Prevalence of fibromyalgia in patients treated at the bariatric surgery outpatient clinic of Hospital de Clínicas do Paraná - Curitiba.

INTRODUCTION: Fibromyalgia (FM) is a chronic pain syndrome characterized by generalized pain. It is known that obese patients have more skeletal muscle pain and physical dysfunction than normal weight patients. Therefore, it is important that the early diagnosis of FM be attained in obese patients. OBJECTIVE: To determine the prevalence of FM in a group of obese patients with indication of bariatric surgery. MATERIALS AND METHODS: The patients were recruited from the Bariatric Surgery outpatient clinic of Hospital de Clínicas of UFPR (HC-UFPR) before being submitted to surgery. Patient assessment consisted in verifying the presence or absence of FM using the 1990 and 2011 ACR criteria, as well as the presence of comorbidities. RESULTS: 98 patients were evaluated, of which 84 were females. The mean age was 42.07 years and the BMI was 45.39. The prevalence of FM was 34% (n=29) according to the 1990 criteria and 45% (n=38) according to the 2011 criteria. There was no difference in age, BMI, Epworth score and prevalence of other diseases among patients who met or not the 1990 criteria. Only depression was more common in patients with FM. (24.14% vs. 5.45%). The same findings were seen in patients that met the 2011 criteria. CONCLUSIONS: The prevalence of FM in patients with morbid obesity is extremely high. However, BMI does not differ in patients with or without FM. The presence of depression may be a risk factor for the development of FM in these patients.

Prevalence of fibromyalgia in patients treated at the bariatric surgery outpatient clinic of Hospital de Clínicas do Paraná - Curitiba / Prevalência de fibromialgia em pacientes acompanhados no ambulatório de cirurgia bariátrica do Hospital de Clínicas do Paraná - Curitiba

Abstract Introduction: Fibromyalgia (FM) is a chronic pain syndrome characterized by generalized pain. It is known that obese patients have more skeletal muscle pain and physical dysfunction than normal weight patients. Therefore, it is important that the early diagnosis of FM be attained in obese patients. Objective: To determine the prevalence of FM in a group of obese patients with indication of bariatric surgery. Materials and methods: The patients were recruited from the Bariatric Surgery outpatient clinic of Hospital de Clínicas of UFPR (HC-UFPR) before being submitted to surgery. Patient assessment consisted in verifying the presence or absence of FM using the 1990 and 2011 ACR criteria, as well as the presence of comorbidities. Results: 98 patients were evaluated, of which 84 were females. The mean age was 42.07 years and the BMI was 45.39. The prevalence of FM was 34% (n = 29) according to the 1990 criteria and 45% (n = 38) according to the 2011 criteria. There was no difference in age, BMI, Epworth score and prevalence of other diseases among patients who met or not the 1990 criteria. Only depression was more common in patients with FM. (24.14% vs. 5.45%). The same findings were seen in patients that met the 2011 criteria. Conclusions: The prevalence of FM in patients with morbid obesity is extremely high. However, BMI does not differ in patients with or without FM. The presence of depression may be a risk factor for the development of FM in these patients.

Resumo Introdução: Fibromialgia (FM) é uma síndrome de dor crônica caracterizada por dor generalizada. Sabe-se que pacientes obesos têm mais dor músculo esquelética e disfunção física do que pacientes de peso normal. Portanto, é importante que o diagnóstico precoce da FM seja feito em pacientes obesos. Objetivo: Determinar a prevalência de FM em um grupo de pacientes obesos com indicação de cirurgia bariátrica. Materiais e métodos: Os pacientes foram captados do ambulatório de Cirurgia Bariátrica do Hospital de Clínicas da UFPR (HC-UFPR), antes de serem submetidos à cirurgia. A avaliação dos pacientes consistia em constatar a presença ou ausência de FMG pelos critérios ACR 1990 e 2011 e também a presença de comorbidades. Resultados: Foram avaliados 98 pacientes, 84 mulheres. A idade média foi de 42,07 anos e o IMC de 45,39. A prevalência de FM foi de 34% (n = 29) pelos critérios de 1990 e de 45% (n = 38) pelos de 2011. Não houve diferença em idade, IMC, escala de Epworth e prevalência de outras doenças entre pacientes que preenchiam ou não os critérios de 1990. Apenas depressão foi mais comum nas pacientes com FM (24,14% vs. 5,45%). Os mesmos achados foram vistos nas pacientes que preenchiam os critérios de 2011. Conclusões: A prevalência de FM em pacientes com obesidade mórbida é extremamente alta. Porém o IMC não difere nos pacientes com ou sem FM. A presença de depressão pode ser um fator de risco para o desenvolvimento de FM nesses pacientes.

Good weight loss responders and poor weight loss responders after Roux-en-Y gastric bypass: clinical and nutritional profiles.

BACKGROUND: Bariatric surgery is one of the main treatments for severity obesity, but weight regain after surgery is an important issue. OBJECTIVES: To compare the clinical and nutritional profiles of good and poor weight loss responders in the late postoperative period after bariatric surgery. METHODS: A cross-sectional study with patients undergoing Roux-en-Y gastric bypass in a University Hospital. Patients were divided into good weight loss responders (GWLR) and poor weight loss responders (PWLR) defined as ≥ 50% or < 50% excess weight loss (EWL), respectively, at least 2 years post-surgery. RESULTS: The sample included 204 individuals (87.7% women; mean age 50.15 ± 11.1 years; mean time after surgery 67.38 ± 30.76 months). Two years post-surgery, 71.1% were considered GWLR and 28.9% PWLR (mean EWL 72.33% ± 13.86%, and 35.06% ± 12.10%, respectively; p = 0.000). Weight regain was < 10% for 36.3% of patients, 10.1-20% for 36.3%, and > 20% for 21.3%, compared with the lowest post-surgery weight. Among PWLR, 49.0% regained > 20% of the lowest post-surgery weight. GWLR lost most weight at all time points analyzed (p < 0.05). GWLR presented improvement or remission of diabetes, dyslipidemia and hypertension more frequently compared to PWLR (p < 0.05). Eating patterns was similar between GWLR and PWLR (p > 0.05, study's power 100%). Quality of life improved in 79.5% of the total study sample, with greater improvements in the GWLR (p < 0.05). CONCLUSIONS: Greater weight loss correlated with improved remission in comorbidities and better quality of life.

Good weight loss responders and poor weight loss responders after Roux-en-Y gastric bypass: clinical and nutritional profiles / Buenos y malos respondedores después de bypass gástrico en Y de Roux: perfiles clínicos y nutricionales

Background: Bariatric surgery is one of the main treatments for severity obesity, but weight regain after surgery is an important issue. Objectives: To compare the clinical and nutritional profiles of good and poor weight loss responders in the late postoperative period after bariatric surgery. Methods: A cross-sectional study with patients undergoing Roux-en-Y gastric bypass in a University Hospital. Patients were divided into good weight loss responders (GWLR) and poor weight loss responders (PWLR) defined as ≥ 50% or < 50% excess weight loss (EWL), respectively, at least 2 years post-surgery. Results: The sample included 204 individuals (87.7% women; mean age 50.15 ± 11.1 years; mean time after surgery 67.38 ± 30.76 months). Two years post-surgery, 71.1% were considered GWLR and 28.9% PWLR (mean EWL 72.33% ± 13.86%, and 35.06% ± 12.10%, respectively; p = 0.000). Weight regain was < 10% for 36.3% of patients, 10.1-20% for 36.3%, and > 20% for 21.3%, compared with the lowest post-surgery weight. Among PWLR, 49.0% regained > 20% of the lowest post-surgery weight. GWLR lost most weight at all time points analyzed (p < 0.05). GWLR presented improvement or remission of diabetes, dyslipidemia and hypertension more frequently compared to PWLR (p < 0.05). Eating patterns was similar between GWLR and PWLR (p > 0.05, study’s power 100%). Quality of life improved in 79.5% of the total study sample, with greater improvements in the GWLR (p < 0.05). Conclusions: Greater weight loss correlated with improved remission in comorbidities and better quality of life (AU)

Introducción: la cirugía bariátrica es uno de los principales tratamientos para la obesidad, pero la recuperación de peso después de la cirugía es una cuestión importante. Objetivo: comparar los perfiles clínicos y nutricionales de los buenos y malos respondedores en postoperatorio (PO) tardío de la cirugía bariátrica. Método: estudio transversal con pacientes sometidos a bypass gástrico en Y de Roux en un hospital universitario. La muestra se divide en buenos respondedores (BR) y respuesta deficiente (MR), teniendo en cuenta el porcentaje de pérdida de exceso de peso (PEP) del 50,0%, después de al menos 2 años de PO. Resultados: un total de 204 personas (87,7% mujeres, con una edad media de 50,15 ± 11,1 años y 67,38 ± 30,76 meses después de la operación). Después de 2 años de la operación, el 71,1% se consideraron BR y el 28,9% MR (PEP promedio 72,33 ± 13,86% y 35,06 ± 12,10%, respectivamente) (p < 0,05). La recuperación de peso fue < 10% para el 36,3% de los pacientes, 10,1 a 20% a 36,3% y > 20% a 21,3% en comparación con el menor peso después de la cirugía. Entre MR, el 49,0% recuperó más del 20% del peso más bajo después de la cirugía. El BR perdió la mayor parte de sobrepeso en los diferentes tiempos analizados PO (p < 0,05). El BR mostró mejoría o remisión de la diabetes mellitus, dislipidemia e hipertensión con más frecuencia, en comparación con los MR (p < 0,05). El patrón de dieta fue similar entre la BR y MR (p > 0,05; 100% de la potencia del estudio). La calidad de vida mejoró en el 79,5% del total del grupo, con la mejor evolución en los BR (p < 0,05). Conclusión: la pérdida de peso mayor se correlaciona con la mejora de la remisión de comorbilidades y una mejor calidad de vida (AU)