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Special Issue "Bariatric Surgery: Current Challenges and Future Perspectives"

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "General Surgery".

Deadline for manuscript submissions: closed (20 September 2023) | Viewed by 4920

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Dr. Ana De Hollanda

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Guest Editor

1. Hospital Clinic Barcelona, 08036 Barcelona, Spain
2. Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
3. CIBER de Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
Interests: diabetes; insulin resistance; glucose metabolism; metabolism; metabolic diseases; nutrition; lipid metabolism; abdominal obesity; fat; surgery

Special Issue Information

Dear Colleagues,

To date, bariatric surgery remains the most effective treatment for severe obesity. However, there are still many questions to be answered and challenges to be faced.

In this Special Collection, we aim to summarize the latest advances in both clinical and basic research involving bariatric surgery as a model of intensive weight loss.

Dr. Ana De Hollanda
Guest Editor

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Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Keywords

bariatric surgery
obesity
body composition
nutrients deficiency
adipose tissue
metabolic fatty liver disease
metabolic-associated fatty liver disease

Published Papers (4 papers)

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Research

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Open AccessArticle

Bariatric Surgery Outcomes in Patients with Chronic Kidney Disease

Adriana Pané

Maria Claro

Alicia Molina-Andujar

Romina Olbeyra

Bárbara Romano-Andrioni

Laura Boswell

Enrique Montagud-Marrahi

and

J. Clin. Med. 2023, 12(18), 6095; https://doi.org/10.3390/jcm12186095 - 21 Sep 2023

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Abstract

Obesity increases the risk of developing chronic kidney disease (CKD), which has a major negative impact on global health. Bariatric surgery (BS) has demonstrated a substantial improvement of obesity-related comorbidities and thus, it has emerged as a potential therapeutic tool in order to prevent end-stage renal disease. A limited number of publications to date have examined the beneficial effects and risks of BS in patients with non-advanced stages of CKD. We aimed to investigate the safety of BS in patients with CKD stages 3–4 (directly related or not to obesity) and both the metabolic/renal outcomes post-BS. A total of 57 individuals were included (n = 19 for CKD-group; n = 38 for patients with obesity, but normal eGFR [control-group]). Weight loss and obesity comorbidities resolution after BS were similar in both groups. Renal function (eGFR [CKD-EPI]) improved significantly at the 1-year follow-up: Δ10.2 (5.2–14.9) (p < 0.001) for CKD-group and Δ4.0 (−3.9–9.0) mL/min/1.73 m² (p = 0.043) for controls. Although this improvement tended to decrease in the 5-year follow-up, eGFR remained above its basal value for the CKD-group. Noteworthy, eGFR also improved in those patients who presented CKD not directly attributed to obesity. For patients with CKD, BS appears to be safe and effective regarding weight loss and obesity comorbidities resolution, irrespective of the main cause of CKD (related or not to obesity). Full article

(This article belongs to the Special Issue Bariatric Surgery: Current Challenges and Future Perspectives)

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Open AccessArticle

FABP4 Expression in Subcutaneous Adipose Tissue Is Independently Associated with Circulating Triglycerides in Obesity

and

J. Clin. Med. 2023, 12(3), 1013; https://doi.org/10.3390/jcm12031013 - 28 Jan 2023

Cited by 2 | Viewed by 1085

Abstract

Hypertriglyceridemia (HTG) has been associated with an increased risk of pancreatitis and cardiovascular disease. Adipose tissue plays a major role in lipid metabolism, mobilization and distribution. We have compared the histological and transcriptomic profiles of the subcutaneous (SAT) and visceral (VAT) adipose tissues from subjects with severe obesity undergoing bariatric surgery with (Ob-HTG, n = 37) and without HTG (Ob-NTG, n = 67). Mean age and BMI were 51.87 ± 11.21 years, 45.78 ± 6.96 kg/m² and 50.03 ± 10.17 years, 44.04 ± 4.69 kg/m², respectively. The Ob-HTG group showed higher levels of glycosylated hemoglobin, fasting plasma glucose, high-sensitivity C-reactive protein and prevalence of hypertension. The degree of fibrosis was increased by 14% in SAT from the Ob-HTG group (p = 0.028), while adipocyte size distribution was comparable. Twenty genes were found differentially expressed in SAT and VAT between study groups. Among them, only SAT expression of FABP4 resulted significantly associated with circulating triglyceride levels after adjusting for other covariates and independently explained 5% of the variance in triglyceride levels in the combined model. This relationship was not found in the cohort of lean or overweight patients with normotriglyceridemia (non-Ob, n = 21). These results emphasize the contribution of SAT to triglyceride concentrations in obesity and indicate that FABP4 may be a potential drug target for the treatment of HTG. Full article

(This article belongs to the Special Issue Bariatric Surgery: Current Challenges and Future Perspectives)

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Open AccessArticle

Bariatric Surgery Outcomes in Patients with Kidney Transplantation

Adriana Pané

Alicia Molina-Andujar

Romina Olbeyra

Bárbara Romano-Andrioni

Laura Boswell

Enrique Montagud-Marrahi

and

J. Clin. Med. 2022, 11(20), 6030; https://doi.org/10.3390/jcm11206030 - 13 Oct 2022

Cited by 2 | Viewed by 1182

Abstract

Obesity and kidney transplantation (KTx) are closely related. Obesity increases the risk of chronic kidney disease and can be a relative contraindication for KTx. Besides, KTx recipients are predisposed to obesity and its comorbidities. Consequently, bariatric surgery (BS) emerges as a powerful therapeutic tool either before or after KTx. Since evidence regarding the best approach is still scarce, we aimed to describe renal and metabolic outcomes in a single centre with more than 15-year experience in both surgeries. Methods: A retrospective study including patients who had received a KTx either before or after BS. Usual metabolic and renal outcomes, but also new variables (as renal graft dysfunction) were collected for a minimum follow-up of 1-year post-BS. Results: A total of 11 patients were included: n = 6 (BS-post-KTx) and n = 5 (BS-pre-KTx). One patient was assessed in both groups. No differences in the main outcomes were identified, but BS-post-KTx group tended to gain more weight during the follow-up. The incidence of renal graft dysfunction was comparable (4/6 for BS-post-KTx, 3/5 for BS-pre-KTx) between groups. Conclusions: BS in patients with KTx appears to be safe and effective attending to metabolic and renal outcomes. These results seem irrespective of the time course, except for weight regain, which appears to be a common pattern in the BS-post-KTx group. Full article

(This article belongs to the Special Issue Bariatric Surgery: Current Challenges and Future Perspectives)

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Bariatric Surgery and Myocardial Mechanics: A Meta-Analysis of Speckle Tracking Echocardiographic Studies

and

J. Clin. Med. 2022, 11(16), 4655; https://doi.org/10.3390/jcm11164655 - 09 Aug 2022

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Abstract

Aim: Current evidence on the effects of bariatric surgery on cardiac mechanics in patients with obesity is based on a few single studies. We investigated this issue through a meta-analysis of speckle tracking echocardiography (STE) studies that reported data on changes in left ventricular (LV) mechanics as assessed by global longitudinal strain (GLS). Methods: The PubMed, OVID-MEDLINE and Cochrane library databases were systematically analysed to search English-language articles published from inception to 31 May 2022. Studies were identified by using Me-SH terms and crossing the following terms: “obesity”, “bariatric surgery”, “left ventricular mechanics”, “left ventricular hypertrophy”, “systolic dysfunction”, “global longitudinal strain”, “echocardiography” and “STE echocardiography”. Results: The meta-analysis, including a total of 512 patients with obesity from 13 studies (follow-up 1–23 months), showed a significant GLS improvement after bariatric procedures, with standard mean difference (SMD) being 0.50 ± 0.08, CI: 0.34/0.65, p < 0.0001. Corresponding SMD value for LV ejection fraction (LVEF) was 0.15 ± 0.09, CI: −0.04/0.34, p = 0.11. A sensitivity analysis restricted to 11 studies with follow-up ≥ 6 months confirmed that GLS (SMD: 0.47 ± 0.08, CI: 0.30/0.63, p < 0.0001) but not LVEF (SMD: 0.14 ± 0.11, CI: −0.08/0.37, p = 0.21) improved after surgery. Conclusions: Our meta-analysis adds a new piece of information on the beneficial effects of bariatric surgery on LV systolic function and, more importantly, suggests that the assessment of myocardial strain should be routinely implemented for a comprehensive evaluation of cardiac functional changes associated with bariatric procedures. Full article

(This article belongs to the Special Issue Bariatric Surgery: Current Challenges and Future Perspectives)

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