Publications
345 results found
Jain AK, le Roux CW, Puri P, et al., 2018, Proceedings of the 2017 ASPEN Research WorkshopGastric Bypass: Role of the Gut, JOURNAL OF PARENTERAL AND ENTERAL NUTRITION, Vol: 42, Pages: 279-295, ISSN: 0148-6071
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- Citations: 8
Al-Najim W, le Roux CW, Docherty NG, 2018, Integrated insights into the role of alpha-melanocyte stimulatory hormone in the control of food intake and glycaemia, PEPTIDES, Vol: 100, Pages: 243-248, ISSN: 0196-9781
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- Citations: 1
le Roux CW, Heneghan HM, 2018, Bariatric Surgery for Obesity, MEDICAL CLINICS OF NORTH AMERICA, Vol: 102, Pages: 165-+, ISSN: 0025-7125
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- Citations: 66
Sinclair P, Docherty N, le Roux CW, 2018, Metabolic Effects of Bariatric Surgery, CLINICAL CHEMISTRY, Vol: 64, Pages: 72-81, ISSN: 0009-9147
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- Citations: 16
Doody A, Jackson S, Elliott JA, et al., 2018, Validating the association between plasma tumour necrosis factor receptor 1 levels and the presence of renal injury and functional decline in patients with Type 2 diabetes, JOURNAL OF DIABETES AND ITS COMPLICATIONS, Vol: 32, Pages: 95-99, ISSN: 1056-8727
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- Citations: 12
Mangan A, Docherty NG, Le Roux CW, et al., 2018, Current and emerging pharmacotherapy for prediabetes: are we moving forward?, EXPERT OPINION ON PHARMACOTHERAPY, Vol: 19, Pages: 1663-1673, ISSN: 1465-6566
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- Citations: 6
Martin WP, Docherty NG, Le Roux CW, 2018, Impact of bariatric surgery on cardiovascular and renal complications of diabetes: a focus on clinical outcomes and putative mechanisms, EXPERT REVIEW OF ENDOCRINOLOGY & METABOLISM, Vol: 13, Pages: 251-262, ISSN: 1744-6651
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- Citations: 23
Abdelaal M, le Roux CW, Docherty NG, 2017, Validated Scoring Systems for Predicting Diabetes Remission After Bariatric Surgery, BARIATRIC SURGICAL PRACTICE AND PATIENT CARE, Vol: 12, Pages: 153-161, ISSN: 2168-023X
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- Citations: 2
Murphy CF, Docherty NG, le Roux CW, 2017, Liraglutide: another reason to target prediabetes?, ONCOTARGET, Vol: 8, Pages: 99203-99204
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- Citations: 1
Glaysher M, Mohanaruban A, Prechtl CG, et al., 2017, A randomised controlled trial of a duodenal-jejunal bypass sleeve device (EndoBarrier) compared with standard medical therapy for the management of obese subjects with type 2 diabetes mellitus, BMJ Open, Vol: 7, ISSN: 2044-6055
Introduction The prevalence of obesity and obesity-related diseases, including type 2 diabetes mellitus (T2DM), is increasing. Exclusion of the foregut, as occurs in Roux-en-Y gastric bypass, has a key role in the metabolic improvements that occur following bariatric surgery, which are independent of weight loss. Endoscopically placed duodenal-jejunal bypass sleeve devices, such as the EndoBarrier (GI Dynamics, Lexington, Massachusetts, USA), have been designed to create an impermeable barrier between chyme exiting the stomach and the mucosa of the duodenum and proximal jejunum. The non-surgical and reversible nature of these devices represents an attractive therapeutic option for patients with obesity and T2DM by potentially improving glycaemic control and reducing their weight.Methods and analysis In this multicentre, randomised, controlled, non-blinded trial, male and female patients aged 18–65 years with a body mass index 30–50 kg/m2 and inadequately controlled T2DM on oral antihyperglycaemic medications (glycosylated haemoglobin (HbA1c) 58–97 mmol/mol) will be randomised in a 1:1 ratio to receive either the EndoBarrier device (n=80) for 12 months or conventional medical therapy, diet and exercise (n=80). The primary outcome measure will be a reduction in HbA1c by 20% at 12 months. Secondary outcome measures will include percentage weight loss, change in cardiovascular risk factors and medications, quality of life, cost, quality-adjusted life years accrued and adverse events. Three additional subgroups will investigate the mechanisms behind the effect of the EndoBarrier device, looking at changes in gut hormones, metabolites, bile acids, microbiome, food hedonics and preferences, taste, brain reward system responses to food, eating and addictive behaviours, body fat content, insulin sensitivity, and intestinal tissue gene expression.
Cohen R, Le Roux CW, Junqueira S, et al., 2017, Roux-En-Y Gastric Bypass in Type 2 Diabetes Patients with Mild Obesity: a Systematic Review and Meta-analysis, OBESITY SURGERY, Vol: 27, Pages: 2733-2739, ISSN: 0960-8923
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- Citations: 18
Docherty NG, Fandriks L, le Roux CW, et al., 2017, Urinary sodium excretion after gastric bypass surgery, SURGERY FOR OBESITY AND RELATED DISEASES, Vol: 13, Pages: 1506-1514, ISSN: 1550-7289
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- Citations: 16
Risstad H, Kristinsson JA, Fagerland MW, et al., 2017, Bile acid profiles over 5 years after gastric bypass and duodenal switch: results from a randomized clinical trial, SURGERY FOR OBESITY AND RELATED DISEASES, Vol: 13, Pages: 1544-1554, ISSN: 1550-7289
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- Citations: 43
Gero D, Steinert RE, le Roux CW, et al., 2017, Do Food Preferences Change After Bariatric Surgery?, CURRENT ATHEROSCLEROSIS REPORTS, Vol: 19, ISSN: 1523-3804
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- Citations: 29
Kapoor N, Al-Najim W, le Roux CW, et al., 2017, Shifts in Food Preferences After Bariatric Surgery: Observational Reports and Proposed Mechanisms, CURRENT OBESITY REPORTS, Vol: 6, Pages: 246-252, ISSN: 2162-4968
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- Citations: 19
Koliaki C, Liatis S, Le Roux CW, et al., 2017, The role of bariatric surgery to treat diabetes: current challenges and perspectives, BMC ENDOCRINE DISORDERS, Vol: 17, ISSN: 1472-6823
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- Citations: 94
Elliott JA, Docherty NG, Eckhardt H-G, et al., 2017, Weight Loss, Satiety, and the Postprandial Gut Hormone Response After Esophagectomy: A Prospective Study., Ann Surg, Vol: 266, Pages: 82-90
OBJECTIVE: To prospectively characterize changes in body weight, satiety, and postprandial gut hormone profiles following esophagectomy. BACKGROUND: With improved oncologic outcomes in esophageal cancer, there is an increasing focus on functional status and health-related quality of life in survivorship. Early satiety and weight loss are common after esophagectomy, but the pathophysiology of these phenomena remains poorly understood. METHODS: In this prospective study, consecutive patients undergoing esophagectomy with gastric conduit reconstruction were studied preoperatively and at 10 days, 6 weeks, and 3 months postoperatively. Glucagon-like peptide 1 (GLP-1) immunoreactivity of plasma collected immediately before and at 15, 30, 60, 90, 120, 150, and 180 minutes after a standardized 400-kcal mixed meal was determined. Gastrointestinal symptom scores were computed using European Organization for Research and Treatment of Cancer questionnaires. RESULTS: Body weight loss at 6 weeks and 3 months postoperatively among 13 patients undergoing esophagectomy was 11.1 ± 2.3% (P < 0.001) and 16.3 ± 2.2% (P < 0.0001), respectively. Early satiety (P = 0.043), gastrointestinal pain and discomfort (P = 0.01), altered taste (P= 0.006), and diarrhea (P= 0.038) scores increased at 3 months postoperatively. Area under the curve for the satiety gut hormone GLP-1 was significantly increased from 10 days postoperatively (2.4 ± 0.2-fold increase, P < 0.01), and GLP-1 peak increased 3.8 ± 0.6-, 4.7 ± 0.8-, and 4.4 ± 0.5-fold at 10 days, 6 weeks, and 3 months postoperatively (all P < 0.0001). Three months postoperatively, GLP-1 area under the curve was associated with early satiety (P = 0.0002, R = 0.74), eating symptoms (P = 0.007, R = 0.54), and trouble enjoying meals (P = 0.0004, R = 0.73). CONCLUSIONS: After esophagectomy, patients demonstrate an exaggerated postprandial satiety gut hormone response, which may mediate postoperativ
Arora T, Seyfried F, Docherty NG, et al., 2017, Diabetes-associated microbiota in fa/fa rats is modified by Roux-en-Y gastric bypass, ISME JOURNAL, Vol: 11, Pages: 2035-2046, ISSN: 1751-7362
Miras AD, le Roux CW, 2017, Metabolic Surgery in a Pill, CELL METABOLISM, Vol: 25, Pages: 985-987, ISSN: 1550-4131
Nielsen MS, Christensen BJ, Ritz C, et al., 2017, Roux-En-Y Gastric Bypass and Sleeve Gastrectomy Does Not Affect Food Preferences When Assessed by an Ad libitum Buffet Meal, OBESITY SURGERY, Vol: 27, Pages: 2599-2605, ISSN: 0960-8923
Le Roux CW, Astrup A, Fujioka K, 2017, 3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial (vol 389, pg 1399, 2017), LANCET, Vol: 389, Pages: 1398-1398, ISSN: 0140-6736
Abdelaal M, le Roux CW, Docherty NG, 2017, Morbidity and mortality associated with obesity, ANNALS OF TRANSLATIONAL MEDICINE, Vol: 5, ISSN: 2305-5839
Cohen RV, Luque A, Junqueira S, et al., 2017, What is the impact on the healthcare system if access to bariatric surgery is delayed?, Surg Obes Relat Dis, Vol: 13, Pages: 1619-1627
BACKGROUND: Bariatric surgery has been available as part of the Brazilian Public Health System for patients with body mass index>40 kg/m(2) (or>35 kg/m(2) with co-morbidities) since 1999. However, access to surgery is challenging, with eligible patients waiting up to 7 years before surgery. OBJECTIVE: Our objective was to compare costs and effectiveness of different waiting times before surgery versus prompt surgery. SETTINGS: Public practice. METHODS: A Markov microsimulation model compared 5 different strategies: no surgery, prompt surgery, and delaying surgery for 1, 2, 4, and 7 years. Markov tracker variables and states reflected changes in body mass index, type 2 diabetes status (including remission and relapse), and cardiovascular events. Time horizon was 20 years; discount rate, 5%; and the perspective of the Brazilian Public Health System. Effectiveness was calculated as quality adjusted life years. RESULTS: Prompt surgery was the least costly and most effective strategy compared with any delay. Costs increased and effectiveness diminished progressively with the length of delays. Waiting 7 years for surgery was the most expensive and least effective strategy. Prompt surgery maintained dominance in 99.9%, 90.7%, 96.1%, and 94.2% of simulations in probabilistic sensitivity analyses versus 1-, 2-, 4-, and 7-year delays, respectively. Immediate surgery was very cost effective compared with no surgery in the case base. In the scenario with all patients having type 2 diabetes, immediate surgery was dominant to any strategy, including the no surgery group. CONCLUSIONS: Delaying bariatric operations is more expensive and less effective compared with prompt surgery and very cost effective compared with no surgery. Public health systems should pursue strategies to accelerate access to surgery to decrease obesity related complications and mortality of patients, but also to improve cost effectiveness.
Hyde KM, Blonde GD, le Roux CW, et al., 2017, Liraglutide suppression of caloric intake competes with the intake-promoting effects of a palatable cafeteria diet, but does not impact food or macronutrient selection, PHYSIOLOGY & BEHAVIOR, Vol: 177, Pages: 4-12, ISSN: 0031-9384
Ooi GJ, Doyle L, Tie T, et al., 2017, Weight loss after laparoscopic adjustable gastric band and resolution of the metabolic syndrome and its components., Int J Obes (Lond), Vol: 41, Pages: 902-908
BACKGROUND: Substantial weight loss in the setting of obesity has considerable metabolic benefits. Yet some studies have shown improvements in obesity-related metabolic comorbidities with more modest weight loss. By closely monitoring patients undergoing bariatric surgery, we aimed to determine the effects of weight loss on the metabolic syndrome and its components and determine the weight loss required for their resolution. METHODS: We performed a prospective observational study of obese participants with metabolic syndrome (Adult Treatment Panel III criteria) who underwent laparoscopic adjustable gastric banding. Participants were assessed for all criteria of the metabolic syndrome monthly for the first 9 months, then 3-monthly until 24 months. RESULTS: There were 89 participants with adequate longitudinal data. Baseline body mass index was 42.4±6.2 kg m(-2) with an average age was 48.2±10.7 years. There were 56 (63%) women. Resolution of the metabolic syndrome occurred in 60 of the 89 participants (67%) at 12 months and 60 of the 75 participants (80%) at 24 months. The mean weight loss when metabolic syndrome resolved was 10.9±7.7% total body weight loss (TBWL). The median weight loss at which prevalence of disease halved was 7.0% TBWL (17.5% excess weight loss (EWL)) for hypertriglyceridaemia; 11% TBWL (26.1-28% EWL) for high-density lipoprotein cholesterol and hyperglycaemia; 20% TBWL (59.5% EWL) for hypertension and 29% TBWL (73.3% EWL) for waist circumference. The odds ratio for resolution of the metabolic syndrome with 10-12.5% TBWL was 2.09 (P=0.025), with increasing probability of resolution with more substantial weight loss. CONCLUSIONS: In obese participants with metabolic syndrome, a weight loss target of 10-12.5% TBWL (25-30% EWL) is a reasonable initial goal associated with significant odds of having metabolic benefits. If minimal improvements are seen with this initial target, additional weight loss substantially in
Laurenius A, Werling M, le Roux CW, et al., 2017, Dumping symptoms is triggered by fat as well as carbohydrates in patients operated with Roux-en-Y gastric bypass, SURGERY FOR OBESITY AND RELATED DISEASES, Vol: 13, Pages: 1159-1164, ISSN: 1550-7289
le Roux CW, Astrup A, Fujioka K, et al., 2017, 3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial, LANCET, Vol: 389, Pages: 1399-1409, ISSN: 0140-6736
Cohen R, Pereira T, Aboud C, et al., 2017, Microvascular Outcomes after Metabolic Surgery (MOMS) in patients with Type 2 Diabetes Mellitus and class I obesity: rationale and design for a randomised controlled trial, BMJ Open, Vol: 7, ISSN: 2044-6055
Introduction There are several randomised controlled trials (RCTs) that have already shown that metabolic/bariatric surgery achieves short-term and long-term glycaemic control while there are no level 1A of evidence data regarding the effects of surgery on the microvascular complications of type 2 diabetes mellitus (T2DM).Purpose The aim of this trial is to investigate the long-term efficacy and safety of the Roux-en-Y gastric bypass (RYGB) plus the best medical treatment (BMT) versus the BMT alone to improve microvascular outcomes in patients with T2DM with a body mass index (BMI) of 30–34.9 kg/m2.Methods and analysis This study design includes a unicentric randomised unblinded controlled trial. 100 patients (BMI from 30 to 34.9 kg/m2) will be randomly allocated to receive either RYGB plus BMT or BMT alone. The primary outcome is the change in the urine albumin-to-creatinine ratio (uACR) captured as the proportion of patients who achieved nephropathy remission (uACR<30 mg/g of albumin/mg of creatinine) in an isolated urine sample over 12, 24 and 60 months.Ethics and dissemination The study was approved by the local Institutional Review Board. This study represents the first RCT comparing RYGB plus BMT versus BMT alone for patients with T2DM with a BMI below 35 kg/m2.
Spector AC, le Roux CW, Munger SD, et al., 2017, Proceedings of the 2015 ASPEN Research WorkshopTaste Signaling: Impact on Food Selection, Intake, and Health, JOURNAL OF PARENTERAL AND ENTERAL NUTRITION, Vol: 41, Pages: 113-124, ISSN: 0148-6071
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- Citations: 6
Murphy CF, le Roux CW, 2016, The Neurobiological Impact of Ghrelin Suppression after Oesophagectomy, International Journal of Molecular Sciences, Vol: 18, ISSN: 1422-0067
Ghrelin, discovered in 1999, is a 28-amino-acid hormone, best recognized as a stimulator of growth hormone secretion, but with pleiotropic functions in the area of energy homeostasis, such as appetite stimulation and energy expenditure regulation. As the intrinsic ligand of the growth hormone secretagogue receptor (GHS-R), ghrelin appears to have a broad array of effects, but its primary role is still an area of debate. Produced mainly from oxyntic glands in the stomach, but with a multitude of extra-metabolic roles, ghrelin is implicated in complex neurobiological processes. Comprehensive studies within the areas of obesity and metabolic surgery have clarified the mechanism of these operations. As a stimulator of growth hormone (GH), and an apparent inducer of positive energy balance, other areas of interest include its impact on carcinogenesis and tumour proliferation and its role in the cancer cachexia syndrome. This has led several authors to study the hormone in the cancer setting. Ghrelin levels are acutely reduced following an oesophagectomy, a primary treatment modality for oesophageal cancer. We sought to investigate the nature of this postoperative ghrelin suppression, and its neurobiological implications.
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