Results from the first Kuwait National Bariatric Surgery Report.

BACKGROUND: Currently, more than 30% of the population in the gulf demonstrate a body mass index (BMI) exceeding 30. This burden of obesity has proven to take a toll on the population; therefore, we created the first Kuwait National Bariatric Surgery Database to report on bariatric surgeries performed in Kuwait. METHODS: Data was collected from the six public hospitals in Kuwait. This data was then submitted to a merged National Registry. Data web portal were used to upload, merge, and analyze the data. RESULTS: The average age for participants was 32.6 years. The average preoperative BMI was 45.9 kg/m2 for males and 43.3 kg/m2 for females. 16.4% of males and 12.3% of females presented with type 2 diabetes, while the most prevalent obesity related disease was a poor functional status in both males and females (90.8% and 90.5%, respectively). Most procedures performed in Kuwait are sleeve gastrectomy. The most encountered in-hospital complication after primary bariatric surgery was bleeding (1.5%), with Roux-en-Y gastric bypass (RYGB) having the highest recorded rate of post-operative complications (3.6% bleeding). The overall rate of operative complications was 2.6%, which was most prevalent post-RYGB (10.3%) and lowest post-sleeve gastrectomy (2.5%). CONCLUSION: The importance of tracking and documenting the journey and change in the rates of obesity and effectiveness of bariatric procedures in individual countries with significantly high obesity rates is imperative to be able to create a plan of action to tackle this worldwide epidemic. This report will be able to provide the population with an accurate accounting that demonstrates further the safety of bariatric/metabolic surgery.

Effect of epigallocatechin gallate on uncoupling protein 2 in acute liver injury.

BACKGROUND: The aim of this study was to investigate the effect of epigallocatechin gallate (EGCG) on uncoupling protein 2 regulation in an acute liver injury-animal model. METHODS: Twenty seven male Wistar rats were divided into three groups: control group (n = 9), TAA group (n = 9): acute liver injury was induced by the intraperitoneal injection of thioacetamide (200 mg/kg) and EGCG/TAA (n = 9 rats): Epigallocatechin gallate was given two weeks prior to the induction of acute liver injury by thioacetamide. The levels of uncoupling protein 2, CRP, TNF-α and interleukins (IL) 6 and 18 were analyzed in the liver using PCR analysis. RESULTS: Q-PCR analysis showed that the genetic expression of UCP2, TNF-α and CRP in the EGCG/TAA group was the least in comparison to other groups (P ≤ 0.005). The IL-6 and IL-18 were upregulated after induction of acute liver injury, but this upregulation was significantly less in the group that received epigallocatechin gallate (EGCG/TAA) compared to the TAA group. In addition, histological examination showed a reduction in hepatocyte injury in EGCG/TAA compared to the TAA group. CONCLUSION: Epigallocatechin gallate administration prior to induction of acute liver injury down-regulates uncoupling protein 2 expression and reduces IL-6, IL-18, TNF-α and CRP.

Dynamics of vitamin D in patients with mild or inactive inflammatory bowel disease and their families.

BACKGROUND: 25(OH) vitamin D levels may be low in patients with moderately or severely active inflammatory bowel diseases (IBD: Crohn's disease and Idiopathic Ulcerative Colitis) but this is less clear in patients with mild or inactive IBD. Furthermore there is limited information of any family influence on 25(OH) vitamin D levels in IBD. As a possible risk factor we hypothesize that vitamin D levels may also be low in families of IBD patients. OBJECTIVES: To evaluate 25[OH] vitamin D levels in patients with IBD in remission or with mild activity. A second objective is to evaluate whether there are relationships within IBD family units of 25[OH] vitamin D and what are the influences associated with these levels. METHODS: Participants underwent medical history, physical examination and a 114 item diet questionnaire. Serum 25[OH] vitamin D was measured, using a radioimmunoassay kit, (replete ≥ 75, insufficient 50-74, deficient < 25-50, or severely deficient < 25 nmol/L). Associations between 25[OH] vitamin D and twenty variables were evaluated using univariate regression. Multivariable analysis was also applied and intrafamilial dynamics were assessed. RESULTS: 55 patients and 48 controls with their respective families participated (N206). 25[OH] vitamin D levels between patients and controls were similar (71.2 ± 32.8 vs. 68.3 ±26.2 nmol/L). Vitamin D supplements significantly increased intake but correlation with serum 25[OH] vitamin D was significant only during non sunny months among patients. Within family units, patients' families had mean replete levels (82.3 ± 34.2 nmol/L) and a modest correlation emerged during sunny months between patients and family (r2 =0.209 p = 0.032). These relationships were less robust and non significant in controls and their families. CONCLUSIONS: In patients with mild or inactive IBD 25[OH] vitamin D levels are less than ideal but are similar to controls. Taken together collectively, the results of this study suggest that patient family dynamics may be different in IBD units from that in control family units. However contrary to the hypothesis, intra familial vitamin D dynamics do not pose additional risks for development of IBD.