Evaluación del efecto de la liposucción con o sin abdominoplastia sobre la resistencia a la insulina en pacientes normoglucémicas con sobrepeso: un estudio prospectivo de cohorte / The effect of liposuction versus liposuction with abdominoplasty on insulin resistance in normoglycemic non-obese females: A prospective cohort study

Introducción: Varios estudios han evaluado el efecto de la liposucción o de la abdominoplastia sobre la salud metabólica, incluyendo la resistencia a la insulina, con resultados mixtos. A varias pacientes con sobrepeso, sin obesidad marcada, se les recomienda el procedimiento de liposucción combinado con abdominoplastia, sin que exista publicada evidencia alguna sobre la efectividad de combinar ambos procedimientos en la salud metabólica. Métodos: El presente estudio prospectivo de cohorte evaluó el cambio en la resistencia a la insulina y otros parámetros metabólicos en dos grupos de mujeres hispanoamericanas normoglucémicas con sobrepeso. Las pacientes del primer grupo fueron sometidas a liposucción únicamente (LIPO), mientras que el segundo grupo fue sometido a liposucción con abdominoplastia (LIPO+ABDO). Resultados: Un total de 31 pacientes fueron evaluadas, incluyendo a 13 con LIPO y 18 con LIPO+ABDO; ambos grupos mostraron HOMA-IR prequirúrgicos similares (p>0,72). En las del grupo LIPO evaluadas 60días después del procedimiento, se observaron HOMA-IR similares a sus niveles prequirúrgicos (2.,98±0,4 vs. 2,70±0,3, p>0,20); las del grupo LIPO+ABDO, sin embargo, mostraron HOMA-IR significativamente reducidos en comparación de sus índices prequirúrgicos (2,37±0,2 vs. 1,73±0,1, p<0,001). También en este grupo, esta reducción se correlacionó positivamente con el valor prequirúrgico de HOMA-IR (p<0,001) y, de manera interesante, se observó una correlación negativa entre la edad de la paciente y el grado de disminución en el HOMA-IR tras la cirugía (Spearman r=−0,56, p<0,05). No se observaron cambios en los otros parámetros bioquímicos evaluados. Conclusiones: Los datos de este estudio sugieren que cuando es combinada con abdominoplastia, la liposucción mejora la resistencia a la insulina en pacientes hispanoamericanas. Se requieren de estudios adicionales para probar dicha posibilidad.(AU)

Introduction: Several studies have evaluated the effect of liposuction or abdominoplasty on metabolic health, including insulin resistance, with mixed results. Many overweight patients, with no marked obesity, are recommended to undergo liposuction combined with abdominoplasty, but no study has evaluated the effectiveness of combining the two procedures on metabolic health. Methods: The present prospective cohort study compares the metabolic parameters of two groups of normoglycemic Hispanic women without obesity. The first group underwent liposuction only (LIPO), while the second group had combined liposuction and abdominoplasty (LIPO+ABDO). Results: A total of 31 patients were evaluated, including 13 in the LIPO group and 18 in the LIPO+ABDO group. The two groups had similar HOMA-IR before surgery (P>.72). When tested 60days after surgery, women in the LIPO group had similar HOMA-IR compared to their preoperative levels (2.98±0.4 vs. 2.70±0.3; P>.20). However, the LIPO+ABDO group showed significantly reduced HOMA-IR values compared to their preoperative levels (2.37±0.2 vs. 1.73±0.1; P<.001). In this group, this decrease also positively correlated with their preoperative HOMA-IR (Spearman r=0.72; P<.001) and, interestingly, we observed a negative correlation between the age of the subjects and the drop in HOMA-IR after surgery (Spearman r=−0.56; P<.05). No changes were observed in the other biochemical parameters that were assessed. Conclusions: These data suggest that, when combined with abdominoplasty, liposuction does improve insulin resistance in healthy Hispanic females. More studies are warranted to address this possibility.(AU)

The effect of liposuction versus liposuction with abdominoplasty on insulin resistance in normoglycemic non-obese Mexican females: A prospective cohort study.

INTRODUCTION: Several studies have evaluated the effect of liposuction or abdominoplasty on metabolic health, including insulin resistance, with mixed results. Many overweight patients, with no marked obesity, are recommended to undergo liposuction combined with abdominoplasty, but no study has evaluated the effectiveness of combining the two procedures on metabolic health. METHODS: The present prospective cohort study compares the metabolic parameters of 2 groups of normoglycemic Hispanic women without obesity. The first group underwent liposuction only (LIPO), while the second group had combined liposuction and abdominoplasty (LIPO + ABDO). RESULTS: A total of 31 patients were evaluated, including 13 in the LIPO group and 18 in the LIPO + ABDO group. The 2 groups had similar HOMA-IR before surgery (P > 0.72). When tested 60 days after surgery, women in the LIPO group had similar HOMA-IR compared to their preoperative levels (2.98 ± 0.4 vs 2.70 ± 0.3; P > .20). However, the LIPO+ABDO group showed significantly reduced HOMA-IR values compared to their preoperative levels (2.37 ± 0.2 vs 1.73 ± 0.1; P < .001). In this group, this decrease also positively correlated with their preoperative HOMA-IR (Spearman r = 0.72; P < .001) and, interestingly, we observed a negative correlation between the age of the subjects and the drop in HOMA-IR after surgery (Spearman r = -0.56; P < .05). No changes were observed in the other biochemical parameters that were assessed. CONCLUSIONS: These data suggest that, when combined with abdominoplasty, liposuction does improve insulin resistance in healthy Hispanic females. More studies are warranted to address this possibility.

Cirugía bariátrica y trastorno por abuso de alcohol y otras sustancias: una revisión sistemática / Bariatric surgery and alcohol and substance abuse disorder: A systematic review

Antecedentes: La cirugía bariátrica es un procedimiento quirúrgico relativamente seguro y con alta tasa de éxito. Sin embargo, reportes recientes indican una mayor prevalencia de abuso de alcohol u otras sustancias en este grupo de pacientes. El propósito del presente estudio fue revisar la evidencia que existe al respecto para que sea tomada en cuenta por el equipo multidisciplinario que atiende a este grupo de pacientes. Métodos: Se realizaron búsquedas en las bases de datos de PubMed y CENTRAL, y se extrajeron las razones de momio de los distintos artículos, comparando la prevalencia por abuso de alcohol o de otras sustancias en el periodo posquirúrgico vs. los niveles prequirúrgicos. También se comparó la prevalencia de abuso de alcohol tras distintos tipos de cirugía bariátrica. Resultados: Un total de 49.121 pacientes bariátricos (80,8% mujeres) fueron evaluados para abuso de alcohol. De manera general, se encontró que la cirugía bariátrica estaba asociada con un aumento en la prevalencia por abuso de alcohol (4,58±5,3 vs. 1,58±10,7% en el periodo prequirúrgico). También encontramos que la población de pacientes que se sometieron a cirugía de tipo RYGB tenía mayor prevalencia de abuso de alcohol que aquellos que se sometieron a otro tipo de cirugía (OR: 1,83; IC 95%: 1,51-2,21). La prevalencia de abuso de sustancias distintas al alcohol tras este procedimiento está menos estudiada, aunque parece existir un aumento en el riesgo por abuso a ciertas sustancias. Conclusiones: La cirugía bariátrica es el mejor tratamiento para la obesidad y sus complicaciones. La evidencia revisada sugiere que se relaciona con un aumento modesto, pero consistente en la prevalencia por abuso de alcohol y otras sustancias. El equipo médico a cargo del paciente bariátrico deberá estar informado acerca de esta eventualidad para su oportuna prevención, diagnóstico y tratamiento. (AU)

Introduction: Bariatric surgery is a relatively safe surgical procedure with a high success rate. However, recent reports indicate a higher prevalence of alcohol or substance abuse disorder in this patient group. The purpose of this study was to review the related evidence to serve as a reference for multidisciplinary teams who treat these patients. Methods: We searched the PubMed and CENTRAL databases. The odds ratios were extracted from the different articles, comparing the prevalence of the abuse of alcohol or other substances in the postoperative period versus preoperative levels. We also compared the prevalence of alcohol use disorder after different types of bariatric surgery. Results: A total of 49 121 bariatric patients (80.8% female) were evaluated for alcohol use disorder. In general, bariatric surgery was found to be associated with an increase in the prevalence of alcohol abuse (4.58±5.3 vs. 1.58±10.7% in the preoperative period). We also found that the population of patients who underwent RYGB procedures had a higher prevalence of alcohol use disorder than patients who underwent another type of surgery (OR: 1.83; 95% CI: 1.51-2.21). The prevalence of substance abuse disorder (other than alcohol) after this procedure is less studied, although there appears to be an increased risk of abuse of certain substances. Conclusions: Bariatric surgery is the best treatment for obesity and its complications. The evidence reviewed suggests that it correlates with a modest but consistent increase in the prevalence of abuse of alcohol and other substances. Medical teams who treat bariatric patients must be informed about this eventuality for its timely prevention, diagnosis and treatment. (AU)

Bariatric surgery and alcohol and substance abuse disorder: A systematic review.

INTRODUCTION: Bariatric surgery is a relatively safe surgical procedure with a high success rate. However, recent reports indicate a higher prevalence of alcohol or substance abuse disorder in this patient group. The purpose of this study was to review the related evidence to serve as a reference for multidisciplinary teams who treat these patients. METHODS: We searched the PubMed and CENTRAL databases. The odds ratios were extracted from the different articles, comparing the prevalence of the abuse of alcohol or other substances in the postoperative period versus preoperative levels. We also compared the prevalence of alcohol use disorder after different types of bariatric surgery. RESULTS: A total of 49 121 bariatric patients (80.8% female) were evaluated for alcohol use disorder. In general, bariatric surgery was found to be associated with an increase in the prevalence of alcohol abuse (4.58 ± 5.3 vs. 1.58 ± 10.7% in the preoperative period). We also found that the population of patients who underwent RYGB procedures had a higher prevalence of alcohol use disorder than patients who underwent another type of surgery (OR: 1.83; 95% CI: 1.51-2.21). The prevalence of substance abuse disorder (other than alcohol) after this procedure is less studied, although there appears to be an increased risk of abuse of certain substances. CONCLUSIONS: Bariatric surgery is the best treatment for obesity and its complications. The evidence reviewed suggests that it correlates with a modest but consistent increase in the prevalence of abuse of alcohol and other substances. Medical teams who treat bariatric patients must be informed about this eventuality for its timely prevention, diagnosis and treatment.

Bariatric surgery and alcohol and substance abuse disorder: A systematic review. / Cirugía bariátrica y trastorno por abuso de alcohol y otras sustancias: una revisión sistemática.

INTRODUCTION: Bariatric surgery is a relatively safe surgical procedure with a high success rate. However, recent reports indicate a higher prevalence of alcohol or substance abuse disorder in this patient group. The purpose of this study was to review the related evidence to serve as a reference for multidisciplinary teams who treat these patients. METHODS: We searched the PubMed and CENTRAL databases. The odds ratios were extracted from the different articles, comparing the prevalence of the abuse of alcohol or other substances in the postoperative period versus preoperative levels. We also compared the prevalence of alcohol use disorder after different types of bariatric surgery. RESULTS: A total of 49 121 bariatric patients (80.8% female) were evaluated for alcohol use disorder. In general, bariatric surgery was found to be associated with an increase in the prevalence of alcohol abuse (4.58±5.3 vs. 1.58±10.7% in the preoperative period). We also found that the population of patients who underwent RYGB procedures had a higher prevalence of alcohol use disorder than patients who underwent another type of surgery (OR: 1.83; 95% CI: 1.51-2.21). The prevalence of substance abuse disorder (other than alcohol) after this procedure is less studied, although there appears to be an increased risk of abuse of certain substances. CONCLUSIONS: Bariatric surgery is the best treatment for obesity and its complications. The evidence reviewed suggests that it correlates with a modest but consistent increase in the prevalence of abuse of alcohol and other substances. Medical teams who treat bariatric patients must be informed about this eventuality for its timely prevention, diagnosis and treatment.

Spatial Memory Impairment is Associated with Intraneural Amyloid-ß Immunoreactivity and Dysfunctional Arc Expression in the Hippocampal-CA3 Region of a Transgenic Mouse Model of Alzheimer's Disease.

Dysfunction of synaptic communication in cortical and hippocampal networks has been suggested as one of the neuropathological hallmarks of the early stages of Alzheimer's disease (AD). Also, several lines of evidence have linked disrupted levels of activity-regulated cytoskeletal associated protein (Arc), an immediate early gene product that plays a central role in synaptic plasticity, with AD "synaptopathy". The mapping of Arc expression patterns in brain networks has been extensively used as a marker of memory-relevant neuronal activity history. Here we evaluated basal and behavior-induced Arc expression in hippocampal networks of the 3xTg-AD mouse model of AD. The basal percentage of Arc-expressing cells in 10-month-old 3xTg-AD mice was higher than wild type in CA3 (4.88% versus 1.77% , respectively) but similar in CA1 (1.75% versus 2.75% ). Noteworthy, this difference was not observed at 3 months of age. Furthermore, although a Morris water maze test probe induced a steep (∼4-fold) increment in the percentage of Arc+ cells in the CA3 region of the 10-month-old wild-type group, no such increment was observed in age-matched 3xTg-AD, whereas the amount of Arc+ cells in CA1 increased in both groups. Further, we detected that CA3 neurons with amyloid-ß were much more likely to express Arc protein under basal conditions. We propose that in 3xTg-AD mice, intraneuronal amyloid-ß expression in CA3 could increase unspecific neuronal activation and subsequent Arc protein expression, which might impair further memory-stabilizing processes.