Publications
345 results found
Risstad H, Sovik TT, Engstrom M, et al., 2015, Five-Year Outcomes After Laparoscopic Gastric Bypass and Laparoscopic Duodenal Switch in Patients With Body Mass Index of 50 to 60 A Randomized Clinical Trial, JAMA SURGERY, Vol: 150, Pages: 352-361, ISSN: 2168-6254
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- Citations: 128
Wu Q, Li JV, Seyfried F, et al., 2015, Metabolic phenotype-microRNA data fusion analysis of the systemic consequences of Roux-en-Y gastric bypass surgery., International Journal of Obesity, Vol: 2015, Pages: 1126-1134, ISSN: 1476-5497
Background/Objectives: Bariatric surgery offers sustained dramatic weight loss and often remission of type 2 diabetes, yet the mechanisms of establishment of these health benefits are not clear.Subjects/MethodsWe mapped the co-ordinated systemic responses of gut hormones, the circulating miRNAome and the metabolome in a rat model of Roux-en-Y gastric bypass (RYGB) surgery. Results: The response of circulating miRNAs to RYGB was striking and selective. Analysis of 14 significantly altered circulating miRNAs within a pathway context was suggestive of modulation of signalling pathways including G protein signalling, neurodegeneration, inflammation, and growth and apoptosis responses. Concomitant alterations in the metabolome indicated increased glucose transport, accelerated glycolysis and inhibited gluconeogenesis in the liver. Of particular significance, we show significantly decreased circulating miRNA-122 levels and a more modest decline in hepatic levels, following surgery. In mechanistic studies, manipulation of miRNA-122 levels in a cell model induced changes in the activity of key enzymes involved in hepatic energy metabolism, glucose transport, glycolysis, TCA cycle, pentose phosphate shunt, fatty acid oxidation and gluconeogenesis, consistent with the findings of the in vivo surgery-mediated responses, indicating the powerful homeostatic activity of the miRNAs. Conclusions: The close association between energy metabolism, neuronal signalling and gut microbial metabolites derived from the circulating miRNA, plasma, urine and liver metabolite and gut hormone correlations further supports an enhanced gut-brain signaling, which we suggest is hormonally mediated by both traditional gut hormones and miRNAs. This transomic approach to map the crosstalk between the circulating miRNAome and metabolome offers opportunities to understand complex systems biology within a disease and interventional treatment setting.International Journal of Obesity accepted article previe
Sathyapalan T, Thatcher NJ, Hammersley R, et al., 2015, Aspartame Sensitivity? A Double Blind Randomised Crossover Study, PLOS One, Vol: 10, ISSN: 1932-6203
BackgroundAspartame is a commonly used intense artificial sweetener, being approximately 200 timessweeter than sucrose. There have been concerns over aspartame since approval in the1980s including a large anecdotal database reporting severe symptoms. The objective ofthis study was to compare the acute symptom effects of aspartame to a control preparation.MethodsThis was a double-blind randomized cross over study conducted in a clinical research unitin United Kingdom. Forty-eight individual who has self reported sensitivity to aspartamewere compared to 48 age and gender matched aspartame non-sensitive individuals. Theywere given aspartame (100mg)-containing or control snack bars randomly at least 7 daysapart. The main outcome measures were acute effects of aspartame measured using repeatedratings of 14 symptoms, biochemistry and metabonomics.ResultsAspartame sensitive and non-sensitive participants differed psychologically at baseline inhandling feelings and perceived stress. Sensitive participants had higher triglycerides (2.05± 1.44 vs. 1.26 ± 0.84mmol/L; p value 0.008) and lower HDL-C (1.16 ± 0.34 vs. 1.35 ± 0.54mmol/L; p value 0.04), reflected in 1H NMR serum analysis that showed differences in thebaseline lipid content between the two groups. Urine metabonomic studies showed no significantdifferences. None of the rated symptoms differed between aspartame and controlbars, or between sensitive and control participants. However, aspartame sensitive participantsrated more symptoms particularly in the first test session, whether this was placebo or control. Aspartame and control bars affected GLP-1, GIP, tyrosine and phenylalanine levelsequally in both aspartame sensitive and non-sensitive subjects.ConclusionUsing a comprehensive battery of psychological tests, biochemistry and state of the artmetabonomics there was no evidence of any acute adverse responses to aspartame. Thisindependent study gives reassurance to both regulatory bodies an
Sam AH, Sleeth ML, Thomas EL, et al., 2015, Circulating pancreatic polypeptide concentrations predict visceral and liver fat content, Journal of Clinical Endocrinology and Metabolism, Vol: 100, Pages: 1048-1052, ISSN: 0021-972X
Context and objective:No current biomarker can reliably predict visceral and liver fat content, both of which are risk factors for cardiovascular disease. Vagal tone has been suggested to influence regional fat deposition. Pancreatic polypeptide (PP) is secreted from the endocrine pancreas under vagal control. We investigated the utility of PP in predicting visceral and liver fat.Patients and Methods:Fasting plasma PP concentrations were measured in 104 overweight and obese subjects (46 men and 58 women). In the same subjects, total and regional adipose tissue, including total visceral adipose tissue (VAT) and total subcutaneous adipose tissue (TSAT), were measured using whole-body magnetic resonance imaging. Intrahepatocellular lipid content (IHCL) was quantified by proton magnetic resonance spectroscopy.Results:Fasting plasma PP concentrations positively and significantly correlated with both VAT (r = 0.57, P < .001) and IHCL (r = 0.51, P < .001), but not with TSAT (r = 0.02, P = .88). Fasting PP concentrations independently predicted VAT after controlling for age and sex. Fasting PP concentrations independently predicted IHCL after controlling for age, sex, body mass index (BMI), waist-to-hip ratio, homeostatic model assessment 2-insulin resistance, (HOMA2-IR) and serum concentrations of triglyceride (TG), total cholesterol (TC), and alanine aminotransferase (ALT). Fasting PP concentrations were associated with serum ALT, TG, TC, low- and high-density lipoprotein cholesterol, and blood pressure (P < .05). These associations were mediated by IHCL and/or VAT. Fasting PP and HOMA2-IR were independently significantly associated with hepatic steatosis (P < .01).Conclusions:Pancreatic polypeptide is a novel predictor of visceral and liver fat content, and thus a potential biomarker for cardiovascular risk stratification and targeted treatment of patients with ectopic fat deposition.
Abegg K, Corteville C, Docherty NG, et al., 2015, Effect of bariatric surgery combined with medical therapy versus intensive medical therapy or calorie restriction and weight loss on glycemic control in Zucker diabetic fatty rats, AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY, Vol: 308, Pages: R321-R329, ISSN: 0363-6119
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- Citations: 12
Goyale A, Ashley SL, Taylor DR, et al., 2015, Predicting refeeding hypophosphataemia: insulin growth factor 1 (IGF-1) as a diagnostic biochemical marker for clinical practice, ANNALS OF CLINICAL BIOCHEMISTRY, Vol: 52, Pages: 82-87, ISSN: 0004-5632
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- Citations: 23
Neff KJ, O'Donohoe PK, le Roux CW, 2015, Anti-inflammatory effects of gastric bypass surgery and their association with improvement in metabolic profile, EXPERT REVIEW OF ENDOCRINOLOGY & METABOLISM, Vol: 10, Pages: 435-446, ISSN: 1744-6651
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- Citations: 3
Papamargaritis D, Aasheim ET, Sampson B, et al., 2015, Copper, selenium and zinc levels after bariatric surgery in patients recommended to take multivitamin-mineral supplementation, JOURNAL OF TRACE ELEMENTS IN MEDICINE AND BIOLOGY, Vol: 31, Pages: 167-172, ISSN: 0946-672X
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- Citations: 47
Chuah LL, Miras AD, Papamargaritis D, et al., 2014, Impact of perioperative management of glycemia in severely obese diabetic patients undergoing gastric bypass surgery, SURGERY FOR OBESITY AND RELATED DISEASES, Vol: 11, Pages: 578-584, ISSN: 1550-7289
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- Citations: 11
Jackson S, le Roux CW, Docherty NG, 2014, Bariatric Surgery and Microvascular Complications of Type 2 Diabetes Mellitus, CURRENT ATHEROSCLEROSIS REPORTS, Vol: 16, ISSN: 1523-3804
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- Citations: 20
Elias E, Casselbrant A, Werling M, et al., 2014, Bone mineral density and expression of vitamin D receptor-dependent calcium uptake mechanisms in the proximal small intestine after bariatric surgery, BRITISH JOURNAL OF SURGERY, Vol: 101, Pages: 1566-1575, ISSN: 0007-1323
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- Citations: 20
Seyfried F, Bueter M, Spliethoff K, et al., 2014, Roux-en Y Gastric Bypass Is Superior to Duodeno-Jejunal Bypass in Improving Glycaemic Control in Zucker Diabetic Fatty Rats, OBESITY SURGERY, Vol: 24, Pages: 1888-1895, ISSN: 0960-8923
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- Citations: 20
Miras AD, Seyfried F, Phinikaridou A, et al., 2014, Rats fed diets with different energy contribution from fat do not differ in adiposity, Obesity Facts, Vol: 7, Pages: 302-310, ISSN: 1662-4025
Objective: To determine whether rats reaching the same body mass, having been fed either a low-fat (LFD) or a high-fat diet (HFD), differ in white adipose tissue (WAT) deposition. Methods: In experiment 1, 22 Sprague-Dawley rats of the same age were divided into 11 rats with body mass below the batch median and fed a HFD, and 11 above the median and fed a LFD. In experiment 2, 20 Sprague-Dawley rats of the same age and starting body mass were randomised to either a HFD or LFD. When all groups reached similar final body mass, WAT was quantified using magnetic resonance imaging (MRI), dissection, and plasma leptin. Results: In experiment 1, both groups reached similar final body mass at the same age; in experiment 2 the HFD group reached similar final body mass earlier than the LFD group. There were no significant differences in WAT as assessed by MRI or leptin between the HFD and LFD groups in both experiments. Dissection revealed a trend for higher retroperitoneal and epididymal adiposity in the HFD groups in both experiments. Conclusions: We conclude that at similar body mass, adiposity is independent of the macronutrient composition of the feeding regimen used to achieve it.
Bhutta HY, Deelman TE, le Roux CW, et al., 2014, Intestinal sweet-sensing pathways and metabolic changes after Roux-en-Y gastric bypass surgery, AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY, Vol: 307, Pages: G588-G593, ISSN: 0193-1857
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- Citations: 22
Docherty NG, le Roux CW, 2014, Improvements in the metabolic milieu following Roux-en-Y gastric bypass and the arrest of diabetic kidney disease, EXPERIMENTAL PHYSIOLOGY, Vol: 99, Pages: 1146-1153, ISSN: 0958-0670
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- Citations: 19
Docherty NG, le Roux CW, 2014, Physiological and pathophysiological signalling between the gut and the kidney: role in diabetic kidney disease, EXPERIMENTAL PHYSIOLOGY, Vol: 99, Pages: 1138-1139, ISSN: 0958-0670
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- Citations: 1
le Roux CW, Bueter M, 2014, The physiology of altered eating behaviour after Roux-en-Y gastric bypass, EXPERIMENTAL PHYSIOLOGY, Vol: 99, Pages: 1128-1132, ISSN: 0958-0670
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- Citations: 39
Kim JY, Ha TK, Le Roux CW, 2014, Metabolic effects of gastrectomy with or without omentectomy in gastric cancer., Hepatogastroenterology, Vol: 61, Pages: 1830-1834, ISSN: 0172-6390
The metabolic effects of gastrectomy and the reduction of visceral adiposity through omentectomy for gastric cancer are unknown.
Kim JY, Ha TK, le Roux CW, 2014, Metabolic Effects of Gastrectomy with or Without Omentectomy in Gastric Cancer, HEPATO-GASTROENTEROLOGY, Vol: 61, Pages: 1830-1834, ISSN: 0172-6390
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- Citations: 2
Buhmann H, le Roux CW, Bueter M, 2014, The gut-brain axis in obesity, BEST PRACTICE & RESEARCH CLINICAL GASTROENTEROLOGY, Vol: 28, Pages: 559-571, ISSN: 1521-6918
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- Citations: 51
Miras AD, Al-Najim W, Jackson SN, et al., 2014, Psychological characteristics, eating behavior, and quality of life assessment of obese patients undergoing weight loss interventions., Scand J Surg, ISSN: 1457-4969
Bariatric surgery is the most effective treatment for obesity. However, not all patients have similar weight loss following surgery and many researchers have attributed this to different pre-operative psychological, eating behavior, or quality-of-life factors. The aim of this study was to determine whether there are any differences in these factors between patients electing to have bariatric surgery compared to less invasive non-surgical weight loss treatments, between patients choosing a particular bariatric surgery procedure, and to identify whether these factors predict weight loss after bariatric surgery.
Angelopoulos T, Kokkinos A, Liaskos C, et al., 2014, The effect of slow spaced eating on hunger and satiety in overweight and obese patients with type 2 diabetes mellitus., BMJ Open Diabetes Research and Care, Vol: 2, ISSN: 2052-4897
BACKGROUND: Slow spaced eating is associated with improved satiety and gut hormone responses in normal-weight participants. This crossover study compared the effect of slow and rapid eating patterns on hunger, fullness, glucose, insulin, and the appetite-related gut hormones peptide YY (PYY), glucagon-like peptide-1 (GLP-1), and ghrelin in overweight and obese participants with type 2 diabetes mellitus (T2DM). METHODS: 20 overweight and obese participants with T2DM on metformin were recruited. A test meal of 300 mL ice-cream was consumed in random order in two different sessions by each participant; meal duration was 5 or 30 min. Fullness and hunger as assessed by visual analog scales (VAS), and glucose, insulin, PYY, GLP-1, and ghrelin were measured at baseline and at 30 min intervals after meal termination for 3 h. RESULTS: Fullness VAS ratings were significantly higher at the 90', 120', 150', and 180' time points and hunger ratings were lower at 90', 150', and 180' for the 30 min meal. The area under the curve (AUC) for fullness was higher after the 30 min meal than after the 5 min meal (11 943.7±541.2 vs 10 901.0±568.8 mm min, p=0.003) whereas the hunger AUC was lower (4442.9±328 vs 4966.7±347.5 mm min, p=0.012). There were no differences in glucose, insulin, PYY, GLP-1, and ghrelin responses. CONCLUSIONS: Slow spaced eating increased fullness and decreased hunger ratings in overweight and obese participants with T2DM, without the improvement in gut hormone responses found in normal-weight participants. Slow spaced eating may be a useful prevention strategy, but might also help curb food intake in those already suffering from obesity and diabetes.
Scholtz S, Miras AD, Chhina N, et al., 2014, Obese patients after gastric bypass surgery have lower brain-hedonic responses to food than after gastric banding, GUT, Vol: 63, Pages: 891-902, ISSN: 0017-5749
Scholtz S, Miras AD, Chhina N, et al., 2014, Obese patients after gastric bypass surgery have lower brain-hedonic responses to food than after gastric banding, Gut, Vol: 63, Pages: 891-902, ISSN: 0017-5749
Objectives Roux-en-Y gastric bypass (RYGB) has greater efficacy for weight loss in obese patients than gastric banding (BAND) surgery. We hypothesise that this may result from different effects on food hedonics via physiological changes secondary to distinct gut anatomy manipulations.Design We used functional MRI, eating behaviour and hormonal phenotyping to compare body mass index (BMI)-matched unoperated controls and patients after RYGB and BAND surgery for obesity.Results Obese patients after RYGB had lower brain-hedonic responses to food than patients after BAND surgery. RYGB patients had lower activation than BAND patients in brain reward systems, particularly to high-calorie foods, including the orbitofrontal cortex, amygdala, caudate nucleus, nucleus accumbens and hippocampus. This was associated with lower palatability and appeal of high-calorie foods and healthier eating behaviour, including less fat intake, in RYGB compared with BAND patients and/or BMI-matched unoperated controls. These differences were not explicable by differences in hunger or psychological traits between the surgical groups, but anorexigenic plasma gut hormones (GLP-1 and PYY), plasma bile acids and symptoms of dumping syndrome were increased in RYGB patients.Conclusions The identification of these differences in food hedonic responses as a result of altered gut anatomy/physiology provides a novel explanation for the more favourable long-term weight loss seen after RYGB than after BAND surgery, highlighting the importance of the gut–brain axis in the control of reward-based eating behaviour.
Neff KJ, le Roux CW, 2014, Bariatric Surgery: The Indications in Metabolic Disease, DIGESTIVE SURGERY, Vol: 31, Pages: 6-12, ISSN: 0253-4886
Tako AA, Kotiadis K, Vasilakis C, et al., 2014, Improving patient waiting times: a simulation study of an obesity care service, BMJ Quality & Safety, Vol: 23, Pages: 373-381, ISSN: 2044-5415
Background Obesity care services are often faced with the need to adapt their resources to rising levels of demand. The main focus of this study was to help prioritise planned investments in new capacity allowing the service to improve patient experience and meet future anticipated demand.Methods We developed computer models of patient flows in an obesity service in an Academic Health Science Centre that provides lifestyle, pharmacotherapy and surgery treatment options for the UK's National Health Service. Using these models we experiment with different scenarios to investigate the likely impact of alternative resource configurations on patient waiting times.Results Simulation results show that the timing and combination of adding extra resources (eg, surgeons and physicians) to the service are important. For example, increasing the capacity of the pharmacotherapy clinics equivalent to adding one physician reduced the relevant waiting list size and waiting times, but it then led to increased waiting times for surgical patients. Better service levels were achieved when the service operates with the resource capacity of two physicians and three surgeons. The results obtained from this study had an impact on the planning and organisation of the obesity service.Conclusions Resource configuration combined with demand management (reduction in referral rates) along the care service can help improve patient waiting time targets for obesity services, such as the 18 week target of UK's National Health Service. The use of simulation models can help stakeholders understand the interconnectedness of the multiple microsystems (eg, clinics) comprising a complex clinical service for the same patient population, therefore, making stakeholders aware of the likely impact of resourcing decisions on the different microsystems.
Carswell KA, Vincent RP, Belgaumkar AP, et al., 2014, The Effect of Bariatric Surgery on Intestinal Absorption and Transit Time, OBESITY SURGERY, Vol: 24, Pages: 796-805, ISSN: 0960-8923
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- Citations: 79
Tham JC, Howes N, le Roux CW, 2014, The role of bariatric surgery in the treatment of diabetes., Ther Adv Chronic Dis, Vol: 5, Pages: 149-157, ISSN: 2040-6223
The obesity epidemic contributes to approximately 44% of the world's type 2 diabetes burden. Bariatric surgery is an effective treatment for type 2 diabetes mellitus in patients with morbid obesity as it improves glycaemia, blood pressure, lipids and inflammation. This review describes the evidence supporting the addition of bariatric surgery to the treatment algorithms used by diabetologists. We emphasize the need to view bariatric surgery as an adjuvant therapy which should not be used instead of but rather together with best medical therapy.
Neff KJ, Chuah LL, Aasheim ET, et al., 2014, Beyond Weight Loss: Evaluating the Multiple Benefits of Bariatric Surgery After Roux-en-Y Gastric Bypass and Adjustable Gastric Band, OBESITY SURGERY, Vol: 24, Pages: 684-691, ISSN: 0960-8923
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- Citations: 17
Werling M, Fandriks L, Royce VP, et al., 2014, Preoperative assessment of gut hormones does not correlate to weight loss after Roux-en-Y gastric bypass surgery, SURGERY FOR OBESITY AND RELATED DISEASES, Vol: 10, Pages: 822-828, ISSN: 1550-7289
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- Citations: 10
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