QUALITY OF LIFE AND PSYCHOLOGICAL CHANGES IN BARIATRIC SURGERY: AN OBSERVATIONAL STUDY.

INTRODUCTION: Candidates for bariatric surgery may have psychiatric disorders that must be evaluated. The aim of this study was to describe the psychological state and quality of life (QoL) of patients with obesity awaiting bariatric surgery prior to surgical procedure and one year after surgery. METHODS: A longitudinal retrospective observational study was carried out in 71 patients awaiting bariatric surgery. Anthropometric data were collected, and the following were evaluated before and one year after the intervention: 44 patients were evaluated to rule out personality disorder, using the Salamanca Questionnaire of Personality Disorders; eating disorder, with the Bulimia Test of Edinburgh (BITE); depression, using the Beck Depression Inventory (BDI); and 71 patients were evaluated QoL, with the "Short Form Health Survey"(SF-36). RESULTS: A total of 34.1% (n=15) of patients presented personality disorder (Group B most frequent). 31.8% (n=14) obtained scores suggesting anomalous food behavior (6.8% n=3 severe). According to the BDI, 43.2% (n=19) showed low mood prior to the intervention. Lower scores were obtained when evaluating QoL for physical functioning (physical function:56.81±24.9; physical problems:66.76±37.64). One year after the intervention, QoL improved in those patients who underwent the sleeve gastrectomy (SG). CONCLUSIONS: Patients with bariatric surgery more frequently presented with Type B and C personalities. One year after bariatric surgery an improvement in QoL test was observed. Patients who underwent SG technique showed better mean scores than those after bilopancreatic diversion (BPD).

Impact of the rs822393 Variant on Adiponectin Levels and Metabolic Parameters after Weight Loss Secondary to a High-Fat Hypocaloric Diet with Mediterranean Pattern.

INTRODUCTION: The effects of the rs822393 variant of ADIPOQ gene on metabolic parameters such as insulin resistance and adiponectin levels following weight loss through dietary intervention are still uncertain. The aim of this study was to evaluate the role of rs822393 of ADIPOQ gene on adiponectin levels and metabolic parameters after weight loss with a high-fat hypocaloric diet with Mediterranean pattern during 12 weeks. METHODS: A population of 283 patients with obesity was allocated to a dietary intervention trial with a high-fat hypocaloric diet during 12 weeks. Adiposity and biochemical parameters were determined. rs822393 was assessed with a dominant model analysis (CC vs. CT + TT). RESULTS: These patients had three different genotypes: CC (59.0%), CT (33.6%), and TT (7.4%). The allelic frequencies for C and T were 0.89 and 0.20, respectively. Basal and post-intervention HDL cholesterol, adiponectin levels, and adiponectin/leptin ratio were lower in T-allele than non-T-allele carriers. After dietary intervention, BMI, weight, fat mass, waist circumference, systolic blood pressure, insulin, HOMA-IR, leptin, total cholesterol, and LDL cholesterol levels improved significantly in both genotype groups. Moreover, HDL cholesterol (CC vs. CT + TT) (delta: 8.9 ± 1.1 mg/dL vs. 1.7 ± 0.8 mg/dL; p = 0.02), serum adiponectin in non-T-allele carriers (43.1 ± 5.9 ng/dL vs. 2.8 ± 3 0.0 ng/dL; p = 0.01), and adiponectin/leptin ratio (1.37 ± 0.1 units vs. 0.17 ± 0.08 units; p = 0.02) improved only in non-T-allele carriers after weight loss. CONCLUSION: Individuals with obesity and without the T allele of rs822393 experienced improvements in adiponectin levels, adiponectin/leptin ratio, and HDL cholesterol levels after following a high-fat hypocaloric diet with a Mediterranean pattern.

Papel de la variante del promotor G308 del factor de necrosis tumoral α sobre el peso y parámetros metabólicos tras una dieta rica en grasas monoinsaturadas frente a una dieta rica en grasas poliinsaturadas / Role of G308 promoter variant of tumor necrosis factor alpha gene on weight loss and metabolic parameters after a high monounsaturated versus a high polyunsaturated fat hypocaloric diets

Background and objective: The aim of our study was to investigate the influence of G-308 promoter variant of the tumor necrosis factor (TNF) alpha gene on metabolic changes and weight loss secondary to a high monounsaturated fat vs a high polyunsaturated fat hypocaloric diet in obese subjects. Patients and method: A sample of 261 obese subjects were enrolled in a consecutive prospective way, from May 2011 to July 2012 in a tertiary hospital. In the basal visit, patients were randomly allocated during 3 months to Diet M (high monounsaturated fat hypocaloric diet) and Diet P (high polyunsaturated fat hypocaloric diet). Results: One hundred and ninety seven patients (73.2%) had the genotype G-308G and 64 (26.8%) patients had the genotype G-308A. There were no significant differences between the effects (on weight, body mass index (BMI), waist circumference, fat mass) in either genotype group with both diets. With the diet type P and in genotype G-308G, glucose levels (−6.7(22.1) mg/dl vs −3.7(2.2) mg/dl: p = 0.02), HOMA-R (−0.6(2.1) units vs −0.26(3.1) units: p = 0.01), insulin levels (−1.7(6.6) UI/L vs −0.6(7.1) UI/L: p = 0.009), total cholesterol levels (−15.3(31.1) mg/dl vs −8.4(22.1) mg/dl: p = 0.01), LDL cholesterol levels (−10.7(28.1) mg/dl vs −3.8(21.1) mg/dl: p = 0.008) and triglycerides (−12.1(52.1) mg/dl vs −6.6(43.1) mg/dl: p = 0.02) decreased. Conclusion: Carriers of the G-308G promoter variant of TNF alpha gene have a better metabolic response than A-308 obese with a high polyunsaturated fat hypocaloric diet (AU)

Fundamento y objetivo: El objetivo de este estudio es investigar la influencia de la variante G-308 del promotor del gen TNF-αsobre los cambios metabólicos y pérdida de peso secundaria a una dieta hipocalórica rica en grasas monoinsaturadas frente a una dieta rica en grasas poliinsaturadas. Pacientes y método: Una muestra de 261 obesos fue reclutada de una manera prospectiva consecutiva, desde mayo de 2011 a julio de 2012 en un hospital terciario. En la visita basal fueron aleatorizados a recibir las siguientes dietas durante al menos 3 meses: dieta M (rica en grasa monoinsaturada) y dieta P (rica en grasa poliinsaturada). Resultados: Ciento noventa y siete (73,2%) obesos presentaron el genotipo G-308G, y 64 (26,8%), el genotipo G-308A. No hubo diferencias significativas en la mejoría de peso, IMC, circunferencia de la cintura y masa grasa con ambas dietas y en ambos genotipos. Tras la dieta P y con el genotipo G-308G, los niveles de glucosa (−6,7 [22,1] vs. −3,7 [2,2] mg/dl; p = 0,02), HOMA-R (−0,6 [2,1] vs. −0,26 [3,1] unidades; p = 0,01), insulina (−1,7 [6,6] vs. −0,6 [7,1] UI/l; p = 0,009), colesterol total (−15,3 [31,1] vs. −8,4 [22,1] mg/dl; p = 0,01), colesterol LDL (−10,7 [28,1] vs. −3,8 [21,1] mg/dl; p = 0,008) y triglicéridos (−12,1 [52,1] mg/dl vs. −6,6 [43,1] mg/dl; p = 0,02) disminuyeron. Conclusión: Los portadores del genotipo G-308G presentan mayores beneficios metabólicos tras la pérdida de peso generada por la dieta rica en grasas poliinsaturadas (AU)

Visfatina en pacientes obesos, relación con factores de riesgo cardiovascular, un estudio tranversal / Visfatin in obese patients, relation with cardiovascular risk factors, a cross sectional study

Fundamento y objetivo: La obesidad y resistencia a la insulina se asocian con diferentes factores de riesgo cardiovascular. El objetivo de este estudio fue explorar la relación de la visfatina circulante con la resistencia a la insulina, factores de riesgo cardiovascular y antropometría en una muestra de pacientes obesos sin comorbilidad asociada. Pacientes y método: Una muestra de 270 pacientes ambulatorios con obesidad se analizó de manera prospectiva. A todos los pacientes se les realizó un análisis bioquímico (lipidograma, insulina, HOMA y visfatina) y una evaluación nutricional (ingesta dietética, antropometría convencional e impedanciometría). Resultados: Los pacientes fueron divididos en dos grupos por el valor de la mediana de visfatina (8,32 ng/ml): grupo I (pacientes con valores bajos, cuyo valor medio [DE] fue 7,11 [0,7] ng/ml) y grupo II (pacientes con valores altos, cuyo valor medio fue de 13,5 [10,1] ng/ml). Los pacientes en el grupo I tienen unos valores más elevados de indice de masa corporal, peso, circunferencia de la cintura, e indice cintura cadera. Los pacientes del grupo I presentan tambien unos valores más bajos de colesterol unido a lipoproteínas de baja densidad (colesterol LDL) y proteína C reactiva. El análisis de correlación mostró una correlación positiva entre los valores de visfatina y los de colesterol LDL (r=0,194; p<0,05) y proteína C reactiva (r=0,266; p<0,05) y una correlacion negativa con el peso (r=-0,162; p<0,05). En el análisis de regresión logística ajustado por sexo, edad e ingesta dietética con la variable dependiente visfatina (grupoII/I), permanecieron en el modelo el peso (odds ratio [OR] 0,97, intervalo de confianza del 95% [IC 95%] 0,95-0,99), colesterol LDL (OR 1,012, IC 95% 1,010-1,023) y la proteína C reactiva (OR 1,15, IC 95% 1,03-1,3). Conclusión: El colesterol LDL y los valores de proteína C reactiva se relacionan de manera positiva con los valores de visfatina, presentado el peso una relación negativa en pacientes obesos, de manera independiente ajustado por edad, sexo e ingesta dietética (AU)

Background and objective: Obesity and insulin resistance are associated with cardiovascular risk factors. The aim of the present study was to explore the relation of visfatin with insulin resistance, cardiovascular risk factors and anthropometry in obese patients without comorbidities. Patients and method: A population of 270 obese patients was analyzed in a prospective way. In all patients we performed a biochemical analysis (lipid profile, insulin, HOMA and visfatina), and a nutritional evaluation (dietary intake, conventional anthropometry and bioimpedance). Results: Patients were divided in two groups by median visfatin value (8,32 ng/ml), group I (patients with the low values, average value 7,11 (0,7) ng/ml) and group II (patients with the high values, average value 13,5 (10,1) ng/ml). Patients in the group I had higher weight, body mass index, waist circumference, and waist to hip ratio than patients in group II. Patients in group I had lower LDL-cholesterol and C reactive protein than patients in group II. Correlation analysis showed a positive correlation between visfatin levels and LDL cholesterol (r=0.194; p<0.05) and C reactive protein (r=0.266; p<0.05) and a negative corelation with weight (r=-0.162; p<0.05). In the logistic analysis with age-, sex- and dietary intake- adjusted basal visfatin concentration as a dependent variable, the next variables remained in the model; weight with an odds ratio (OR) 0,97 (IC95% 0,95-0,99), LDL cholesterol 1,012(1,010-1.023) and C reactive protein 1,15 (1.03-1.3). Conclusion: LDL cholesterol and c reactive protein levels are positively correlated with visfatin levels. Weight is negatively correlated with visfatin levels, in an independent way and adjusted by age, sex and dietary intake (AU)

Polimorfismo C358A de la enzima «amida hidrolasa de ácidos grasos» y los niveles de adipocitoquinas en obesos mórbidos / C358A polymorphism of the endocannabinoid degrading enzyme fatty acid amide hydrolase (FAAH) and adipocytokine levels in the morbidly obese

Introducción Se ha demostrado que el polimorfismo C358A de la amida hidrolasa de ácidos grasos (AHAG) se relaciona con la obesidad. EL objetivo de nuestro estudio fue evaluar la relación entre el polimorfismo (cDNA 385C->A) del gen de la amida hidrolasa de ácidos grasos parámetros antropométricos, factores de riesgo cardiovascular y niveles de adipocitoquinas en una muestra de pacientes con obesidad mórbida. Material y métodos Se analizó una muestra de 66 pacientes con obesidad mórbida. A todos los pacientes se les determinaron el peso, la presión arterial, glucemia en ayunas, lipoproteína (a), proteína C reactiva (PCR), insulina, colesterol total, colesterol LDL, colesterol HDL, triglicéridos y adipocitoquinas, así como el genotipo del polimorfismo C358A de AHAG. Resultados La edad de los pacientes fue de 48,0 (16,1) años, con un IMC de 44,4 (4,1), con un total de 17 varones (25,8%) y 49 mujeres (74,2%). Un total de 45 pacientes (8 varones/37 mujeres) (68,2%) presentaron un genotipo G358G (grupo salvaje) y 21 pacientes (4 varones/17 mujeres) G358A (31,8%) (grupo mutante).No se detectó ninguna diferencia significativa en los parámetros analizados entre ambos genotipos. Conclusión El polimorfismo de la AHAG no se relaciona con variables antropométricas, bioquímicas o concentraciones de adipocitoquinas en pacientes con obesidad mórbida (AU)

Introduction The 385 C/A polymorphism of fatty acid amide hydrolase (FAAH) has recently been demonstrated to be associated with overweight and obesity. The aim of our study was to investigate the association between missense polymorphism (cDNA 385 C->A) of the FAAH gene and anthropometric parameters, cardiovascular risk factors and adipocytokines in morbidly obese patients. Material and methods A sample of 66 morbidly obese patients was analyzed. In all patients, weight, blood pressure, fasting glycemia, lipoprotein(a), C-reactive protein, insulin, total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, triglyceride and adipocytokine levels, as well as the genotype of the C358A polymorphism of FAAH, were determined. Results The mean age was 48.0(16.1) years and the mean body mass index was 44.4 (4.1). There were 17 males (25.8%) and 49 females (74.2%). Forty-five patients (8 males/37 females) (68.2%) were G358G (wild genotype) and 21 patients (4 males/17 females) were G358A (31.8%) (mutant group). Biochemical, anthropometrical and adipocytokine levels showed no statistically significant differences between the two genotypes. Conclusion In patients with morbid obesity, the C358A polymorphism of FAAH was not associated with anthropometric parameters, biochemical markers or adipocytokine levels (AU)

Efectos de una dieta baja en grasas frente a una dieta rica en proteínas y grasa en pacientes obesos / The effects of a low-fat versus a low carbohydrate diet in obese adults

Fundamento y objetivo: el objetivo del estudio ha sido comparar el efecto de dos dietas sobre la pérdida de peso: una con alto contenido en grasa y proteínas, frente a otra con restricción de grasas. Pacientes y método: se incluyó en el estudio a un total de 74 pacientes obesos, a los que se asignó de forma aleatoria al grupo I (dieta de 1.500kcal/día; un 52% de hidratos de carbono, un 20% de proteínas y un 27% de grasas) o al grupo II, que debía seguir una dieta con alto contenido en grasas y proteínas (1.507kcal/día; un 38% de hidratos de carbono, un 26% de proteínas y un 36% de grasas). Antes de iniciar la dieta y a los 3 meses se determinaron: peso, presión arterial, glucemia en ayunas, proteína C reactiva, insulina, resistencia a la insulina, colesterol total, colesterol unido a lipoproteínas de baja densidad (cLDL), colesterol unido a lipoproteínas de alta densidad y triglicéridos. Resultados: se asignó de forma aleatoria a un total de 35 pacientes (4 varones y 31 mujeres) al grupo I y a 39 pacientes (6 varones y 33 mujeres) al grupo II. El grupo I experimentó una mejoría significativa de las siguientes variables: índice de masa corporal, peso, masa libre de grasa, masa grasa, agua corporal total y presión sistólica. En el grupo II se apreció una disminución significativa del índice de masa corporal, peso, masa grasa, masa magra, glucosa, colesterol toral, cLDL y presión sistólica. Las diferencias de las medias tras el tratamiento con ambas dietas no fueron significativas. Conclusiones: en este estudio no se han observado diferencias en la pérdida de peso de los pacientes obesos con una dieta restringida en grasa frente a una dieta rica en grasa y proteínas (AU)

Background and objective: The aim of our study was to compare the effect of a high fat and a high protein diet vs a fat restricted diet on weight loss in obese patients. Subjects and methods: A population of 74 obesity non diabetic outpatients was analyzed in a prospective way. Patients were randomly allocated to two groups: a) diet I (low fat diet: 1500kcal/day, 52% carbohydrates, 20% proteins, 27% fats) with a distribution of fats and b) diet II (high fat and high protein diet: 1507kcal/day, 38% carbohydrates, 26% proteins, 36% fats). After three months with diet, weight, blood pressure, glucose, C reactive protein, insulin, insulin resistance, total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides were evaluated. Results: There were randomized 35 patients (4 males and 31 females) in the group I and 39 patients (6 males and 33 females) in diet group II. In group I, systolic pressure, BMI, weight, fat free mass, fat mass total body water, intracellular body water and waist circumference decreased significantly. In group II, glucose, total cholesterol, LDL cholesterol, systolic blood, BMI, weight, fat mass, total body water and waist circumference decreased significantly. Differences among averages of parameters before treatment with both diets were not detected. Conclusions: No differences were detected on weight loss between a fat-restricted diet and a high fat and high protein enhanced diet (AU)