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1.
Food Chem ; 455: 140147, 2024 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-38905783

RESUMEN

Plasma-activated seawater (PASW) presents a promising approach for marine fish preservation, yet its antimicrobial efficacy and mechanisms remain unclear. This study found that PASW exhibits superior bactericidal properties against the fish spoilage bacterium Shewanella putrefaciens compared to plasma-activated water (PAW), and increased effectiveness in preserving fish fillets. To clarify the mechanisms, a detailed investigation was conducted, including the generation of reactive oxygen/nitrogen species (ROS/RNS) and active halogen species in PASW, and their antimicrobial efficacy. Findings showed greater nitrite and hydrogen peroxide production in PASW relative to PAW, as well as the conversion of chloride/bromide ions into active species, which collectively enhanced PASW's antimicrobial activity. The synergistic action of ROS/RNS and active chlorine/bromine species in PASW promoted the generation of intracellular ROS, causing increased membrane damage, redox imbalance, and consequently higher bacterial mortality. This study enhances our understanding of PASW's antimicrobial effects and highlights its potential applications in the seafood industry.


Asunto(s)
Antibacterianos , Peces , Agua de Mar , Shewanella putrefaciens , Shewanella putrefaciens/efectos de los fármacos , Shewanella putrefaciens/metabolismo , Shewanella putrefaciens/crecimiento & desarrollo , Animales , Agua de Mar/microbiología , Agua de Mar/química , Antibacterianos/farmacología , Antibacterianos/química , Peces/microbiología , Especies Reactivas de Oxígeno/metabolismo , Conservación de Alimentos/métodos , Alimentos Marinos/microbiología , Alimentos Marinos/análisis , Gases em Plasma/farmacología
2.
Diabetes Obes Metab ; 2024 Jun 25.
Artículo en Inglés | MEDLINE | ID: mdl-38924605

RESUMEN

AIM: To investigate the relationship between thyroid function and weight regain in patients with obesity after metabolic surgery. METHODS: This retrospective study enrolled 162 patients who underwent metabolic surgery. Correlations between decreases in thyroid hormone levels and changes in weight, waist circumference (WC) and the Chinese visceral adiposity index (CVAI) were assessed. Binary logistic regression and receiver operating characteristic (ROC) curves were used to identify predictors and clinically useful cut-off values, respectively. RESULTS: The levels of thyroid-stimulating hormone (TSH) and free triiodothyronine (FT3) decreased markedly at 1 year after surgery, as did weight, body mass index (BMI), triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, WC and CVAI. Decreases in TSH and FT3 after metabolic surgery were associated with changes in weight, BMI and CVAI. Binary logistic regression and ROC curve analyses confirmed that decreases in TSH can predict good weight loss after metabolic surgery to some extent. Finally, binary logistic regression and ROC curve analyses confirmed that changes in TSH can predict weight regain after metabolic surgery. CONCLUSIONS: Changes in TSH and FT3 after metabolic surgery were correlated with changes in weight and CVAI. Changes in thyroid hormones can predict weight regain in patients with obesity who underwent metabolic surgery.

3.
Food Chem ; 450: 139276, 2024 Aug 30.
Artículo en Inglés | MEDLINE | ID: mdl-38626711

RESUMEN

This study presents a new method combining cold plasma-activated oxygen (CPAO) and microwave (MW) to decontaminate milkshake powder, exploring its effectiveness, mechanisms, and quality impact. CPAO (6 min) alone reduced bacterial load by 0.419 log CFU/g, and MW (3 min) by 0.030 log CFU/g. However, their co-application significantly amplified decontamination, achieving a 1.265 log CFU/g reduction. CPAO-MW co-treatment inflicted more oxidative damage on bacterial cell membranes and intracellular antioxidant defense system, leading to higher mortality. It also raised protein and lipid oxidation, while decreasing vitamin C and A levels in the powder. Specifically, CPAO (6 min)-MW (3 min) co-treatment increased the carbonyl content from 0.438 to 0.891 nmol/mg protein, malondialdehyde from 0.824 to 0.996 mg/kg, and lowered vitamin C from 162.151 to 137.640 mg/kg, and vitamin A from 2.05 to 1.38 mg/kg. This study shows CPAO-MW is effective for decontaminating powdered foods but highlights a need to reduce negative effects.


Asunto(s)
Descontaminación , Microondas , Oxígeno , Gases em Plasma , Polvos , Descontaminación/métodos , Polvos/química , Gases em Plasma/farmacología , Gases em Plasma/química , Oxígeno/metabolismo , Animales
4.
J Sci Food Agric ; 104(7): 4226-4233, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38299755

RESUMEN

BACKGROUND: Dried shrimp is a high-value fishery product worldwide, but rapid and accurate assessment of its quality remains challenging. In the present study, a new method based on Raman spectroscopy was developed for assessing the quality changes in dried shrimp (Parapenaeopsis hardwickii) during storage. RESULTS: A high-quality Raman spectrum of astaxanthin (AST) was obtained from the third abdominal segment of dried shrimp. The intensity ratio (I1520/I1446) of the band from 1520 cm-1 to that at 1446 cm-1, which was ascribed to AST and protein/lipid, respectively, was calculated. I1520/I1446 can probe AST degradation in dried shrimp during storage at both 37 and 4 °C and further reflect quality changes of dried shrimp, as indicated by indices including total volatile basic nitrogen, pH and thiobarbituric acid reactive substances. CONCLUSION: Compared to conventional methods, the proposed method avoids complex and time-consuming preprocessing and provides significant advantages including cost-effectiveness and rapid detection. © 2024 Society of Chemical Industry.


Asunto(s)
Penaeidae , Espectrometría Raman , Animales , Alimentos Marinos , Xantófilas/química , Penaeidae/química
5.
Metabolism ; 152: 155743, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38007149

RESUMEN

The gut has been increasingly recognized in recent years as a pivotal organ in the maintenance of glucose homeostasis. Specifically, the profound and enduring improvement in glucose metabolism achieved through metabolic surgery to modify the anatomy of the gut has prompted scholars to acknowledge that the most effective strategy for treating type 2 diabetes mellitus (T2DM) involves the gut. The mechanisms underlying the regulation of glucose metabolism by the gut encompass gut hormones, bile acids, intestinal gluconeogenesis, gut microbiota, and signaling interactions between the gut and other organs (liver, brain, adipose, etc.). Recent studies have also revealed a novel phenomenon of glucose lowering through the gut: metabolic surgery and metformin promote the excretion of glucose from the circulation into the intestinal lumen by enterocytes. However, there is still limited understanding regarding the underlying mechanisms of intestinal glucose excretion and its contribution to glycemic control. This article reviews current research on intestinal glucose excretion while focusing on its role in T2DM management as well as potential mechanisms.


Asunto(s)
Diabetes Mellitus Tipo 2 , Derivación Gástrica , Humanos , Glucosa/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Control Glucémico , Intestinos
6.
J Hazard Mater ; 465: 133282, 2024 03 05.
Artículo en Inglés | MEDLINE | ID: mdl-38142652

RESUMEN

Aged microplastics (MPs) in the environment are a growing concern due to their higher ecological toxicity compared to pristine MPs. While previous studies have explored aging behaviors of MPs under various stress conditions, little is known about their aging during food processing. In this study, we investigated the effects of different thermal food processing methods on the aging of polystyrene (PS) MPs within mussels. We subjected the mussels containing PS MPs to boiling, boiling/solar drying, boiling/hot air drying, and boiling/microwave drying treatments, all of which are common preservation methods used in industry. We analyzed the particle size, surface morphology, yellowing, crystallinity, chemical groups, and hydrophilicity of the PS MPs to understand the aging process. Results show that all processing methods led to aging of PS MPs, with boiling/microwave drying having the most significant impact, followed by boiling/hot air drying, boiling/solar drying, and boiling alone. The aged PS MPs exhibited smaller size, morphological changes, reduced crystallinity, increased yellowness index and carbonyl index, higher presence of O-containing groups, and enhanced hydrophilicity. These findings provide evidence of MPs aging during thermal food processing and emphasize the potential risks associated with this pathway.


Asunto(s)
Mytilus , Contaminantes Químicos del Agua , Animales , Microplásticos/metabolismo , Poliestirenos/metabolismo , Plásticos/metabolismo , Contaminantes Químicos del Agua/análisis , Envejecimiento
7.
Obes Surg ; 33(10): 3051-3061, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37561268

RESUMEN

BACKGROUND: Bariatric surgery (BS) is known to improve the components of metabolic syndrome (MS) in patients with obesity. However, few studies have evaluated the effect of BS on patients with MS at low BMI levels. The study aims to assess the effect of BS on MS in patients with low BMI by comparing BS with medical therapy (MT). METHODS: A total of 271 patients with MS who underwent BS and MT at a single institution were reviewed in this retrospective cohort study. A 1:1 propensity score matching was performed for the BS and MT groups with BMI<35 kg/m2. We analyzed the 5 years effect of BS versus MT on the remission of MS, its components, atherosclerotic cardiovascular disease (ASCVD) risk, and medication used. RESULTS: Patients in the MT group showed a decrease in the prevalence of MS to 62% at the 1st year and 10% at the 5th year. In the BS group, MS prevalence in patients with BMI<35 kg/m2 decreased to 30% and 9% at the 1st and 5th year, whereas in patients with BMI≥35 kg/m2 was 26% and 7%, respectively. The 10-year ASCVD risk and the lifetime ASCVD were significantly decreased 5 years after BS in patients with BMI<35 kg/m2. The number and daily drug dose of hypoglycemic drugs, antihypertensive medications, and lipid-lowering drugs were reduced from baseline in both BS and MT groups. CONCLUSION: Bariatric surgery significantly improves MS remission rates and long-term cardiovascular risk in Chinese patients with metabolic syndrome and a BMI <35 kg/m2.


Asunto(s)
Aterosclerosis , Cirugía Bariátrica , Síndrome Metabólico , Obesidad Mórbida , Humanos , Aterosclerosis/epidemiología , Índice de Masa Corporal , Pueblos del Este de Asia , Síndrome Metabólico/epidemiología , Obesidad Mórbida/cirugía , Puntaje de Propensión , Estudios Retrospectivos , Pérdida de Peso
9.
Food Chem ; 412: 135480, 2023 Jun 30.
Artículo en Inglés | MEDLINE | ID: mdl-36731231

RESUMEN

Shucking is an indispensable step in the preparation of cooked mussel products, as it facilitates the detachment of meat from the shell. In this study, we comprehensively investigated the effects of boiling, steaming, and microwaving on taste constituents in half-cooked mussel meat. Two-dimensional correlation spectroscopy revealed the key differential taste components of the different shucking groups. Structural equation modeling (SEM) indicated the positive effects of saltiness and bitterness on umami taste, while sweetness and sourness had negative effects on umami taste in half-cooked mussel meat. Furthermore, Glu, Asp, Ala, Arg, betaine, malic acid, succinic acid, glycogen, Cl-, Na+, K+, and PO3- 4 were quantitatively determined as the main taste compounds. The steaming shelling group had the most enriched taste components, with the highest equivalent umami concentration compared to the other shelling groups. Hence, steaming shucking may be favored due to abundant tastes and nutrients.


Asunto(s)
Mytilus , Gusto , Animales , Percepción del Gusto , Carne/análisis , Culinaria
10.
Food Chem ; 403: 134387, 2023 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-36358095

RESUMEN

An interesting phenomenon that plasma-activated water (PAW) treatment reduced the malonaldehyde (MDA) content in muscle foods was observed in both previous reports and the present study. However, the mechanism remains unclear. To clarify the theoretical basis of this phenomenon, the main reactive components in PAW were determined, and the changes in the fatty acid profile in tuna muscle after PAW treatment were analyzed. The results showed that the MDA content reduction upon PAW treatment was not due to the inhibition of lipid oxidation. To mimic the possible reaction of the components in PAW with MDA, individual hydrogen peroxide, nitrite, and nitrate or their mixture solution were added into MDA standard and tuna muscle. The results showed that the reaction of nitrite in PAW with MDA occurred during its measurement processes caused its reduction. The results in this work fully explained why PAW treatment reduced the MDA content in muscle foods.


Asunto(s)
Nitritos , Purificación del Agua , Malondialdehído , Nitratos , Músculos
12.
Food Chem ; 389: 132972, 2022 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-35500412

RESUMEN

In this study, the degradation of myoglobin both in solution and in tuna muscle by cold plasma (CP) was investigated through ultraviolet-visible and fluorescence spectroscopy analysis, and the effect of the degradation products on lipid oxidation in washed turbot muscle (WTM) was explored. Results showed that heme in myoglobin was degraded upon CP treatment, from which a fluorescent product was formed and iron was released. The degradation products promoted lipid oxidation in WTM during cold storage, in which the released iron played an important role. Results of gas chromatography-ion mobility spectrometry analysis showed that the contents of 37 volatile compounds in WTM were increased by heme degradation products induced lipid oxidation, including 20 aldehydes, 9 alcohols, 5 ketones and 3 furans. This study provides a new insight to the mechanism of lipid oxidation in CP-treated fish during cold storage, as well as guidance for preserving myoglobin-containing foods with CP.


Asunto(s)
Mioglobina , Gases em Plasma , Animales , Peces/metabolismo , Cromatografía de Gases y Espectrometría de Masas/métodos , Hemo/metabolismo , Hemina/metabolismo , Hierro/análisis , Lípidos/análisis , Músculos/metabolismo , Mioglobina/química , Oxidación-Reducción , Estrés Oxidativo
13.
Food Chem ; 377: 131932, 2022 May 30.
Artículo en Inglés | MEDLINE | ID: mdl-34999450

RESUMEN

In this study, the main reactive oxygen/nitrogen species (ROS/RNS) in cold plasma treated air (CPTA) were determined, and their effects on lipid oxidation, fatty acid composition and volatile profile in dry-cured black carp were investigated. Results showed that ozone (O3) and nitrogen dioxide (NO2) were the main ROS/RNS, both of which were in a few mg/m3 to tens mg/m3. Increased peroxide value (POV), thiobarbituric acid reactive substances (TBARS) and 4-hydroxy-2-nonenal (HNE) level indicated CPTA promoted lipid oxidation in samples. The contents of unsaturated fatty acids (UFA) especially polyunsaturated fatty acids (PUFA) in samples after CPTA exposure were decreased significantly. Volatile analysis by headspace-gas chromatography-ion mobility spectrometry (HS-GC-IMS) and headspace solid-phase microextraction-gas chromatography-mass spectrometry (HS-SPME-GC-MS) showed that CPTA exposure promoted the formation of characteristic volatile flavor compounds in dry-cured black carp via facilitating the oxidation of UFA. This work provides new ideas for the application of cold plasma in food processing.


Asunto(s)
Carpas , Gases em Plasma , Compuestos Orgánicos Volátiles , Animales , Cromatografía de Gases y Espectrometría de Masas , Lípidos , Microextracción en Fase Sólida , Compuestos Orgánicos Volátiles/análisis
14.
Surg Obes Relat Dis ; 18(4): 475-483, 2022 04.
Artículo en Inglés | MEDLINE | ID: mdl-34969592

RESUMEN

BACKGROUND: Reducing the risk of death due to cardiovascular disease (CVD) is an important direction for diabetes prevention and treatment. The Chinese population with type 2 diabetes (T2D) has a high risk of developing CVD at relatively low body mass index (BMI) levels. Currently, no studies have evaluated the effect of bariatric surgery versus medical therapy on long-term CVD risk in patients with T2D and low BMI. OBJECTIVES: To compare bariatric surgery versus medical therapy for long-term CVD risk in Chinese patients with T2D and low BMI by using the China Prediction for ASCVD Risk equations and the United Kingdom Prospective Diabetes Study risk engine. SETTING: University hospital, China. METHODS: Medical records of patients with T2D with a BMI <35 kg/m2 undergoing bariatric surgery or medical therapy from May 2010 to December 2018 were reviewed. A 1:1 propensity score matching was performed by using 7 preoperative characteristics. Variables for calculating CVD risk scores over the 5-year follow-up were assessed. RESULTS: A total of 684 patients with T2D underwent bariatric surgery (n = 75) or medical therapy (n = 609), and 52 pairs of matched subjects were selected from both groups after propensity score matching. The 10-year and lifetime atherosclerotic CVD risk by using the China Prediction for ASCVD Risk equation at 5 years follow-up period in the bariatric surgery group improved significantly compared with the medical therapy group. In the fifth year of follow-up, the 10-year risk of coronary heart disease, fatal coronary heart disease, stroke, and fatal stroke by using the United Kingdom Prospective Diabetes Study risk engine were much lower in the bariatric surgery group than in the medical therapy group (10.37 ± 5.64% versus 27.25 ± 7.28%, P = .004; 6.3 ± 4.5% versus 22.3 ± 7.35%, P = .002; 4.97 ± 3.73% versus 15.05 ± 3.63%, P = .001; .59 ± .45% versus 1.52 ± .14%, P < .001. respectively). The use of glucose-lowering medications, including insulin, was reduced from baseline in both groups, and patients in the bariatric surgery group required significantly fewer of these medications than those in the medical therapy group. CONCLUSION: Bariatric surgery in patients with T2D and low BMI conferred a lower calculated risk of CVD compared with medical therapy over 5 years of follow-up.


Asunto(s)
Cirugía Bariátrica , Enfermedades Cardiovasculares , Enfermedad Coronaria , Diabetes Mellitus Tipo 2 , Accidente Cerebrovascular , Índice de Masa Corporal , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/prevención & control , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/epidemiología , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Puntaje de Propensión , Estudios Prospectivos , Estudios Retrospectivos , Factores de Riesgo , Pérdida de Peso
15.
Food Microbiol ; 98: 103686, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33875196

RESUMEN

This study aimed to achieve deeper insights into the microbiota composition and dynamic succession of the dry-cured black carp during storage using a high-throughput sequencing technique (HTS). The effect of lipid oxidation on microorganisms was also evaluated. Over 651 bacterial genera belonging to 37 phyla were identified. Firmicutes, Proteobacteria and Actinobacteria were the main bacterial phylum, some are highly associated with meat spoilage. Staphylococcus, Macrococcus and Acinetobacter were the most three microbial genera throughout the entire storage period (30 days). Between two different storage temperature, refrigeration at 4 °C could facilitate maintaining the microbial diversity, while 25 °C storage led to the formation of dominant microflora and the reduction of community diversity. Canonical correspondence analysis (CCA) showed that acid value (AV), malondialdehyde (MDA) and 4-hydroxy-2-hexenal (HHE) contents were three key environmental factors (oxidation products) affecting the profile of the microbiota. Staphylococcus presented a positive correlation with HHE content, while Macrococcus and Acinetobacter were negatively correlated with HHE content. These results could expand our knowledge on the effect of lipid oxidation on change of microbial distribution, it could also present an guideline to develop advanced storage methods for the vacuum packed dry-cured fish products.


Asunto(s)
Bacterias/aislamiento & purificación , Productos Pesqueros/microbiología , Lípidos/química , Microbiota , Animales , Bacterias/clasificación , Bacterias/genética , Bacterias/metabolismo , Biodiversidad , Carpas/microbiología , Productos Pesqueros/análisis , Microbiología de Alimentos , Embalaje de Alimentos/instrumentación , Embalaje de Alimentos/métodos , Almacenamiento de Alimentos , Secuenciación de Nucleótidos de Alto Rendimiento , Oxidación-Reducción , Refrigeración , Vacio
16.
Wideochir Inne Tech Maloinwazyjne ; 16(1): 129-138, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33786126

RESUMEN

INTRODUCTION: Although laparoscopic Roux-en-Y gastric bypass (RYGB) is still widely accepted as a valid procedure in the treatment of obesity and type 2 diabetes mellitus (T2DM), there continues to be a significant controversy about how long the Roux and biliopancreatic limb should be bypassed for optimum results. AIM: To assess the effect of a longer biliopancreatic limb (BPL) length on glycemic control after RYGB in T2DM patients. MATERIAL AND METHODS: Eighty-four patients with uncontrolled T2DM who underwent RYGB between May 2010 and April 2017 were collected from the prospectively designed database. Forty patients (S-BPL group) received BPL lengths ≤ 50 cm, including 30 cm (n = 1), 40 cm (n = 1), and 50 cm (n = 38). Forty-four patients (L-BPL group) received 100 cm BPL. Anthropometry, serum glucose and lipid metabolic parameters were measured at baseline and 1, 3, 6, 12, 24 and 36 months after surgery. RESULTS: Comparing the two groups, there were no significant differences in anthropometric and biochemical measures, except the weight and body mass index, which were higher in the S-BPL group (85.91 ±20.32 vs. 76.25 ±16.99, p = 0.038; 31.87 ±6.61 vs. 28.7 ±4.29, p = 0.005) compared to the L-BPL group. The body weight, glucose and lipid metabolic parameters decreased over time and then remained essentially stable from the first year in both groups. Two years after surgery, the remission (HbA1c% ≤ 6%) of T2DM was 31.2% in the S-BPL group and 37.5% in the L-BPL group (p = 0.685). CONCLUSIONS: With consistent total small bowel bypass (AL + BPL) lengths, lengthening of the BPL from 30 to 100 cm did not affect the post-RYGB glycemic control and weight loss.

18.
Surg Obes Relat Dis ; 17(3): 498-507, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33358863

RESUMEN

BACKGROUND: In recent years, many reports have highlighted that metabolic surgery may ameliorate the cardiovascular risk in morbidly obese patients with or without type 2 diabetes (T2D). However, few studies have evaluated the long-term cardiovascular disease (CVD) risk after metabolic surgery in T2D patients with a low body mass index (BMI). OBJECTIVES: To use the Prediction for ASCVD Risk in China (China-PAR) equations and United Kingdom Prospective Diabetes Study (UKPDS) risk engine to assess the 10-year CVD risk in low-BMI T2D patients after metabolic surgery. SETTING: University hospital, China. METHODS: We retrospectively reviewed our prospectively collected data of T2D patients who underwent metabolic surgery at our hospital between 2010 and 2018. We included patients who met the criteria for calculating a 10-year cardiovascular risk score by the China-PAR equations and UKPDS risk engine. Demographic characteristics, anthropometric variables, and glycolipid metabolic parameters were assessed preoperatively and during a 4-year follow-up period. Patients with a BMI < 30 kg/m2 were compared with those with a BMI > 30 kg/m2. RESULTS: We evaluated 117 patients, of whom 62 (53%) had a BMI < 30 kg/m2 and 55 (47%) had a BMI > 30 kg/m2. Patients with a BMI < 30 kg/m2 were significantly older and had a longer duration of diabetes. The rate of complete T2D remission in the group of patients with BMIs < 30 kg/m2 was significantly lower than that in the group with BMIs > 30 kg/m2 (35.2% versus 56.1%, respectively; P = .042). The overall 10-year and lifetime atherosclerotic cardiovascular disease risks were reduced from 4.2% to 2.3% and 25.3% to 13.9%, respectively (both P < .05), at 1 year postoperatively using the China-PAR equation. The overall 10-year coronary heart disease (CHD) and fatal CHD risks were reduced by 48.1% and 53.1%, respectively, at 1 year after surgery using the UKPDS risk engine. The advantages of metabolic surgery in reducing CVD risks are similar in both BMI groups, whether using the China-PAR equation or the UKPDS risk engine. CONCLUSION: The 10-year CVD risk in T2D patients with BMIs < 30 kg/m2 and BMIs > 30 kg/m2 were significantly reduced after metabolic surgery, although the rate of complete T2D remission T2Din patients with BMIs < 30 kg/m2 was lower than that in patients with BMIs > 30 kg/m2. The China-PAR equation is a reliable and useful clinical tool for CVD risk evaluation in Chinese patients after metabolic surgery.


Asunto(s)
Cirugía Bariátrica , Enfermedades Cardiovasculares , Diabetes Mellitus Tipo 2 , Obesidad Mórbida , Índice de Masa Corporal , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , China/epidemiología , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Humanos , Obesidad Mórbida/complicaciones , Obesidad Mórbida/cirugía , Estudios Prospectivos , Estudios Retrospectivos , Factores de Riesgo , Reino Unido
19.
Obes Surg ; 31(2): 805-812, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33063158

RESUMEN

BACKGROUND: Visceral Adiposity Index (VAI) is considered to be a reliable indicator for evaluation of visceral adipose dysfunction and cardiovascular disease risk. However, no previous studies have reported the VAI variation after bariatric surgery and the predictive effect of preoperative VAI on diabetes remission. The aim of this study is to evaluate whether preoperative VAI is useful to predict diabetes remission in low BMI Chinese patients after bariatric surgery. METHODS: Eighty-seven type 2 diabetes mellitus patients with BMI < 35 kg/m2 underwent bariatric surgery from May 2010 to March 2018 in our hospital. VAI, glycolipid metabolic parameters, and anthropometric variables were measured before and 4 years after surgery. Complete remission was defined as follows: HbA1c < 6%, FPG < 5.6 mmol/L, achieved without anti-diabetic medication. Analysis included using binary logistic regression to identify predictors and ROC curves to determine clinically useful cutoff values. RESULTS: Seventy-four patients (85.1%) underwent Roux-en-Y gastric bypass (RYGB), while the remaining 13 patients (14.9%) underwent sleeve gastrectomy (SG). Patients' weight, glycemic control, and lipid profiles were improved significantly after surgery (p < 0.05). Complete remission of T2DM was found in 35 patients (40.2%) 1 year after surgery. VAI decreased from baseline 4.41 to 1.74 in 3 months after surgery (p < 0.05) and showed a downward trend over the period from 6 months to 4 years. Patients with complete remission had a significantly shorter duration of diabetes, lower HbA1c level, and higher VAI, in comparison to those without remission. Binary logistics regression and ROC curves analysis confirm that VAI, HbA1c, and duration of diabetes can predict diabetes remission after bariatric surgery, and the VAI of 4.46 is a useful threshold for predicting surgical efficacy. CONCLUSION: VAI is a significant predictor of diabetes remission for lower BMI patients with T2DM following bariatric surgery in China. The VAI of 4.46 is a useful threshold for predicting surgical efficacy. Multi-center and larger prospective studies are needed to confirm our findings.


Asunto(s)
Cirugía Bariátrica , Diabetes Mellitus Tipo 2 , Derivación Gástrica , Obesidad Mórbida , Adiposidad , Índice de Masa Corporal , China/epidemiología , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/cirugía , Humanos , Obesidad Mórbida/cirugía , Estudios Prospectivos , Inducción de Remisión , Resultado del Tratamiento
20.
Diabetes Metab Res Rev ; 37(4): e3422, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33197293

RESUMEN

AIMS: The effect of metabolic surgery compared with that of conventional therapy on target blood pressure (BP)and defined daily dose (DDD) of antihypertensive drugs in type 2 diabetes (T2DM) patients with hypertension remains unclear. This study aimed to investigate the differences in target BP and DDD between metabolic surgery and conventional treatment in T2DM patients with hypertension. MATERIALS AND METHODS: This was a prospective study of 535 diabetes patients who underwent metabolic surgery (n = 112) and medical treatment (n = 423). Changes in the target BP from baseline to every follow-up were analysed. RESULTS: Metabolic surgery decreased both office systolic and diastolic BP (DBP) and also significantly reduced ambulatory systolic BP (SBP; 132 ± 2 vs. 119 ± 1 mmHg, p < 0.0001), but not DBP (78 ± 1 vs. 76 ± 1 mmHg, p = 0.177). Patients maintained their SBP at <120 mmHg after 2 years (50% vs. 1.9%, p < 0.0001). Moreover, the rate of achieving the target SBP of 130 and 140 mmHg was also significantly higher in the surgery group, and this started from the initial 6 months after commencing treatment to the end of follow-up. The dosage (DDD: 1.44 ± 0.65 vs. 0.32 ± 0.05, p < 0.001) of antihypertensive medication was significantly decreased after metabolic surgery. Furthermore, metabolic surgery, but not medical treatment, markedly improved the risks of atherosclerotic cardiovascular disease. CONCLUSIONS: Metabolic surgery can effectively achieve the BP target and reduce the usage of antihypertensive medications as well as improve multiple metabolic dysfunction in T2DM patients with hypertension. This study provides an alternative approach to antagonize the metabolic related hypertension.


Asunto(s)
Cirugía Bariátrica , Diabetes Mellitus Tipo 2 , Hipertensión , Antihipertensivos/uso terapéutico , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/cirugía , Humanos , Hipertensión/complicaciones , Hipertensión/tratamiento farmacológico , Hipertensión/cirugía , Estudios Prospectivos , Resultado del Tratamiento
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