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)

Screening of celiac disease in patients with autoimmune thyroid disease from Southern Brazil.

OBJECTIVE: The objective of this study was to determine the prevalence of celiac disease (CD) in adults with autoimmune thyroid disease (ATD) from the endocrinology outpatient setting in a university hospital in Southern Brazil. SUBJECTS AND METHODS: From the years 2007 to 2011, 254 patients with ATD were enrolled consecutively, Grave's disease was diagnosed in 143 (56.3%) and Hashimoto's thyroiditis in 111 (43.7%) of them. All patients answered a questionnaire related to symptoms that could be associated with CD and serum samples to screen for IgA anti-endomysial (EmA-IgA) were collected. EmA-IgA-positive patients were offered upper gastrointestinal endoscopy and biopsy of duodenum. RESULTS: A total of 254 patients were included; 222 (87.4%) female, mean age 45.4 ± 13.43 years (18 to 79 years). EmA-IgA was positive in seven patients (2.7%) and five done endoscopy with biopsy. Of these, three diagnosis of CD was confirmed (1.2%). All the three patients with CD had higher EmA-IgA titration, were female and had Hashimoto's thyroiditis. Like other patients with ATD, CD patients had nonspecific gastrointestinal symptoms, such as heartburn and gastric distention. In our study, one in each 85 patients confirmed the diagnosis of CD. CONCLUSION: We found a prevalence of 1.2% (1:85) of confirmed CD among Brazilian patients with ATD. Although some IgA-EmA positive patients had Graves' disease and one was male, all three patients with confirmed CD were female and had Hashimoto's thyroiditis.

Screening of celiac disease in patients with autoimmune thyroid disease from Southern Brazil / Pesquisa de doença celíaca em pacientes com doença autoimune de tireoide do sul do Brasil

Objective: The objective of this study was to determine the prevalence of celiac disease (CD) in adults with autoimmune thyroid disease (ATD) from the endocrinology outpatient setting in a university hospital in Southern Brazil. Subjects and methods: From the years 2007 to 2011, 254 patients with ATD were enrolled consecutively, Grave’s disease was diagnosed in 143 (56.3%) and Hashimoto’s thyroiditis in 111 (43.7%) of them. All patients answered a questionnaire related to symptoms that could be associated with CD and serum samples to screen for IgA anti-endomysial (EmA-IgA) were collected. EmA-IgA-positive patients were offered upper gastrointestinal endoscopy and biopsy of duodenum. Results: A total of 254 patients were included; 222 (87.4%) female, mean age 45.4 ± 13.43 years (18 to 79 years). EmA-IgA was positive in seven patients (2.7%) and five done endoscopy with biopsy. Of these, three diagnosis of CD was confirmed (1.2%). All the three patients with CD had higher EmA-IgA titration, were female and had Hashimoto’s thyroiditis. Like other patients with ATD, CD patients had nonspecific gastrointestinal symptoms, such as heartburn and gastric distention. In our study, one in each 85 patients confirmed the diagnosis of CD. Conclusion: We found a prevalence of 1.2% (1:85) of confirmed CD among Brazilian patients with ATD. Although some IgA-EmA positive patients had Graves’ disease and one was male, all three patients with confirmed CD were female and had Hashimoto’s thyroiditis. Arq Bras Endocrinol Metab. 2014;58(6):625-9 .

Objetivo: O objetivo do presente estudo foi determinar a prevalência de doença celíaca (DC) em adultos com doenças autoimunes de tireoide (DAT) que foram atendidos em um serviço de endocrinologia de um hospital universitário do sul do Brasil. Sujeitos e métodos: Entre os anos de 2007 a 2011, 254 pacientes com DAT foram consecutivamente incluídos, sendo 143 (56,3%) desses diagnosticados com doença de Graves e 111 (43,7%) com doença de Hashimoto. Todos os pacientes responderam a um questionário relatando sintomas que poderiam ser associados com DC, e amostras de soro para a pesquisa de anticorpo antiendomisial (EmA-IgA) foram coletadas. Os pacientes com sorologia positiva foram encaminhados para endoscopia gastrointestinal com biópsia duodenal. Resultados: No total, 254 pacientes foram incluídos, sendo 222 (87,4%) mulheres com média de idade 45,4 ± 13,43 anos (18 a 79 anos). EmA-IgA foi positivo em sete (2,7%) pacientes e cinco fizeram endoscopia com biópsia. Desses, três (1,2%) tiveram o diagnóstico de DC confirmada. Todos os três pacientes com DC apresentaram altos títulos de EmA-IgA, eram mulheres e tinham doença de Hashimoto. Assim como outras pacientes com DAT, os pacientes celíacos tinham sintomas gastrointestinais inespecíficos, como queimação e distensão gástrica. Em nosso estudo, um em cada 85 pacientes com DAT tiveram o diagnóstico de DC confirmado. Conclusão: Em nosso estudo, foi observada prevalência de 1,2% (1:85) de DC confirmada entre os pacientes com DAT, sendo todas mulheres e com doença de Hashimoto. Arq Bras Endocrinol Metab. 2014;58(6):625-9 .