Gástrica
10.
Int J Obes (Lond) ; 45(3): 631-638, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33504933

RESUMO

INTRODUCTION: Subjects with obesity have metabolic risk factors for nerve fibre damage. Because bariatric surgery improves these risk factors we have assessed whether this can ameliorate nerve fibre damage. METHODS: Twenty-six obese subjects without diabetes (age: 46.23 ± 8.6, BMI: 48.7 ± 1.5, HbA1c: 38.0 ± 4.5) and 20 controls (age: 48.3 ± 6.2, BMI: 26.8 ± 4.2, HbA1c: 39.1 ± 2.6) underwent detailed assessment of neuropathy at baseline and 12 months after bariatric surgery. RESULTS: Obese subjects had normal peroneal (45.9 ± 5.5 vs. 48.1 ± 4.5, P = 0.1) and sural (46.9 ± 7.6 vs. 47.9 ± 10.6, P = 0.1) nerve conduction velocity, but a significantly higher neuropathy symptom profile (NSP) (4.3 ± 5.7 vs. 0.3 ± 0.6, P = 0.001), vibration perception threshold (VPT) (V) (10.2 ± 6.8 vs. 4.8 ± 2.7, P < 0.0001), warm threshold (C°) (40.4 ± 3.5 vs. 37.2 ± 1.8, P = 0.003) and lower peroneal (3.8 ± 2.2 vs. 4.9 ± 2.2, P = 0.02) and sural (8.9 ± 5.8 vs. 15.2 ± 8.5, P < 0.0001) nerve amplitude, deep breathing-heart rate variability (DB-HRV) (beats/min) (21.7 ± 4.1 vs. 30.1 ± 14, P = 0.001), corneal nerve fibre density (CNFD) (n/mm2) (25.6 ± 5.3 vs. 32.0 ± 3.1, P < 0.0001), corneal nerve branch density (CNBD) (n/mm2) (56.9 ± 27.5 vs. 111.4 ± 30.7, P < 0.0001) and corneal nerve fibre length (CNFL) (mm/mm2) (17.9 ± 4.1 vs. 29.8 ± 4.9, P < 0.0001) compared to controls at baseline. In control subjects there was no change in neuropathy measures over 12 months. However, 12 months after bariatric surgery there was a significant reduction in BMI (33.7 ± 1.7 vs. 48.7 ± 1.5, P = 0.001), HbA1c (34.3 ± 0.6 vs. 38.0 ± 4.5, P = 0.0002), triglycerides (mmol/l) (1.3 ± 0.6 vs. 1.6 ± 0.8, P = 0.005) and low-density lipoprotein cholesterol (mmol/l) (2.7 ± 0.7 vs. 3.1 ± 0.9, P = 0.02) and an increase in high-density lipoprotein cholesterol (mmol/l) (1.2 ± 0.3 vs. 1.04 ± 0.2, P = 0.002). There was a significant improvement in NSP (1.6 ± 2.7 vs. 4.3 ± 5.7, P = 0.004), neuropathy disability score (0.3 ± 0.9 vs. 1.3 ± 2.0, P = 0.03), CNFD (28.2 ± 4.4 vs. 25.6 ± 5.3, P = 0.03), CNBD (64.7 ± 26.1 vs. 56.9 ± 27.5, P = 0.04) and CNFL (20.4 ± 1.2 vs. 17.9 ± 4.1, P = 0.02), but no change in cold and warm threshold, VPT, DB-HRV or nerve conduction velocity and amplitude. Increase in CNFD correlated with a decrease in triglycerides (r = -0.45, P = 0.04). CONCLUSION: Obese subjects have evidence of neuropathy, and bariatric surgery leads to an improvement in weight, HbA1c, lipids, neuropathic symptoms and deficits and small nerve fibre regeneration without a change in quantitative sensory testing, autonomic function or neurophysiology.


Assuntos
Cirurgia Bariátrica/estatística & dados numéricos , Córnea , Fibras Nervosas/fisiologia , Obesidade , Adulto , Estudos de Coortes , Córnea/inervação , Córnea/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Obesidade/cirurgia
11.
Diabetes Obes Metab ; 23(12): 2697-2706, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34402152

RESUMO

AIM: To assess the association of country-level obesity prevalence with COVID-19 case and mortality rates, to evaluate the impact of obesity prevalence on worldwide variation. METHODS: Data on COVID-19 prevalence and mortality, country-specific governmental actions, socioeconomic, demographic, and healthcare capacity factors were extracted from publicly available sources. Multivariable negative binomial regression was used to assess the independent association of obesity with COVID-19 case and mortality rates. RESULTS: Across 168 countries for which data were available, higher obesity prevalence was associated with increased COVID-19 mortality and prevalence rates. For every 1% increase in obesity prevalence, the mortality rate was increased by 8.3% (incidence rate ratio [IRR] 1.083, 95% confidence interval [CI] 1.048-1.119; P < 0.001) and the case rate was higher by 6.6% (IRR 1.066, 95% CI 1.035-1.099; P < 0.001). Additionally, higher median population age, greater female ratio, higher Human Development Index (HDI), lower population density, and lower hospital bed availability were all significantly associated with higher COVID-19 mortality rate. In addition, stricter governmental actions, higher HDI and lower mean annual temperature were significantly associated with higher COVID-19 case rate. CONCLUSION: These findings demonstrate that obesity prevalence is a significant and potentially modifiable risk factor of increased COVID-19 national caseload and mortality. Future research to study whether weight loss improves COVID-19 outcomes is urgently required.


Assuntos
COVID-19 , Feminino , Humanos , Incidência , Obesidade/complicações , Obesidade/epidemiologia , Densidade Demográfica , SARS-CoV-2
12.
Curr Opin Lipidol ; 31(4): 246-256, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32618731

RESUMO

PURPOSE OF REVIEW: Bariatric surgery is an effective therapy for morbid obesity that also improves weight-related metabolic parameters and reduces morbidity and mortality. The purpose of this review is to consolidate our current understanding of metabolic, macrovascular and microvascular benefits of bariatric surgery and to provide an update. RECENT FINDINGS: Early resolution of insulin resistance and type 2 diabetes mellitus (T2DM) varies by type of bariatric surgery and appears to be mediated by changes in secretion of gut hormones, metabolism of bile acids, expression of glucose transporters and the gut microbiome. Dyslipidaemia, atherosclerosis, microvascular complications of obesity and diabetes, systemic and tissue-level inflammation show evidence of regression and hypertension improves significantly after bariatric surgery. SUMMARY: Bariatric surgery leads to improvements in obesity-related metabolic comorbidities such as dyslipidaemia, HDL functionality, hypertension, T2DM, insulin resistance and inflammation. It slows the atherosclerotic process and reduces cardiovascular and all-cause mortality. Recent data have demonstrated regression of the microvascular complications of obesity and diabetes including the regeneration of small nerve fibres. The magnitude of change in short-term metabolic effects depends on the surgical procedure whilst longer term effects are related to the amount of sustained excess weight loss.


Assuntos
Cirurgia Bariátrica , Metabolismo , Animais , Doenças Cardiovasculares/epidemiologia , Comorbidade , Humanos , Obesidade/epidemiologia , Obesidade/metabolismo , Obesidade/cirurgia
13.
Int J Cancer ; 144(3): 641-650, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30289975

RESUMO

Obesity is the strongest risk factor for endometrial cancer (EC). To inform targeted screening and prevention strategies, we assessed the impact of obesity and subsequent bariatric surgery-induced weight loss on endometrial morphology and molecular pathways implicated in endometrial carcinogenesis. Blood and endometrial tissue were obtained from women with class III-IV obesity (body mass index ≥40 and ≥50 kg/m2 , respectively) immediately prior to gastric bypass or sleeve gastrectomy, and at two and 12 months' follow up. The endometrium underwent pathological examination and immunohistochemistry was used to quantify proliferation (Ki-67), oncogenic signaling (PTEN, pAKT, pERK) and hormone receptor (ER, PR) expression status. Circulating biomarkers of insulin resistance, reproductive function and inflammation were also measured at each time point. Seventy-two women underwent bariatric surgery. At 12 months, the mean change in total and excess body weight was -32.7 and -62.8%, respectively. Baseline endometrial biopsies revealed neoplastic change in 10 women (14%): four had EC, six had atypical hyperplasia (AH). After bariatric surgery, most cases of AH resolved (5/6) without intervention (3/6) or with intrauterine progestin (2/6). Biomarkers of endometrial proliferation (Ki-67), oncogenic signaling (pAKT) and hormone receptor status (ER, PR) were significantly reduced, with restoration of glandular PTEN expression, at 2 and 12 months. There were reductions in circulating biomarkers of insulin resistance (HbA1c, HOMA-IR) and inflammation (hsCRP, IL-6), and increases in reproductive biomarkers (LH, FSH, SHBG). We found an unexpectedly high prevalence of occult neoplastic changes in the endometrium of women undergoing bariatric surgery. Their spontaneous reversal and accompanying down-regulation of PI3K-AKT-mTOR signaling with weight loss may have implications for screening, prevention and treatment of this disease.


Assuntos
Cirurgia Bariátrica/métodos , Neoplasias do Endométrio/prevenção & controle , Obesidade/cirurgia , Adulto , Idoso , Biomarcadores/sangue , Estudos de Coortes , Neoplasias do Endométrio/sangue , Neoplasias do Endométrio/patologia , Endométrio/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Obesidade/sangue , Obesidade/patologia , Estudos Prospectivos , Adulto Jovem
17.
Int J Phytoremediation ; 20(11): 1075-1086, 2018 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-30156921

RESUMO

Dye pollutants from research laboratories are one of the major sources for environmental contamination. In the present study, a nutraceutical industrial fennel seed spent (NIFSS) was explored as potential adsorbent for removal of ethidium bromide (EtBr) from aqueous solution. The adsorbent was characterized by scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR). Through batch experiments, the operating variables like initial dye concentration, adsorbent dosage, temperature, contact time, and pH were optimized. Equilibrium data were analyzed using three number of two-parameter and six number of three-parameter isotherm models. The adsorption kinetics was studied using pseudo-first order and pseudo-second order. The diffusion effects were studied by film diffusion, Webber-Morris, and Dumwald-Wagner diffusion models. The thermodynamic parameters; change in enthalpy (ΔHº), entropy (ΔSº), and Gibbs free energy (ΔGº) of adsorption system were also determined and evaluated.


Assuntos
Foeniculum , Poluentes Químicos da Água/química , Adsorção , Biodegradação Ambiental , Suplementos Nutricionais , Etídio , Concentração de Íons de Hidrogênio , Cinética , Termodinâmica
19.
Int J Phytoremediation ; 19(7): 686-694, 2017 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-28121459

RESUMO

Fennel seed spent (FSS)-an inexpensive nutraceutical industrial spent has been used as an efficient biosorbent for the removal of Congo red (CR) from aqueous media. Results show that the conditions for maximum adsorption would be pH 2-4 and 30°C were ideal for maximum adsorption. Based on regression fitting of the data, it was determined that the Sips isotherm (R2 = 0.994, χ2 = 0.5) adequately described the mechanism of adsorption, suggesting that the adsorption occurs homogeneously with favorable interaction between layers with favorable interaction between layers. Thermodynamic analysis showed that the adsorption is favorable (negative values for ΔG°) and endothermic (ΔH° = 12-20 kJ mol-1) for initial dye concentrations of 25, 50, and 100 ppm. The low ΔH° value indicates that the adsorption is a physical process involving weak chemical interactions like hydrogen bonds and van der Waals interactions. The kinetics revealed that the adsorption process showed pseudo-second-order tendencies with the equal influence of intraparticle as well as film diffusion. The scanning electron microscopy images of FSS show a highly fibrous matrix with a hierarchical porous structure. The Fourier transform infrared spectroscopy analysis of the spent confirmed the presence of cellulosic and lignocellulosic matter, giving it both hydrophilic and hydrophobic properties. The investigations indicate that FSS is a cost-effective and efficient biosorbent for the remediation of toxic CR dye.


Assuntos
Biodegradação Ambiental , Vermelho Congo/química , Foeniculum , Poluentes Químicos da Água/química , Purificação da Água , Adsorção , Suplementos Nutricionais , Concentração de Íons de Hidrogênio , Cinética , Espectroscopia de Infravermelho com Transformada de Fourier , Temperatura , Termodinâmica
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