Changes in serum albumin and liver enzymes following three different types of bariatric surgery: six-month follow-up. A retrospective cohort study

ABSTRACT BACKGROUND: Few reports have examined the effects of Roux-en-Y gastric bypass (RYGB), one-anastomosis gastric bypass (OAGB) and sleeve gastrectomy (SG) on changes to serum albumin (Alb) and liver enzyme levels. OBJECTIVE: To compare short-term post-surgery changes in serum Alb, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALKP) levels. Body composition changes were also measured and compared among three groups. DESIGN AND SETTING: Retrospective cohort study conducted in Tehran, Iran. METHODS: 151 OAGB, RYGB and SG patients referred to the obesity clinic of Hazrat-e Rasool General Hospital, Tehran, Iran, were evaluated. Physical characteristics and biochemical parameters were measured pre-surgery and then after three and six months. RESULTS: Through repeated measurements to determine intragroup changes, significant changes in serum AST (P = 0.003) and ALT (P < 0.001) were observed in follow-ups. However, Alb levels did not change (P = 0.413). Body fat, fat-free mass and muscle mass decreased significantly in each group (P < 0.05). In a univariate general linear model for determining intergroup changes, SG showed greater decreases in ALT and AST at three and six months (P < 0.05) and in ALKP at six months (P = 0.037), compared with OAGB. There were no significant differences in Alb levels. Also, RYGB had a greater effect on reducing fat percentage (three months, P = 0.011; six months, P = 0.059) and fat mass (three months, P = 0.042) than OAGB. CONCLUSION: SG and RYGB may be superior to OAGB in reducing liver enzymes and body fat, respectively. However, Alb levels showed no significant differences.

Parathyroid Hormone and 25-Hydroxyvitamin D Do Not Mediate the Association between Dietary Calcium, Protein and Vitamin D Intake and Adiposity and Lipid Profile in Patients with Type 2 Diabetes: a Structural Equation Modeling Approach

This study aimed to utilize structural equation modeling (SEM) techniques to determine the effects of dietary calcium, protein and vitamin D on adiposity and lipidemia and to assess mediatory effects of parathyroid hormone (PTH) and 25-hydroxyvitamin D (25(OH)D) in patients with type 2 diabetes. In this cross-sectional study, a total of 150 diabetic patients (93 females and 57 males) were randomly selected. Anthropometric measures, biochemical analyses, and fat mass percent were recorded. Nutritional data were collected. SEM was performed. Based on the primary hypothesis, adiposity and lipidemia were fitted in a model. The direct effects of dietary calcium (λ = –0.165, p value = 0.002) and PTH (λ = –0.143, p value = 0.011) were significantly associated with lipidemia. There were no significant effects for dietary protein on PTH (λ = –0.270, p value = 0.057), 25(OH)D (λ = –0.071, p value = 0.613), lipidemia (λ = –0.044; p value = 0.638) or adiposity (λ = –0.009, p value = 0.949) as well as for dietary vitamin D on PTH (λ = –0.119, p value = 0.194), 25(OH)D (λ = 0.023, p value = 0.806), lipidemia (λ = 0.034, p value = 0.587) or adiposity (λ = –0.221, p value = 0.118). The correlation between calcium intake and lipidemia, and adiposity are not mediated by 25(OH)D and PTH. There were the direct effects of dietary calcium on adiposity in patients with type 2 diabetes. The model can be tested in future longitudinal and intervention studies to identify the predictors of obesity.

Parathyroid Hormone and 25-Hydroxyvitamin D Do Not Mediate the Association between Dietary Calcium, Protein and Vitamin D Intake and Adiposity and Lipid Profile in Patients with Type 2 Diabetes: a Structural Equation Modeling Approach

This study aimed to utilize structural equation modeling (SEM) techniques to determine the effects of dietary calcium, protein and vitamin D on adiposity and lipidemia and to assess mediatory effects of parathyroid hormone (PTH) and 25-hydroxyvitamin D (25(OH)D) in patients with type 2 diabetes. In this cross-sectional study, a total of 150 diabetic patients (93 females and 57 males) were randomly selected. Anthropometric measures, biochemical analyses, and fat mass percent were recorded. Nutritional data were collected. SEM was performed. Based on the primary hypothesis, adiposity and lipidemia were fitted in a model. The direct effects of dietary calcium (λ = –0.165, p value = 0.002) and PTH (λ = –0.143, p value = 0.011) were significantly associated with lipidemia. There were no significant effects for dietary protein on PTH (λ = –0.270, p value = 0.057), 25(OH)D (λ = –0.071, p value = 0.613), lipidemia (λ = –0.044; p value = 0.638) or adiposity (λ = –0.009, p value = 0.949) as well as for dietary vitamin D on PTH (λ = –0.119, p value = 0.194), 25(OH)D (λ = 0.023, p value = 0.806), lipidemia (λ = 0.034, p value = 0.587) or adiposity (λ = –0.221, p value = 0.118). The correlation between calcium intake and lipidemia, and adiposity are not mediated by 25(OH)D and PTH. There were the direct effects of dietary calcium on adiposity in patients with type 2 diabetes. The model can be tested in future longitudinal and intervention studies to identify the predictors of obesity.

[24 hour survival rate and its determinants in patients with successful cardiopulmonary resuscitation in Ghaem Hospital of Mashhad]

Introduction and Aims: the main cause of death in the adult population in the industrialized world is sudden cardiac arrest. The first purpose of cardiopulmonary resuscitation is return of spontaneous circulation. Post cardiopulmonary resuscitation cares are fifth stage of American Heart Association cardiopulmonary resuscitation that less take into consideration. Therefore, the present study was conducted with the aim of "24 Hour Survival Rate and it's determinants in patients with Successful Cardiopulmonary Resuscitation in Ghaem Hospital of Mashhad"

Materials and Methods: in this descriptive and analytical study, 80 cases of CPR were selected by convenience sampling in Ghaem hospital of Mashhad. After confirming of cardiac arrest by a resident physician in the wards and declaration of code 99, was performed cardiopulmonary resuscitation by CPR team. Rate of 24 hour survival was determined in patients that had return of spontaneous circulation by form the researcher's observations. Data were collected and analyzed using of descriptive statistics [frequency, mean, standard deviation] and inferential statistics [Fishers, Chi-square, logistic regression] and SPSS software version of 16

Results: mean and standard deviation of age patients was 67.3+/-1.5 year. In 45 patients [56.2%], was achieved return of spontaneous circulation. The rate of 24 hour survival was in 30 patients that cardiopulmonary resuscitation on them was successful. The chi-square test, showed that is significant differences between 24 hour survival with sex and diabetes in patients [P<0.05]. The Fisher's test, showed that there is significant differences between 24 hour survival and history of cardiopulmonary resuscitation [P<0.04]

Conclusion: the rate of 24 hour survival was 66.7% in patients with a successful cardiopulmonary resuscitation. This reflects that must be considered after cardiopulmonary resuscitation cares

[Effects of L-asparginase administration on anticoagulant proteins and platelet function in patients with acute lymphoblastic leukemia]

Acute lymphoblastic leukemia is one the most common malignancies in children and adolescents. L-asparginase [L-ASP] is one of the leading medications in treatment of ALL. L.ASP interferes with the synthesis of some coagulation proteins and therefore causing disturbance in normal coagulation. In this study, the effects of L-ASP on anticoagulant proteins [protein C, protein S, and antithrombin III] and platelet function were assessed. This was a before-after study on 41 patients with ALL who refered to Mahak hospital [Tehran, Iran]. Before and after the injection of L.ASP, a bleeding time test was performed based on Ivy method. Protein C and protein S performance was assessed by turbidometry and antithrombin III performance was evaluated by chromogenic method. 48.8% of patients were female. Mean [ +/- SD] of age was 4.0 +/- 7.2. A significant reduction in the mean amount of protein C, antithrombin III and bleeding time was recorded. However, the reduction in protein S was not significant. No patient showed the symptoms of thrombosis. The results of this study showed that L. ASP drug reduced coagulation proteins [except the protein S]. This decrease along with other concomitant genetic factors can lead to thrombosis in some patients with ALL during induction therapy