Renal cytokines improve early after bariatric surgery

Bueter, Marco; Dubb, Sukhpreet Singh; Gill, A.; Joannou, L.; Ahmed, Amna; Frankel, Andrew; Tam, Frederick W.K.; Roux, Carel W. le

doi:10.1002/bjs.7264

Cited by 41 publications

(26 citation statements)

References 34 publications

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“…84 In a study of 34 morbidly obese patients, surgically induced weight loss contributed to a decrease in markers of renal inflammation and BP. 85 Moreover, in a study of 255 morbidly obese type 2 diabetic patients, changes in BMI 12 months after bariatric surgery were the only independent predictors of albumin-to-creatinine ratio normalization. 86 In accordance, in a 5-year followup study in 52 obese type 2 diabetic patients who underwent bariatric surgery, diabetic nephropathy resolved in 58%.…”

Section: Treatment Of Obesity In Ckdmentioning

confidence: 98%

Obesity in CKD—What Should Nephrologists Know?

Stenvinkel

Zoccali

İkizler

2013

Journal of the American Society of Nephrology

200

172

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Obesity, the epidemic of the 21st century, carries a markedly increased risk for comorbid complications, such as type 2 diabetes, cancer, hypertension, dyslipidemia, cardiovascular disease, and sleep apnea. In addition, obesity increases the risk for CKD and its progression to ESRD. Paradoxically, even morbid obesity associates with better outcomes in studies of ESRD patients on maintenance dialysis. Because the number of obese CKD and maintenance dialysis patients is projected to increase markedly in developed as well as low-and middle-income countries, obesity is a rapidly emerging problem for the international renal community. Targeting the obesity epidemic represents an unprecedented opportunity for health officials to ameliorate the current worldwide increase in CKD prevalence. Nephrologists need more information about assessing and managing obesity in the setting of CKD. Specifically, more precise estimation of regional fat distribution and the amount of muscle mass should be introduced into regular clinical practice to complement more commonly used practical markers, such as body mass index. Studies examining the effects of obesity on kidney disease progression and other clinical outcomes along with weight management strategies are much needed in this orphan area of research. 24: 172724: -173624: , 201324: . doi: 10.1681 Obesity has emerged as the largest pandemic in near history, with important implications of not only cardiovascular disease (CVD) but also CKD. Recent data from the United States indicate that the incidence and prevalence rates of obesity in maintenance dialysis patients largely exceed the corresponding figures in the general population. 1 A large European population survey documented that a high body mass index (BMI) ranks as one of the strongest risk factors for new-onset CKD. 2 The dimension of the obesity epidemic and the impact of the same epidemic on the kidney demand efforts for understanding the epidemiology and the mechanisms of CKD associated with excess adiposity. It also sets as an absolute public health priority for the development of treatment policies integrated across specialties and general practice to halt this much concerning problem. In this scenario, it is fundamental that nephrologists are updated on current knowledge about obesity in the setting of CKD. However, little attention is still paid to this issue in major nephrology journals. The suboptimal attention to the problem by major sources of dissemination of specialty information suggests that nephrologists may have scarce knowledge of how obesity should be assessed, its epidemiology, mechanisms whereby excess fat mass is conducive to CKD, and management of obesity in the catabolic uremic milieu. 3 J Am Soc Nephrol DEFINITION AND ASSESSMENT OF OBESITYThe most common method for defining obesity is based on BMI (i.e., a person's weight as obese. It should be emphasized that population norms of BMI could be different based on ethnic and racial background (i.e., the proportion of Asian people with a high ...

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Section: Treatment Of Obesity In Ckdmentioning

confidence: 98%

Obesity in CKD—What Should Nephrologists Know?

Stenvinkel

Zoccali

İkizler

2013

Journal of the American Society of Nephrology

200

172

View full text Add to dashboard Cite

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“…Intentional weight loss leads to substantial decreases in levels of circulating cytokines, with an w2% decline in circulating levels for every 1% of loss of body weight (Byers & Sedjo 2011). The immediate effects of acute weight loss following bariatric surgery on reducing levels of circulating cytokines are especially dramatic (Bueter et al 2010). However, as with estrogens, the reductions in cytokine levels with weight loss have only been documented in the relative short term, but the longer-term relationships between circulating cytokines and weight patterns are still unknown.…”

Section: Cancer-relevant Biomarkers and Obesitymentioning

confidence: 99%

Body fatness as a cause of cancer: epidemiologic clues to biologic mechanisms

Byers¹,

Sedjo²

2015

Endocrine-Related Cancer

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Carrying excess body fat is a leading cause of cancer. Epidemiologic evidence gives strong clues about the mechanisms that link excess adiposity to risk for several cancer sites. For postmenopausal breast cancer and endometrial cancer, the hyper-estrogenic state that is induced by excess body fatness is the likely cause. For esophageal cancer and gallbladder cancer, chronic local inflammation induced by acid reflux and gallstones is the likely cause, and for liver cancer, local inflammation induced by hepatic fatty infiltration is the likely cause. However, for several other cancers known to be associated with excess adiposity, including cancers of the colon, pancreas, ovary, kidney, and prostate, specific causes are not known. Possible candidates include elevated systemic or local tissue inflammation induced by adiposity and effects of the elevated levels of leptin, insulin, IGFs, and depressed immune function that are seen with excess adiposity. There is growing evidence that intentional weight loss not only reduces circulating levels of cancer-associated factors but that it also reduces cancer incidence and recurrence. Better research is needed to understand the mechanisms that link excess body fat to cancer risk as well as to understand the amount of weight loss needed for substantial cancer risk reduction. Finally, as we develop better understanding of the mediators of the effects of excess body fatness on cancer risk, we should identify pharmacologic interventions that target those mediators so that they can be used to complement weight loss in order to reduce cancer risk.

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“…Our results should be confirmed in larger, randomized, controlled clinical trials. Further elucidation of the physiological mechanisms at play, such as reductions in systemic or local inflammation (4) and direct effects of gut hormones (5), could eventually lead to the development of more effective and safe pharmacotherapy for both type 2 diabetes and obesity.…”

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confidence: 99%