Irritable bowel syndrome-like symptoms and health related quality of life two years after Roux-en-Y gastric bypass - a prospective cohort study

Blom-Høgestøl, Ingvild Kristine; Aasbrenn, Martin; Chahal-Kummen, Monica; Brunborg, Cathrine; Eribe, Inger; Kristinsson, Jon; Farup, Per G.; Mala, Tom

doi:10.1186/s12876-019-1103-0

Cited by 14 publications

(21 citation statements)

References 30 publications

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“…The data is a subset of the prospective cohort study in subjects with morbid obesity, the MO-BiPS study, (Morbid Obesity – Bio-Psycho-Social disorders) referred for evaluation of bariatric surgery at Innlandet Hospital Trust, Gjøvik, Norway [ 16 – 18 ]. After inclusion and before surgery, the participants followed a conservative weight-loss program for 6 months with dietary advice and increased physical activity (the first treatment period).…”

Section: Methodsmentioning

confidence: 99%

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APOE – a genetic marker of comorbidity in subjects with morbid obesity

2020

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Background: In population-based studies, the genetic variability of the APOE E alleles have been associated with health outcomes. Health problems are common in subjects with obesity. This study explored associations between the APOE E alleles and comorbidity in subjects with morbid obesity. Methods: The study included consecutive subjects referred for evaluation of bariatric surgery with morbid obesity (defined as BMI > 40 or > 35 kg/m 2 with complications related to obesity). The subjects followed a conservative weight loss program for 6 months before surgery and had a follow-up visit 12 months after surgery. Demographic data and a set psychosomatic scores (musculoskeletal pain, WHO-5 Well-Being Index, Rosenberg Self-Esteem Scale, Hopkins Symptom Checklist 10; Epworth Sleepiness Scale, and Fatigue Severity Scale) were collected, and blood samples were analysed for haematological and biochemical parameters and APOE alleles. Results: One hundred and forty subjects (men/women: 32 (23%)/108 (77%) with mean age 43.0 (SD 8.7) years and BMI 42.1 (SD 3.8) kg/m 2 were included. One hundred and eight and 92 subjects had data after conservative treatment and 12 months after surgery, respectively. The prevalence of the APOE alleles were: E2E2: 1 (0.7%), E2E3: 13 (9.3%), E2E4: 4 (2.9%), E3E3: 71 (50.7%), E3E4: 47 (33.6%), and E4E4: 4 (2.9%). The prevalence rates were as anticipated in a Norwegian population. The weight loss during conservative treatment and after bariatric surgery was independent of E allele variability. E2 was associated with a significant or clear trend toward improvement of all psychosomatic disorders. There was a significant fall in CRP during the two treatment periods with weight loss. E2 and E4 were significantly associated with high and low CRP, respectively, but no associations were seen between CRP and comorbidity. Conclusions: The most marked finding was the association between E2 and improvement of all psychosomatic disorders. The positive and negative associations between CRP and E2 and E4, respectively, could indicate effects on inflammation and immunological reactions.

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Section: Methodsmentioning

confidence: 99%

“…P -values < 0.05 were judged as statistically significant. The genetic analyses were performed in previously collected blood samples [ 16 – 18 ]. The analyses were explorative, and no formal power calculation was performed.…”

Section: Methodsmentioning

confidence: 99%

APOE – a genetic marker of comorbidity in subjects with morbid obesity

2020

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“…The sample size was fixed because the cohort was from a previously performed study and a power calculation was not performed [25].…”

Section: Sample Sizementioning

confidence: 99%

Changes in serum zonulin in individuals with morbid obesity after weight-loss interventions: a prospective cohort study

Aasbrenn

Lydersen²,

Farup

2020

BMC Endocr Disord

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Background: Zonulin is a biomarker of impaired intestinal permeability, which has been associated with various disorders. The primary aim was to study serum zonulin (s-zonulin) in individuals with morbid obesity before and after a conservative weight loss intervention followed by bariatric surgery. The secondary aims were to explore predictors of s-zonulin, and the associations between the changes of the predictors and changes in s-zonulin, and to compare the associations in the two treatment periods. Methods: Individuals with morbid obesity were included. Data before any weight loss interventions, after a 6 months' conservative weight loss intervention, and 6 months after bariatric surgery were used. S-zonulin was measured with an ELISA method from Immundiagnostik AB, Bensheim, Germany. Data were analysed with mixed models. Results: The mean body mass index was 42.1 kg/m 2 (SD 3.8) at inclusion and was reduced to 38.7 kg/m 2 (SD 3.8) and 29.8 kg/m 2 (SD 3.8) after the conservative treatment and bariatric surgery respectively. S-zonulin was 63 ng/mL (SD 32) at inclusion and was reduced with 19 ng/ml (95% CI 12 to 26, p < 0.001) after conservative treatment and 11 ng/ml (95% CI 0 to 21, p = 0.04) after bariatric surgery. At inclusion, s-zonulin was significantly associated with factors including p-glucose (B = 2.21, 95% CI 1.09 to 3.33, p < 0.001), c-reactive protein (B = 1.02, 95% CI 0.45 to 1.58, p < 0.001) and the intake of proteins (B = 0.23, 95% CI 0.08 to 0.38, p = 0.003) and non-nutritive sweeteners (B = 0.68, 95% CI 0.19 to 1.17, p = 0.007). The reduction in s-zonulin after the conservative weight loss intervention was significantly associated with improvement in diarrhoea (B = 6.6, 95% CI 1.3 to 11.8, p = 0.02), HbA1c (B = 9.7, 95% CI 1.1 to 18.3, p = 0.03), p-glucose (B = 3.5, 95% CI 1.2 to 5.9, p = 0.004) and gamma-GT (B = 0.28, 95% CI 0.09 to 0.47, p = 0.004), but not associated with the change in body mass index (B = 0.9, 95% CI − 1.5 to 3.3, p = 0.46). Conclusions: S-zonulin was markedly reduced after the conservative weight loss intervention, and further reduced after bariatric surgery. The reduction in s-zonulin was associated with improvement of diarrhoea, markers of glucose intolerance and liver disease, but not associated with the change in body mass index.

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“…Gastrointestinal complaints after RYGB can be of various origins, occasionally serious and acute (e.g., internal herniation), often less severe and nutrition-related, caused by dumping syndrome or food intolerances. However, frequently no direct cause is found, complaints become chronic, and symptoms are attributed to irritable bowel syndrome (IBS) [11, 12]. The majority of patients have elevated levels of faecal calprotectin (fCP) several years after RYGB, which may indicate some degree of intestinal mucosal inflammation and may have implications for use of calprotectin as a diagnostic test after bariatric surgery [13, 14].…”

Section: Introductionmentioning

confidence: 99%

Faecal Inflammatory Biomarkers and Gastrointestinal Symptoms after Bariatric Surgery: A Longitudinal Study

et al. 2021

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Background: Bariatric surgery induces various gastrointestinal (GI) modifications. We performed the first study longitudinally assessing the effect of bariatric surgery on faecal inflammatory biomarker levels and its relation with GI complaints. Method: Faecal calprotectin, lactoferrin, and calgranulin-C levels were determined in 41 patients (34 Roux-en-Y [RYGB], 7 sleeves) before and at 6–16 weeks, 6 months, and 1 year after surgery. Changes in biomarker levels and percentage of patients above reference value were determined. Gastrointestinal symptom rating scale (GSRS) was used to assess GI complaints at corresponding time points. The postoperative relation between GSRS score and biomarker levels above reference value was investigated. Results: After RYGB, median calprotectin levels are significantly higher (>188, 104–415 μg/g) than before surgery (40, 19–78 μg/g; p < 0.001), and over 90% of patients have levels above reference value 1 year after surgery. Median lactoferrin was 0.4 (0.2–1.6) μg/g before, and >5.9 (1.8–13.6) μg/g after surgery (p < 0.001). Median calgranulin-C levels remained far below the reference value and were 0.13 (0.05–0.24) μg/g before and <0.23 (0.06–0.33) μg/g after surgery. Similar results were found after sleeve gastrectomy. No difference was seen in GSRS score for patients with calprotectin and lactoferrin levels above reference values. Conclusion: Faecal inflammatory biomarkers calprotectin and lactoferrin, but not calgranulin-C, rise above reference values shortly after bariatric surgery and remain elevated in the majority of patients. The discrepancy between calprotectin and calgranulin-C levels suggests no GI inflammation. Furthermore, patients after RYGB with biomarkers above the population reference value do not seem to have more GI complaints.

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Irritable bowel syndrome-like symptoms and health related quality of life two years after Roux-en-Y gastric bypass - a prospective cohort study

Cited by 14 publications

References 30 publications

APOE – a genetic marker of comorbidity in subjects with morbid obesity

APOE – a genetic marker of comorbidity in subjects with morbid obesity

Changes in serum zonulin in individuals with morbid obesity after weight-loss interventions: a prospective cohort study

Faecal Inflammatory Biomarkers and Gastrointestinal Symptoms after Bariatric Surgery: A Longitudinal Study

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