☆ 4.4 Article

Involvement of Dietary Fatty Acids in Multiple Biological and Psychological Functions, in Morbidly Obese Subjects

OBESITY SURGERY (2015)

Journal

OBESITY SURGERY

Volume 25, Issue 6, Pages 1031-1038

Publisher

SPRINGER

DOI: 10.1007/s11695-014-1471-z

Keywords

Roux-en-Y gastric bypass; Fatty acids; Vitamin A; Vitamin E

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Abstract

Fatty acid (FA) profile is often altered, in morbidly obese subjects, both before and after bariatric surgery. We measured FA plasma levels before and 6 months after Roux-en-Y gastric bypass (RYGB), in order to evaluate their relationship with different biological and psychological parameters and the impact of RYGB on the FA plasma levels. Thirty eight morbidly obese patients were investigated before RYGB, and 28 of them were reexamined 6 months postoperatively. Anxiety, depression, and quality of life were evaluated by validated questionnaires. Plasma FA (saturated, monounsaturated, polyunsaturated omega-6 and omega-3), vitamins A and E, fasting insulinemia, and high-sensitive C-reactive protein (hs-CRP) were measured. Before surgery, omega-3 polyunsaturated FA and vit A showed significant negative relationship with fasting insulinemia (gamma-linolenic p = 0.03, eicosapentaenoic, vit A p = 0.01) and hs-CRP (eicosapentaenoic p = 0.03, vit A p = 0.02) and a positive link with HDL cholesterol (gamma-linolenic p = 0.03, vit A p = 0.02). Depression score was significantly and negatively linked with palmitoleic (p = 0.03), gamma-linolenic (p = 0.006), dihomo-gamma-linolenic (p = 0.02), and alpha-linolenic (p = 0.03) acids. After surgery, FA and both vit A and E were significantly reduced. Vit A levels were below 2.4 mu mol/l in 63 % of the patients, preoperatively, and in 79 % after surgery. Preoperative levels of linoleic acid were significantly related with the postoperative weight reduction (p = 0.0006). FA are involved in several biological and psychological functions. The RYGB-induced reduction of FA could have deleterious consequences on vitamin absorption, metabolism, and depression. Thus, the surveillance of FA levels is of primary importance both before and after RYGB.

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Laparoscopic sleeve gastrectomy to Roux-en-Y gastric bypass conversion versus primary Roux-en-Y gastric bypass: a propensity score matching analysis

Michael O'Laughlin, Jorge Cornejo, Alba Zevallos, Alisa Coker, Michael Schweitzer, Gina Adrales, Christina Li, Raul Sebastian

Summary: Background: The rates of secondary bariatric surgery have increased, with sleeve gastrectomy to gastric bypass conversion being the most common. This study evaluates the outcomes of this conversion compared to primary Roux-en-Y gastric bypass (RYGB) surgery using MBSAQIP data. Methods: The study analyzed the data of patients who underwent sleeve gastrectomy to RYGB conversion and primary laparoscopic RYGB, matching them based on preoperative characteristics. Results: The analysis showed that the conversion from sleeve gastrectomy to RYGB was associated with higher readmissions, interventions, conversion to open surgery, longer hospital stay, and longer operative time compared to primary RYGB. However, there were no significant differences in mortality or rates of bariatric complications. Conclusion: The study concludes that conversion from sleeve gastrectomy to RYGB is a safe and feasible procedure with reasonable outcomes compared to primary RYGB.

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES (2023)