Long-term association between water intake and kidney function in a population at high cardiovascular risk.

OBJECTIVES: The evidence on water intake in the prevention of kidney function decline is scarce at population level in well-being individuals at high cardiovascular risk. Therefore, we aimed to longitudinally evaluate the associations between total water intake and subtypes and kidney function, through estimated-Glomerular Filtration Rate (eGFR). METHODS: Three-year prospective analysis conducted in 1986 older adults (aged 55-75 year) with overweight/obesity and metabolic syndrome from the PREDIMED-Plus study. Water intake was assessed using validated beverage and food frequency questionnaires. Serum creatinine-based eGFR (SCr-based eGFR; ml/min/1.73 m2) was estimated using the CKD-EPI equation at baseline, one-year and 3-years of follow-up. Mixed-effects linear regression models were fitted to evaluate the associations between baseline total water intake and subtypes, and SCr-based eGFR over 3-years of follow-up. RESULTS: Participants in the highest baseline tertile of total water intake, plain water and water from all fluids showed a lower decrease in SCr-based eGFR after 3-years of follow-up, compared to those in the lowest tertile. Participants with the highest tap water consumption showed a lower SCr-based eGFR decline after 1-year and 3-years of follow-up, in comparerd to participants in the lowest intake category (T3 vs. T1: ß: 1.4 ml/min/1.73 m2; 95%CI: 0.5-2.3, ß: 1.0; 95%CI: 0.1-2.0, respectively). CONCLUSIONS: Plain water rather than other water sources, and especially tap water, was associated with lower kidney function decline assessed through eGFR over 3-years of follow-up, in older individuals at high cardiovascular risk. TRIAL REGISTRATION: ISRCTN89898870. Retrospectively registered on 24 July 2014.

More Adult Women than Men at High Cardiometabolic Risk Reported Worse Lifestyles and Self-Reported Health Status in the COVID-19 Lockdown.

BACKGROUND: The COVID-19 lockdown represented an immense impact on human health, which was characterized by lifestyle and dietary changes, social distancing and isolation at home. Some evidence suggests that these consequences mainly affected women and altered relevant ongoing clinical trials. The aim of this study was to evaluate the status and changes in diet, physical activity (PA), sleep and self-reported health status (SRH) as perceived by older adult men and women with metabolic syndrome during the COVID-19 lockdown. METHODS: We analyzed data from 4681 Spanish adults with metabolic syndrome. We carried out a telephone survey during May and June 2020 to collect information on demographics, dietary habits, PA, sleep, SRH and anthropometric data. RESULTS: The mean age of participants was 64.9 years at recruitment, and 52% of participants were men. Most participants (64.1%) perceived a decrease in their PA during confinement. Regarding gender-specific differences, a higher proportion of women than men perceived a decrease in their PA (67.5% vs. 61.1%), Mediterranean diet adherence (20.9% vs. 16.8%), sleep hours (30.3% vs. 19.1%), sleep quality (31.6% vs. 18.2%) and SRH (25.9% vs. 11.9%) (all p < 0.001). CONCLUSIONS: The COVID-19 lockdown affected women more negatively, particularly their self-reported diet, PA, sleep and health status.

Short-term effects of gastric bypass versus sleeve gastrectomy on high LDL cholesterol: The BASALTO randomized clinical trial.

BACKGROUND: There has been a substantial increase in the use of laparoscopic sleeve gastrectomy (SG) to treat morbid obesity despite observational evidence demonstrating the superiority of Roux-en-Y gastric bypass (RYGB) for reducing low-density lipoprotein (LDL) cholesterol. The main aim was to ascertain whether high LDL cholesterol levels should be considered when selecting the most appropriate surgical procedure for each patient (RYGB or SG). METHODS: In this single-center, randomized clinical trial using intention-to-treat analysis, 38 patients with severe obesity and elevated levels of LDL cholesterol were randomly assigned to undergo RYGB or SG. The primary outcome was LDL cholesterol remission at 12 months, defined as LDL cholesterol < 3.36 nmol/l without lipid-lowering medications. Secondary outcomes included changes in weight, other comorbidities, qualitative lipoprotein traits, cholesterol esters, glycoproteins, cholesterol absorption and synthesis metabolites and complications. RESULTS: Intention-to-treat analysis revealed that LDL cholesterol remission occurred in 66.6% of RYGB patients compared to 27.8% of SG patients (p = 0.019). Among patients completing follow-up, RYGB demonstrated superior remission (80.0% vs. 29.4%, p = 0.005). Exclusive benefits of RYGB included a reduction in large, medium, and small LDL particles. Cholesterol absorption markers showed differential behavior after both techniques: campesterol (Δ -15.2 µg/mg, 95% CI -30.2 to -0.1) decreased after RYGB, and sitosterol (Δ 21.1 µg/mg, 95% CI 0.9 to 41.2), cholestanol (Δ 30.6 µg/mg, 95% CI 14.8 to 57.9) and campesterol (Δ 18.4 µg/mg, 95% CI 4.4 to 32.3) increased after SG. No differences in weight loss, cholesterol esters, glycoproteins, cholesterol synthesis metabolites or postoperative complications were observed between techniques. CONCLUSION: In conclusion, RYGB is superior to SG in terms of short-term of high LDL cholesterol remission. Furthermore, RYGB also led to a greater improvement in lipoprotein parameters that confer an atherogenic profile. Therefore, the presence of elevated levels of LDL cholesterol should be considered when determining the optimal bariatric surgery procedure for each patient. TRIAL REGISTRATION: Clinicaltrials.gov number, NCT03975478).

Relationship between sex, APOE genotype, endocannabinoids and cognitive change in older adults with metabolic syndrome during a 3-year Mediterranean diet intervention.

BACKGROUND: The Mediterranean diet (MedDiet) has demonstrated efficacy in preventing age-related cognitive decline and modulating plasma concentrations of endocannabinoids (eCBs) and N-acylethanolamines (NAEs, or eCB-like compounds), which are lipid mediators involved in multiple neurological disorders and metabolic processes. Hypothesizing that eCBs and NAEs will be biomarkers of a MedDiet intervention and will be related to the cognitive response, we investigated this relationship according to sex and apolipoprotein E (APOE) genotype, which may affect eCBs and cognitive performance. METHODS: This was a prospective cohort study of 102 participants (53.9% women, 18.8% APOE-ɛ4 carriers, aged 65.6 ± 4.5 years) from the PREDIMED-Plus-Cognition substudy, who were recruited at the Hospital del Mar Research Institute (Barcelona). All of them presented metabolic syndrome plus overweight/obesity (inclusion criteria of the PREDIMED-Plus) and normal cognitive performance at baseline (inclusion criteria of this substudy). A comprehensive battery of neuropsychological tests was administered at baseline and after 1 and 3 years. Plasma concentrations of eCBs and NAEs, including 2-arachidonoylglycerol (2-AG), anandamide (AEA), oleoylethanolamide (OEA), palmitoylethanolamide (PEA), and N-docosahexaenoylethanolamine (DHEA), were also monitored. Baseline cognition, cognitive changes, and the association between eCBs/NAEs and cognition were evaluated according to gender (crude models), sex (adjusted models), and APOE genotype. RESULTS: At baseline, men had better executive function and global cognition than women (the effect size of gender differences was - 0.49, p = 0.015; and - 0.42, p = 0.036); however, these differences became nonsignificant in models of sex differences. After 3 years of MedDiet intervention, participants exhibited modest improvements in memory and global cognition. However, greater memory changes were observed in men than in women (Cohen's d of 0.40 vs. 0.25; p = 0.017). In men and APOE-ε4 carriers, 2-AG concentrations were inversely associated with baseline cognition and cognitive changes, while in women, cognitive changes were positively linked to changes in DHEA and the DHEA/AEA ratio. In men, changes in the OEA/AEA and OEA/PEA ratios were positively associated with cognitive changes. CONCLUSIONS: The MedDiet improved participants' cognitive performance but the effect size was small and negatively influenced by female sex. Changes in 2-AG, DHEA, the OEA/AEA, the OEA/PEA and the DHEA/AEA ratios were associated with cognitive changes in a sex- and APOE-dependent fashion. These results support the modulation of the endocannabinoid system as a potential therapeutic approach to prevent cognitive decline in at-risk populations. TRIAL REGISTRATION: ISRCTN89898870.

Dietary intake of Perfluorooctanesulfonic acid (PFOS) and glucose homeostasis parameters in a non-diabetic senior population.

BACKGROUND: Endocrine disruptors (EDs) have emerged as potential contributors to the development of type-2 diabetes. Perfluorooctane sulfonate (PFOS), is one of these EDs linked with chronic diseases and gathered attention due to its widespread in food. OBJECTIVE: To assess at baseline and after 1-year of follow-up associations between estimated dietary intake (DI) of PFOS, and glucose homeostasis parameters and body-mass-index (BMI) in a senior population of 4600 non-diabetic participants from the PREDIMED-plus study. METHODS: Multivariable linear regression models were conducted to assess associations between baseline PFOS-DI at lower bound (LB) and upper bound (UB) established by the EFSA, glucose homeostasis parameters and BMI. RESULTS: Compared to those in the lowest tertile, participants in the highest tertile of baseline PFOS-DI in LB and UB showed higher levels of HbA1c [ß-coefficient(CI)] [0.01 %(0.002 to 0.026), and [0.06 mg/dL(0.026 to 0.087), both p-trend ≤ 0.001], and fasting plasma glucose in the LB PFOS-DI [1.05 mg/dL(0.050 to 2.046),p-trend = 0.022]. Prospectively, a positive association between LB of PFOS-DI and BMI [0.06 kg/m2(0.014 to 0.106) per 1-SD increment of energy-adjusted PFOS-DI was shown. Participants in the top tertile showed an increase in HOMA-IR [0.06(0.016 to 0.097), p-trend = 0.005] compared to participants in the reference tertile after 1-year of follow-up. DISCUSSION: This is the first study to explore the association between DI of PFOS and glucose homeostasis. In this study, a high baseline DI of PFOS was associated with a higher levels of fasting plasma glucose and HbA1c and with an increase in HOMA-IR and BMI after 1-year of follow-up.

Effects of Preoperative Quadruple Therapy for Helicobacter pylori on Bariatric Surgery Metabolic Outcomes.

PURPOSE: To assess the effects of Helicobacter pylori (HP) eradication with an omeprazole, clarithromycin, amoxicillin, and metronidazole (OCAM) regimen on the metabolic profile and weight loss 12 months after bariatric surgery (BS). METHODS: Retrospective analysis of a prospective cohort of patients with morbid obesity undergoing BS. HP presence was tested preoperatively by gastric biopsy and treated with OCAM when positive. Short-term metabolic outcomes and weight loss were evaluated. RESULTS: HP infection was detected in 75 (45.7%) of the 164 patients included. OCAM effectiveness was 90.1%. HP-negative patients had a greater reduction in glucose levels at 3 (-14.6 ± 27.5 mg/dL HP-treated vs -22.0 ± 37.1 mg/dL HP-negative, p=0.045) and 6 months (-13.7 ± 29.4 mg/dL HP-treated vs -26.4 ± 42.6 mg/dL HP-negative, p= 0.021) and greater total weight loss (%TWL) at 6 (28.7 ± 6.7% HP-treated vs 30.45 ± 6.48% HP-negative, p= 0.04) and 12 months (32.21 ± 8.11% HP-treated vs 35.14 ± 8.63% HP-negative, p= 0.023). CONCLUSIONS: Preoperative treatment with OCAM has been associated to poorer glycemic and weight loss outcomes after BS. More research is needed on the influence of OCAM on gut microbiota, and in turn, the effect of the latter on metabolic and weight loss outcomes after BS.

Obesidad mórbida y dislipemia: impacto de la cirugía bariátrica / Morbid obesity and dyslipidaemia: The impact of bariatric surgery

La prevalencia de la obesidad ha aumentado de manera exponencial en las últimas décadas, convirtiéndose en un problema de salud pública de primer orden. La dislipemia de la obesidad, caracterizada por niveles bajos de colesterol de las lipoproteínas de alta densidad (HDL), hipertrigliceridemia y partículas pequeñas y densas de lipoproteínas de baja densidad (LDL), es responsable en parte del elevado riesgo cardiovascular residual de esta situación clínica. Por otro lado, la cirugía bariátrica (CB) es el tratamiento más eficaz para la obesidad; con ella se obtiene una mayor pérdida ponderal que con el tratamiento médico convencional y favorece la mejoría o remisión de las comorbilidades asociadas. Las técnicas de CB más utilizadas en la actualidad son el bypass gástrico laparoscópico en Y de Roux (BGYRL) y la gastrectomía tubular laparoscópica (GTL). Estas han obtenido resultados similares tanto en cuanto a la pérdida de peso como a la remisión de ciertas comorbilidades como la diabetes mellitus tipo 2 o la hipertensión arterial. Un rasgo diferencial entre ambas técnicas podría ser el diferente impacto sobre el perfil lipoproteico. Así, estudios previos con seguimiento a corto y a medio plazo han objetivado una superioridad del BGYRL frente a la GTL en la reducción del colesterol total y del colesterol LDL. Existen resultados discordantes en cuanto a la evolución del colesterol HDL y los triglicéridos. Por todo ello, hemos considerado de interés revisar los efectos de la CB a corto y a medio plazo en el perfil lipoproteico, así como las tasas de remisión de las diferentes alteraciones lipídicas y los posibles factores relacionados

Obesity prevalence has presented an exponential increase in the last decades, becoming a first order public health issue. Dyslipidemia of obesity, characterized by low levels of high density lipoprotein (HDL) cholesterol, hypertriglyceridemia and small and dense low-density lipoprotein (LDL) particles, is partly responsible for the high residual cardiovascular risk of this clinical situation. On the other hand, bariatric surgery (BS) is the most effective treatment for obesity, obtaining a greater weight loss than achieved with conventional medical therapy and favoring the improvement or remission of associated comorbidities. The most commonly used BS techniques nowadays are laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG). Both of these procedures have obtained similar results in terms of weight loss and comorbidity remission such as type 2 diabetes mellitus or hypertension. A differential feature between both techniques could be the different impact on the lipoprotein profile. In this respect, previous studies with short and mid-term follow-up have proved LRYGB to be superior to LSG in total and LDL cholesterol reduction. Results regarding triglycerides and HDL cholesterol are contradictory. Therefore, we consider of interest to review the effects of BS at short and mid-term follow-up on lipoprotein profile, as well as the remission rates of the different lipid abnormalities and the possible related factors

Tenemos un problema con la obesidad / We have a problem with obesity

No disponible

Influencia de la microbiota y de los probióticos en la obesidad / Influence of the microbiota and probiotics in obesity

La microbiota intestinal tiene un papel determinante en el control del peso corporal. En la presente revisión se exponen las diferentes vías por las que puede modular la homeostasis energética del huésped, en base a su capacidad modificadora del metabolismo del individuo y su contribución en la regulación del aprovechamiento energético. Con las evidencias actuales, no está claro cuál es el perfil de microbiota que se atribuye a la presencia de obesidad, aunque en modelos animales parece relacionarse con una mayor proporción de bacterias del filo Firmicutes, en detrimento de las del filo Bacteroidetes. Otros factores claramente implicados serían la diversidad en la microbiota intestinal o sus posibles cambios funcionales. Son necesarios más estudios en humanos para poder esclarecer cómo la disbiosis puede influir en el control ponderal. Por otra parte, los probióticos afectan directamente la microbiota intestinal, modulando su composición y, posiblemente, su funcionalidad. Un gran número de estudios en humanos han evaluado el impacto de los probióticos en la obesidad. A pesar de que esta intervención puede tener un potencial efecto beneficioso, es preciso esclarecer qué cepas de probióticos deben recomendarse, en qué dosis y durante cuánto tiempo

Gut microbiota plays a key role in the control of body weight. In the present review the different ways in which it can modify the energy homeostasis of the host are exposed, based on its capacity to modify the metabolism of the individual and its contribution in the energy consumption regulation. With the current evidence, it is not clear what microbiota profile is associated with the presence of obesity, although in animal models it seems to be related to a higher proportion of bacteria of the Firmicutes phylum, to the detriment of those of the Bacteroidetes phylum. Other factors clearly involved would be the diversity in the gut microbiota or its possible functional changes. More studies in humans are needed to clarify how dysbiosis can influence weight control. On the other hand, probiotics directly affect the gut microbiota, modulating its composition and, possibly, its functionality. A large number of studies in humans have evaluated the impact of probiotics on obesity. Although this intervention may have a potentially beneficial effect, more effort is needed to clarify which strains of probiotics should be recommended, at what dose and for how long

Consultas a Urgencias y reingresos a 30 y 90 días tras cirugía bariátrica / Unplanned emergency department consultations and readmissions within 30 and 90 days of bariatric surgery

INTRODUCCIÓN: Los reingresos son un indicador de calidad de la cirugía. El objetivo del estudio fue determinar la incidencia, las causas y los factores de riesgo relacionados con las consultas a Urgencias y los reingresos a 30 y 90 días en pacientes sometidos a bypass gástrico laparoscópico y gastrectomía vertical laparoscópica. MÉTODOS: Estudio retrospectivo de 429 pacientes intervenidos desde enero de 2004 a julio de 2015 a partir de una base de datos prospectiva y de las historias clínicas electrónicas. Se analizaron datos demográficos, el tipo de intervención, las complicaciones postoperatorias, la duración de la estancia hospitalaria y el registro de las visitas a Urgencias y los reingresos durante el periodo de estudio. RESULTADOS: En los primeros 90 días del postoperatorio, un total de 117 (27%) pacientes consultaron a Urgencias y 24 (6%) reingresaron. Los motivos más frecuentes de consulta a Urgencias fueron los problemas no infecciosos relacionados con la herida quirúrgica (n = 40, 34%) y el dolor abdominal (n = 28, 24%), que además fue la primera causa de reingreso (n = 9, 37%). Las complicaciones postoperatorias, la reintervención, una cirugía asociada en el mismo acto quirúrgico y la depresión fueron factores de riesgo para consultar a Urgencias en los primeros 90 días del periodo postoperatorio. CONCLUSIONES: A pesar del elevado número de pacientes que consulta a Urgencias en los primeros 90 días del periodo postoperatorio, pocos precisan reingreso y ninguno reintervención quirúrgica. Es importante conocer los motivos de las consultas a Urgencias para establecer medidas preventivas y mejorar la calidad asistencial

INTRODUCTION: Hospital readmission is used as a measure of quality healthcare. The aim of this study was to determine the incidence, causes, and risk factors related to emergency consultations and readmissions within 30 and 90 days in patients undergoing laparoscopic gastric bypass and laparoscopic sleeve gastrectomy. METHODS: Retrospective study of 429 patients operated on from January 2004 to July 2015 from a prospectively maintained database and electronic medical records. Demographic data, type of intervention, postoperative complications, length of hospital stay and records of emergency visits and readmissions were analyzed. RESULTS: Within the first 90 days postoperative, a total of 117 (27%) patients consulted the Emergency Department and 24 (6%) were readmitted. The most common reasons for emergency consultation were noninfectious problems related to the surgical wound (n = 40, 34%) and abdominal pain (n = 28, 24%), which was also the first cause of readmission (n = 9, 37%). Postoperative complications, reintervention, associated surgery in the same operation and depression were risk factors for emergency consultation within the first 90 days of the postoperative period. CONCLUSIONS: Despite the high number of patients who visit the Emergency Department in the first 90 days of the postoperative period, few require readmission and none surgical reoperation. It is important to know the reasons for emergency consultation to establish preventive measures and improve the quality of care

Asociación de obesidad general y abdominal con hipertensión, dislipemia y presencia de prediabetes en el estudio PREDAPS / Association of general and abdominal obesity with hypertension, dyslipidemia and prediabetes in the PREDAPS study

Introducción y objetivos: Algunas medidas antropométricas muestran mayor capacidad que otras para discriminar la presencia de factores de riesgo cardiovascular. Este trabajo estima la magnitud de la asociación de diversos indicadores antropométricos de obesidad con hipertensión, dislipemia y prediabetes (glucemia basal o glucohemoglobina alteradas). Métodos: Análisis transversal de la información recogida en 2.022 sujetos del estudio PREDAPS (etapa basal). Se definió obesidad general como índice de masa corporal ≥ 30 kg/m2 y obesidad abdominal con 2 criterios: a) perímetro de cintura (PC) ≥ 102 cm en varones/PC ≥ 88 cm en mujeres, y b) índice cintura/estatura (ICE) ≥ 0,55. La magnitud de la asociación se estimó mediante regresión logística. Resultados: La hipertensión arterial mostró la asociación más alta con la obesidad general en mujeres (OR = 3,01; IC95%, 2,24-4,04) y con la obesidad abdominal según el criterio del ICE en varones (OR = 3,65; IC95%, 2,66-5,01). La hipertrigliceridemia y los valores bajos de colesterol unido a lipoproteínas de alta densidad mostraron la asociación más alta con obesidad abdominal según el criterio del ICE en mujeres (OR = 2,49; IC95%, 1,68-3,67 y OR = 2,70; IC95%, 1,89-3,86) y la obesidad general en varones (OR = 2,06; IC95%, 1,56-2,73 y OR = 1,68; IC95%, 1,21-2,33). La prediabetes mostró la asociación más alta con obesidad abdominal según el criterio del ICE en mujeres (OR = 2,48; IC95%, 1,85-3,33) y con obesidad abdominal según el criterio del PC en varones (OR = 2,33; IC95%, 1,75-3,08). Conclusiones: Los indicadores de obesidad abdominal mostraron la mayor asociación con la presencia de prediabetes. La relación de los indicadores antropométricos con hipertensión y con dislipemia mostró resultados heterogéneos (AU)

Introduction and objectives: Some anthropometric measurements show a greater capacity than others to identify the presence of cardiovascular risk factors. This study estimated the magnitude of the association of different anthropometric indicators of obesity with hypertension, dyslipidemia, and prediabetes (altered fasting plasma glucose and/or glycosylated hemoglobin). Methods: Cross-sectional analysis of information collected from 2022 participants in the PREDAPS study (baseline phase). General obesity was defined as body mass index ≥ 30 kg/m2 and abdominal obesity was defined with 2 criteria: a) waist circumference (WC) ≥ 102 cm in men/WC ≥ 88 cm in women, and b) waist-height ratio (WHtR) ≥ 0.55. The magnitude of the association was estimated by logistic regression. Results: Hypertension showed the strongest association with general obesity in women (OR, 3.01; 95%CI, 2.24-4.04) and with abdominal obesity based on the WHtR criterion in men (OR, 3.65; 95%CI, 2.66-5.01). Hypertriglyceridemia and low levels of high-density lipoprotein cholesterol showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.49; 95%CI, 1.68-3.67 and OR, 2.70; 95%CI, 1.89-3.86) and with general obesity in men (OR, 2.06; 95%CI, 1.56-2.73 and OR, 1.68; 95%CI, 1.21-2.33). Prediabetes showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.48; 95%CI, 1.85-3.33) and with abdominal obesity based on the WC criterion in men (OR, 2.33; 95%CI, 1.75-3.08). Conclusions: Abdominal obesity indicators showed the strongest association with the presence of prediabetes. The association of anthropometric indicators with hypertension and dyslipidemia showed heterogeneous results (AU)

Pasado, presente y futuro de la farmacoterapia para la obesidad / Past, present and future of pharmacotherapy for obesity

El tratamiento convencional de la obesidad con dieta y ejercicio así como la cirugía bariátrica tienen sus limitaciones, por lo que es necesario disponer de fármacos para su tratamiento. En el pasado se comercializaron diferentes fármacos que fueron retirados por problemas de seguridad. Actualmente existen 3 fármacos aprobados por la Agencia Europea del Medicamento (EMA) y la Food and Drug Administration (FDA) para el tratamiento de la obesidad (orlistat, combinación de bupropión y naltrexona de liberación retardada y liraglutida) y 2 más solo autorizados por la FDA (lorcaserina y la combinación de fentermina y topiramato de liberación prolongada). Se aconseja su uso como segunda línea terapéutica y su elección debe individualizarse teniendo en cuenta múltiples aspectos como la pérdida de peso esperada, la vía de administración, su perfil de seguridad y el coste. Por otra parte, actualmente existen varios fármacos en vías de desarrollo que actúan sobre diferentes dianas terapéuticas (AU)

Conventional treatment for obesity with diet, exercise and bariatric surgery has limitations; thus, it is necessary to have pharmacological tools. In the past, different drugs were marketed that were withdrawn due to safety problems. There are currently 3 drugs approved by the European Medicines Agency (EMA) and the Food and Drug Administration (FDA) for obesity therapy (orlistat, combination of bupropion and delayed-release naltrexone and liraglutide) and two more only authorized by FDA (lorcaserin and the combination of phentermine and extended release topiramate). It is recommended to use as a second therapeutic line and its choice should be individualized taking into account multiple aspects such as expected weight loss, route of administration, safety profile and cost. Currently there are several drugs under development that act on different therapeutic targets (AU)

Declaración sobre el tratamiento actual de la obesidad grave en España / Statement on the current treatment of severe obesity in Spain

No disponible

Prevalencia, diagnóstico, tratamiento y control de la hipertensión arterial en España. Resultados del estudio Di@bet.es / Prevalence, diagnosis, treatment, and control of hypertension in Spain. Results of the Di@bet.es Study

Introducción y objetivos: El Di@bet.es es un estudio nacional diseñado con el objetivo de estimar la prevalencia de diabetes mellitus y otros factores de riesgo cardiovascular en la población adulta española. Se presenta la prevalencia de hipertensión arterial y en qué grado se reconoce, se trata y se controla. Métodos: Se incluye una muestra de la población española con 5.048 adultos de edad ≥ 18 años. Se realizó un interrogatorio clínico y una exploración que incluyó 3 lecturas de presión arterial en reposo y sedestación para calcular la media de las 3 lecturas. Se definió hipertensión como presión arterial sistólica ≥ 140 mmHg y/o presión arterial diastólica ≥ 90 mmHg y/o en tratamiento farmacológico antihipertensivo. Resultados: El 42,6% de la población adulta española de edad ≥ 18 años es hipertensa, más los varones (49,9%) que las mujeres (37,1%). La prevalencia fue superior entre los prediabéticos (67,9%) y diabéticos (79,4%). El 37,4% de los hipertensos están sin diagnosticar, más los varones (43,3%) que las mujeres (31,5%). Toman tratamiento farmacológico el 88,3% de los hipertensos conocidos y solo el 30% tiene la presión arterial controlada, más las mujeres (24,9%) que los varones (16%). Conclusiones: La prevalencia de hipertensión en España es alta y un importante porcentaje de pacientes hipertensos aún están sin diagnosticar. La hipertensión se asoció con diabetes y prediabetes, y aunque el tratamiento farmacológico es cada vez más frecuente, no logra mejorar el grado de control, que continúa siendo bajo. Es importante desarrollar y promocionar campañas poblacionales de prevención, detección y tratamiento de la hipertensión arterial (AU)

Introduction and objectives: Di@bet.es is a national study designed to estimate the prevalence of diabetes mellitus and other cardiovascular risk factors in the Spanish adult population. The prevalence of hypertension and the degree to which it is recognized, treated, and controlled are described. Methods: The study included a sample of the Spanish population with 5048 adults aged ≥ 18 years. Patients were questioned and examined, with 3 blood pressure readings while seated and at rest to calculate the mean of the 3 readings. Hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg and/or prescription for antihypertensive drug therapy. Results: Hypertension was found in 42.6% of the Spanish adult population aged ≥ 18 years and was more common among men (49.9%) than women (37.1%). The prevalence was higher among prediabetics (67.9%) and diabetics (79.4%). Undiagnosed hypertension was identified in 37.4% of patients and was more common in men (43.3%) than in women (31.5%). Among patients with known hypertension, 88.3% were receiving drug therapy. Well-controlled blood pressure was found in only 30% and was more common among women (24.9%) than men (16%). Conclusions: The prevalence of hypertension in Spain is high, and a considerable percentage of hypertensive patients have still not been diagnosed. Hypertension is associated with diabetes and prediabetes, and although drug therapy is increasingly common, the degree of control has not improved and remains low. Population campaigns should be developed and promoted for hypertension prevention, detection, and treatment (AU)

Prevalence of impaired fasting glucose and type 1 and 2 diabetes mellitus in a large nationwide working population in Spain / Prevalencia de la glucemia alterada en ayunas, diabetes tipo 1 (DM1) y diabetes tipo 2 (DM2) en una población trabajadora en España

Introduction: To report the prevalence of impaired fasting glucose (IFG), undiagnosed and diagnosed diabetes, and their association to occupational categories in a representative sample of working population in Spain. Materials and methods: A cross-sectional study of workers who attended routine medical check-ups from January 2007 to December 2007. A structured questionnaire was completed, and physical examinations and routine serum biochemical tests were performed. IFG was defined as fasting glucose levels ranging from 100 to 125 mg/dl with no diagnosis of T1DM or T2DM; T1DM was defined as previous diagnosis of T1DM; and T2DM as previous diagnosis of T2DM, treatment with oral antidiabetic drugs or insulin or fasting glucose levels ≥126 mg/dl, according to ADA criteria. Results: Of the 371,997 participants (median age 35 [interquartile range 29-44] years), 72.4% were male. Raw prevalence rates (95% CI) of IFG, undiagnosed (UKDM), and previously known type 2 (KDM2) and type 1 (KDM1) diabetes were 10.4% (10.3-10.5%), 1.3% (1.2-1.3%), 1.1% (1.1-1.2%), and 0.3% (0.3–0.3%), respectively. With the exception of KDM1, prevalence of these conditions increased with age and was greater among manual/blue-collar workers (12.1%, 1.5%, 1.3% and 0.3%, respectively) as compared to non-manual/white-collar workers (7.3%, 0.8%, 0.8% and 0.3%, respectively). Age- and sex-adjusted prevalence rates of IFG, UKDM and KDM2 were 13.1%, 2.0% and 2.4%, respectively. Discussion: In this sample of Spanish working population, impaired glycemic profiles were common. Prevalence rates of IFG and T2DM were high among blue-collar workers (except for T1DM). These data emphasize the need for earlier structured preventive schemes (AU)

Objetivo: Describir la prevalencia de glucemia alterada en ayunas (GAA), diabetes no diagnosticada y diabetes, y su asociación con categorías profesionales en una muestra representativa de población trabajadora en España. Material y métodos: Estudio transversal en trabajadores que realizaron revisión médica entre enero y diciembre de 2007. Se realizó exploración física, análisis de sangre y se utilizó un cuestionario estructurado. Se definió GAA como glucosa en ayunas 100-125 mg/dl sin diagnóstico de diabetes tipo 1 (DM1) o diabetes tipo 2 (DM2); DM1 como diagnóstico previo de DM1; y DM2, según criterios ADA, como diagnóstico previo de DM2, tratamiento con antidiabéticos orales o insulina, glucosa en ayunas ≥ 126 mg/dl. Resultados: De los 371.997 participantes (mediana de edad 35 [rango intercuartílico 29-44] años), el 72,4% eran varones. La prevalencia (IC 95%) de GAA, diabetes no diagnosticada y DM2 y DM1 conocidas previamente fue del 10,4% (10,3-10,5%); 1,3% (1,2-1,3%); 1,1% (1,1-1,2%) y 0,3% (0,3-0,3%), respectivamente. Excepto para DM1, la prevalencia aumentó con la edad y fue mayor en trabajadores manuales (12,1; 1,5; 1,3; y 0,3% respectivamente) que en trabajadores no manuales (7,3; 0,8; 0,8; y 0,3% respectivamente). La prevalencia de GAA, diabetes no diagnosticada y DM2 ajustada por edad y sexo fue del 13,1, 2,0 y 2,4% respectivamente. Conclusiones: En esta muestra de población trabajadora en España, las alteraciones del perfil glucémico fueron frecuentes. En trabajadores manuales (excepto en DM1) las prevalencias de GAA y DM2 fueron mayores. Estos datos resaltan la necesidad de programas preventivos de intervención más temprana (AU)

Estimación del riesgo cardiovascular en España según la guía europea sobre prevención de la enfermedad cardiovascular en la práctica clínica / Estimating cardiovascular risk in spain by the european guidelines on cardiovascular disease prevention in clinical practice

Introducción y objetivos: En España no se dispone de estudios poblacionales de ámbito nacional en los que se haya evaluado el riesgo cardiovascular total. El objetivo del estudio es describir el riesgo cardiovascular y la consecución de los objetivos terapéuticos según lo establecido en la guía europea de 2012 para la estrategia de prevención de la enfermedad cardiovascular. Se investigaron también las características clínicas (factores de riesgo no clásicos) asociadas a un riesgo moderado. Métodos: Se seleccionó a los participantes (n = 2.310; el 58% mujeres), de entre 40 y 65 años de edad, de un estudio de base poblacional de ámbito nacional (estudio Di@bet.es). En primer lugar, se identificó a los sujetos con un riesgo a priori alto o muy alto. A continuación, se utilizó el riesgo cardiovascular total (ecuación Systematic Coronary Risk Evaluation con inclusión del colesterol unido a lipoproteínas de alta densidad) para evaluar el riesgo de los individuos con un riesgo a priori no alto. Se investigaron las variables con asociación independiente con el riesgo moderado frente al riesgo bajo, utilizando para ello un análisis de regresión logística múltiple. Resultados: Los porcentajes estandarizados respecto a edad y sexo (método directo) de los participantes con riesgo alto/muy alto, moderado y bajo fueron del 22,8, el 43,5 y el 33,7% respectivamente. La mayoría de los varones tenían un riesgo moderado (56,2%), mientras que el 55,4% de las mujeres tenían riesgo bajo. Alcanzaron los objetivos de colesterol unido a lipoproteínas de baja densidad (< 70, < 100 y < 115 mg/dl) y presión arterial (< 140/90 mmHg) los participantes de riesgo muy alto, alto y moderado, respectivamente, en el 15, el 26 y el 46% y el 77, el 68 y el 85% de los individuos. El índice de masa corporal, las concentraciones altas de triglicéridos, la presión arterial diastólica y la baja adherencia a la dieta mediterránea (en las mujeres) presentaron asociación independiente con un riesgo moderado (frente a riesgo bajo). Conclusiones El riesgo cardiovascular en España es principalmente moderado en los varones y bajo en las mujeres. Debe mejorarse la consecución de los objetivos terapéuticos por los individuos de alto riesgo. La prevalencia de factores de riesgo cardiovascular no clásicos está aumentada en los individuos de riesgo moderado, lo cual es un aspecto importante que tener en cuenta en una estrategia de base poblacional para reducir las enfermedades cardiovasculares en el grupo de mayor prevalencia (AU)

Introduction and objectives: There are no nationwide, population-based studies in Spain assessing overall cardiovascular risk. We aimed to describe cardiovascular risk and achievement of treatment goals following the 2012 European Guidelines on cardiovascular disease prevention strategy. We also investigated clinical characteristics (non-classical risk factors) associated with moderate risk. Methods: Participants (n = 2310, 58% women) aged 40 to 65 years from a national population-based study (Di@bet.es Study) were identified. First, a priori high/very-high risk individuals were identified. Next, total cardiovascular risk (Systematic Coronary Risk Evaluation equation including high-density lipoprotein cholesterol) was used to assess risk of a priori non-high risk individuals. Variables independently associated with moderate versus low-risk were investigated by multiple logistic regression analysis. Results: Age-and-sex standardized (direct method) percentages of high/very-high, moderate, and low-risk were 22.8%, 43.5%, and 33.7%, respectively. Most men were at moderate (56.2%), while 55.4% of women were at low risk. Low-density lipoprotein cholesterol (< 70, < 100, < 115 mg/dL) and blood pressure (<140/90 mmHg) goals for very-high, high and moderate risk were met in 15%, 26% and 46%, and 77%, 68% and 85% of the individuals, respectively. Body mass index, high triglycerides concentrations, diastolic blood pressure, and low Mediterranean diet adherence (in women) were independently associated with moderate (versus low) risk. Conclusions: Cardiovascular risk in Spain is mainly moderate in men and low in women. Achievement of treatment goals in high-risk individuals should be improved. The prevalence of non-classical cardiovascular risk factors is elevated in subjects at moderate risk, an important aspect to consider in a population-based strategy to decrease cardiovascular disease in the most prevalent group (AU)

Prevalencia de obesidad, diabetes mellitus y otros factores de riesgo cardiovascular en Andalucía. Comparación con datos de prevalencia nacionales. Estudio Di@bet.es / Prevalence of Obesity, Diabetes and Other Cardiovascular Risk Factors in Andalusia (Southern Spain). Comparison With National Prevalence Data. The Di@bet.es Study

Introducción y objetivos El objetivo de este estudio fue comparar la prevalencia de obesidad, diabetes mellitus y otros factores de riesgo cardiovascular en la región de Andalucía con las prevalencias en el resto de España.MétodosEl estudio Di@bet.es es un estudio poblacional transversal de ámbito nacional sobre prevalencia de factores de riesgo cardiometabólicos y su asociación con el estilo de vida. Formaron la muestra 5.103 participantes de edad ≥ 18 años. Se realizó una encuesta clínica, demográfica y de estilo de vida, una exploración física y una prueba de sobrecarga oral de glucosa. La prevalencia de factores de riesgo cardiovascular en Andalucía (n = 1.517) se comparó con la del resto de España (n = 3.586).ResultadosSegún los datos ajustados para la población española, las prevalencias de diabetes mellitus (Organización Mundial de la Salud, 1999), hipertensión (presión arterial ≥ 140/90 mmHg), títulos elevados de PCR ultrasensible (≥ 3 mg/l) y obesidad (índice de masa corporal ≥ 30) fueron del 16,3, el 43,9, el 32,0 y el 37,0% en Andalucía, en comparación con el 12,5, el 39,9, el 28,3 y el 26,6% en el resto de España (p < 0,001 para las diferencias excepto p = 0,01 para la diferencia en los títulos elevados de PCR ultrasensible). Las prevalencias en Andalucía ajustadas para la población andaluza fueron del 15,3, el 42,3, el 31,4 y el 34,0%, respectivamente. Las diferencias en la diabetes mellitus, la hipertensión y los títulos elevados de PCR ultrasensible no fueron significativas en los modelos con ajuste por edad, sexo y mediciones de la adiposidad. Las diferencias en la obesidad no fueron significativas en los modelos ajustados por edad, sexo, nivel de estudios, estado civil, situación laboral y actividad física (p = 0,086). Conclusiones: Este estudio aporta información desde una perspectiva nacional y muestra una prevalencia de factores de riesgo cardiovascular superior en el sur de España, con estrecha correlación con la obesidad, el estilo de vida sedentario e indicadores de una situación socioeconómica desfavorecida

Introduction and objectives The aim of this study was to compare the prevalences of obesity, diabetes and other cardiovascular risk factors in the region of Andalusia with those in the rest of Spain.MethodsThe Di@bet.es study is a national, cross-sectional, population-based survey of cardiometabolic risk factors and their association with lifestyle. The sample consisted of 5103 participants ≥ 18 years. The variables analyzed were clinical, demographic and lifestyle survey, physical examination, and oral glucose tolerance test. The prevalence of cardiovascular risk factors in Andalusia (n = 1517) was compared with that for the rest of Spain (n = 3586).ResultsIn data adjusted to the Spanish population, the prevalence of diabetes (World Health Organization, 1999), hypertension (blood pressure ≥ 140/90 mmHg), high-sensitivity CRP levels (≥ 3 mg/L) and obesity (body mass index ≥ 30 kg/m2) were 16.3%, 43.9%, 32.0%, and 37.0% in Andalusia compared with 12.5%, 39.9%, 28.3%, and 26.6% in the rest of Spain (P < .001 for differences except P = .01 for the difference in high-sensitivity CRP levels). The corresponding figures for the Andalusia data adjusted to the Andalusian population were 15.3%, 42.3%, 31.4%, and 34.0%, respectively. Differences in diabetes, hypertension and high-sensitivity CRP were not significant in models adjusted for age, sex, and adiposity measurements. Differences in obesity were not significant in models adjusted for age, sex, educational level, marital status, work status, and physical activity (P = .086)ConclusionsThis study contributes information from a national study perspective and shows a higher prevalence of cardiovascular risk factors in southern Spain, in close relation to obesity, a sedentary lifestyle, and markers of socioeconomic disadvantage (AU)

Prevalence of plasma lipid abnormalities and its association with glucose metabolism in Spain: The di@bet. es study

Introduction: Dyslipidemia is a significant contributor to the elevated CVD risk observed in type 2 diabetes mellitus. We assessed the prevalence of dyslipidemia and its association with glucose metabolism status in a representative sample of the adult population in Spain and the percentage of subjects at guideline-recommended LDL-C goals. Material and methods: The di@bet.es study is a national, cross-sectional population-based survey of 5728 adults. Results: A total of 4776 subjects were studied. Dyslipidemia was diagnosed in 56.8% of subjects; only 13.2% of subjects were treated with lipid lowering drugs. Lipid abnormalities were found in 56.8% of Spanish adults: 23.3% with high LDL-C, 21.5% high TG, 35.8% high non-HDL-C, and 17.2% low HDL-C. Most normal subjects showed an LDL-C ≤ 3.36 mmol/l. Pre-diabetics presented similar proportion when considering a goal of 3.36 mmol/l, but only 35% of them reached an LDL-C goal ≤ 2.6 mmol/l. Finally, 45.3% of diabetics had an LDL-C ≤ 2.6 mmol/l, and only 11.3% achieved an LDL-C ≤ 1.8 mmol/l. Conclusions: Our study demonstrates a high prevalence of dyslipidemia in the adult Spanish population, and a low use of lipid-lowering drugs. Moreover, the number of subjects achieving their corresponding LDL-C goal is small, particularly in subjects at high cardiovascular risk, such as diabetics

Introducción: La dislipidemia es uno de los factores más importantes implicados en el riesgo de desarrollar enfermedad cardiovascular en la diabetes tipo 2. En el presente estudio evaluamos la prevalencia de dislipidemia y su asociación con el metabolismo hidrocarbonado en una muestra representativa de población adulta española y el porcentaje de sujetos que alcanzaron el objetivo de cLDL. Material y métodos: El estudio Di@bet.es está basado en los datos obtenidos de una encuesta nacional transversal en 5.728 adultos. Resultados: Se estudiaron 4.776 sujetos. La dislipidemia fue diagnosticada en el 56,8% de los sujetos; solo el 13,2% de los individuos estaban en tratamiento con fármacos hipolipemiantes. Las alteraciones lipídicas se distribuyeron del siguiente modo: 23,3% tenían cLDL elevado, el 21,5% TG elevados, el 35,8% elevación de colesterol no HDL, y el 17,2% cHDL bajo. La mayor parte de los sujetos sanos tenían cLDL ≤ 3,36 mmol/l. Los individuos prediabéticos presentaron una proporción similar si consideramos como objetivo cLDL ≤ 3,36 mmol/l, pero solo el 35% de ellos alcanzaron un objetivo de cLDL≤ 2,6 mmol/l. Finalmente, el 45,3% de los diabéticos tenían cLDL≤ 2,6 mmol/l, y solo el 11,3% alcanzaron cLDL-C ≤ 1,8 mmol/l. Conclusiones: Nuestro estudio demuestra una elevada prevalencia de dislipidemia en población adulta española, y un escaso uso de fármacos hipolipemiantes. Además, el número de sujetos que alcanzaron el objetivo de cLDL fue muy pequeño, especialmente en sujetos con elevado riesgo cardiovascular como los diabéticos

Calidad de la ingesta alimentaria tras la cirugía bariátrica: gastrectomía vertical vs bypass gástrico / Quality of food intake after bariatric surgery: vertical gastrectomy versus gastric bypass

Introducción Las diferentes técnicas de cirugía bariátrica influyen en la tolerancia alimentaria y la presencia de vómitos. El impacto de estas técnicas sobre la calidad de la ingesta alimentaria está poco estudiada. Pacientes y métodos Estudio prospectivo y comparativo de una cohorte consecutiva de pacientes operados de obesidad mórbida entre mayo de 2008 y noviembre de 2010. Se evaluó la calidad de la alimentación antes y a los 3, 6, 12 y 24 meses de la intervención quirúrgica, mediante el cuestionario descrito por Suter et al. Resultados Ciento cinco pacientes (64 gastrectomía vertical [GV] y 41 bypass gástrico [BG]) completaron el cuestionario en el preoperatorio, 87 a los 3 meses, 79 a los 6 meses, 53 a los 12 meses y 18 a los 24 meses del postoperatorio. La puntuación total del cuestionario en el preoperatorio fue de 23,5±2,6, con diferencia significativa a los 3 meses (20,4±3,8, p<0,001), a los 6 meses (21,3±4,6, p<0,001) y a los 12 meses (22,4±3,3, p=0,044), y sin diferencia a los 24 meses (23,2±2,5, p=0,622). Al comparar la calidad de la alimentación de la GV frente al BG, la puntuación fue similar tanto en el preoperatorio (23,8±2,4 vs 23,0±2,8, p=0,125) como en el seguimiento postoperatorio de los 3 (20,5±3,9 vs 20,2±3,7, p=0,599), 6 (21,1±5,3 vs 21,7±3,4, p=0, 243), 12 (22,3±3,3 vs 22,7±3,4, p=0,140) y 24 meses (22,9±3,0 vs 23,6±2,2, p=1,00).Conclusiones El empeoramiento de la calidad de la ingesta alimentaria es común en los primeros meses tras la cirugía bariátrica, mejorando progresivamente y sin observar diferencias entre GV y BG (AU)

Introduction The different bariatric surgical techniques have an influence on food tolerance and the presence of vomiting. There have been few studies on the impact of these techniques on the quality of food intake. Patients and method A prospective and comparative study was performed on a consecutive patient cohort operated on due to morbid obesity between May 2008 and November 2010. The quality of the diet was evaluated before and at 3, 6, 12 and 24 months postoperatively, using the questionnaire described by Suter et al. Results One hundred and five patients (64 vertical gastrectomy [VG] and 41 gastric bypass [GB]) completed the questionnaire before the surgery, and 87 at 3 months, 79 at 6 months, 53 at 12 months, and 18 at 24 months after surgery. The overall score of the questionnaire before surgery was 23.5±2.6, with a significant difference at 3 months (20.4±3.8, P<.001), at 6 months (21.3±4.6, P<.001) and at 12 months (22.4±3.3, P<.044), and with no difference at 24 months (23.2±2.5, P<.622), after surgery. On comparing food intake of VG versus GB, the scores were similar before surgery (23.8±2.4 vs 23.0±2.8, P<.125) as well as in the post-surgical follow up at 3 months (20.5±3,9 vs 20.2±3.7, P<.599), 6 months (21.1±5.3 vs 21.7±3.4, P<.243), 12 months (22.3±3.3 vs 22.7±3.4, P<.140) and 24 months (22.9±3.0 vs 23.6±2.2, P=1.00). Conclusions The worsening of the quality of food intake is common in the first months after bariatric surgery, gradually improving and with no differences being seen between VG and GB (AU)

Pérdida de masa ósea tras gastrectomía tubular: estudio prospectivo comparativo con el bypass gástrico / Bone mass loss after sleeve gastrectomy: A prospective comparative study with gastric bypass

Introducción: La cirugía bariátrica es la opción más eficaz para el tratamiento de los pacientes con alto riesgo de complicaciones por su obesidad. Sin embargo provoca una serie de alteraciones metabólicas sobre el calcio y la vitamina D y un aumento de la resorción que conllevan una pérdida de masa ósea. Objetivo: El objetivo del estudio es la comparación de la gastrectomía tubular (GT) con el bypass gástrico en Y de Roux (BGYR) respecto la pérdida de masa ósea medida mediante densitometría y marcadores de remodelado óseo. Pacientes y métodos: Se incluyeron 15 mujeres con obesidad mórbida, 8 en la GT y 7 en el BGYR, de edad media 47,8±9 con un índice de masa corporal 43,3±3,4. Se realizaron mediciones de la masa ósea a nivel de columna, fémur y tercio distal del radio y marcadores de remodelado óseo N-telopéptido (NTx), y fosfatasa alcalina específica ósea (FAO), así como niveles de vitamina D antes y a los 12 meses de la intervención. Resultados: Se observó una pérdida significativa de masa ósea con la GT y el BGYR, en columna lumbar y cadera mientras que en el radio no se observaron diferencias significativas. El porcentaje de pérdida de masa ósea fue menor en columna y fémur tras la GT que con el BGYR, aunque sin llegar a la significación estadística, 4,6&%#x000B1;4,4 (media±DE) y 6,3&%#x000B1;5,4 (media±DE) respectivamente. A los 12 meses el NTx aumentó para ambos tipos de intervención y las FAO aumentaron solo para la GT. Conclusión: La GT provoca una pérdida menor de masa ósea, aunque no significativa, respecto el BGYR (AU)

Introduction: Bariatric surgery is the most effective option for the treatment of patients with a high risk of complications due to their obesity. However, it brings about a series of changes in calcium and vitamin D metabolism and an increase in resorption which lead to a loss of bone mass. Aim: The objective of this study is to compare sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) as regards loss of bone mass using bone densitometry and bone remodelling markers. Patients and methods: Fifteen women with morbid obesity were included, 8 by SG and 7 by RYGB, with a mean age of 47.8±9 and mean body mass index 43.3±3.4. Bone mass measurements were made on the lumbar spine, femur and distal radius, and the bone remodelling markers N-telopeptide (NTx) and bone alkaline phosphatase (BALP), as well as vitamin D levels before and 12 months after surgery. Results: A significant bone mass loss was observed was observed with SG and RYGB, in the lumbar spine and hip, whilst no differences were observed in the radial. The percentage bone mass loss was less in the column and femur after SG than with RYGB, although it did not reach statistical significance, 4.6&%#x000B1;4.4 (mean±SD) and 6.3&%#x000B1;5.4 (mean±SD), respectively. At 12 months the Ntx increased for both types of surgery, and the BAP was only increased for SG. Conclusion: SG causes less, although not significant, bone mass loss compared to RYGB (AU)