RESUMO
BACKGROUND: Bariatric surgery is effective in remission of obesity comorbidities. This study was aimed at comparing CVD risk between morbidly obese patients with type 2 diabetes and pre-diabetes before and after bariatric surgery as well as assessing comorbidities. METHODS: This is a retrospective observational study with 105 patients with type 2 diabetes (DMbaseline) and prediabetes (preDMbaseline) who underwent Roux-en-Y gastric bypass. Data were collected preoperative and then at 3,6,12,18,24,36,48, and 60 months after surgery. Anthropometric, cardiovascular and glycemic parameters were assessed. CVD risk was calculated using the Framingham Risk Score. RESULTS: Prior to surgery, 48 patients had type 2 diabetes, while 57 had pre-diabetes. Mean age was 48 (9.2) and mean BMI was 52 (7.4). 26.1% of patients had a high CVD risk. CVD risk decreased in patients with type 2 diabetes and prediabetes at month 12 after surgery compared to the baseline risk (p < 0.001). BMI, body fat percentage, fasting plasma glucose, HbA1c, c-peptide, HOMA-IR, LDL-c, systolic blood pressure, and diastolic blood pressure decreased during the first year after surgery. From the 12th month until the 60th, they showed a flat trend, or a very mild increase in some cases. 3.2% of patients maintained high CVD risk at 60 months. Type 2 diabetes remission was 92%. No patient of the preDMbaseline group developed type 2 diabetes. CONCLUSION: Bariatric surgery reduces CVD risk in type 2 diabetes and pre-diabetes. Given that patients with type 2 diabetes benefit the most, more studies are necessary to consider pre-diabetes as a criterion for metabolic surgery in patients with BMI ≥ 35 kg/m2.
Assuntos
Cirurgia Bariátrica/tendências , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 2/cirurgia , Obesidade Mórbida/cirurgia , Estado Pré-Diabético/cirurgia , Comportamento de Redução do Risco , Adulto , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/diagnóstico , Análise de Dados , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/sangue , Obesidade Mórbida/diagnóstico , Estado Pré-Diabético/sangue , Estado Pré-Diabético/diagnóstico , Estudos Retrospectivos , Fatores de Risco , Fatores de TempoRESUMO
No disponible
Assuntos
Adulto , Feminino , Humanos , Neoplasia Endócrina Múltipla Tipo 1/complicações , Hipocalcemia/etiologia , Paratireoidectomia , Cirurgia BariátricaAssuntos
Cirurgia Bariátrica/efeitos adversos , Hiperparatireoidismo/etiologia , Hiperparatireoidismo/cirurgia , Hipocalcemia/etiologia , Neoplasia Endócrina Múltipla/complicações , Paratireoidectomia , Complicações Pós-Operatórias/etiologia , Adulto , Feminino , Humanos , Índice de Gravidade de DoençaAssuntos
Neoplasias das Glândulas Suprarrenais/cirurgia , Adrenalectomia/efeitos adversos , Inoculação de Neoplasia , Feocromocitoma/cirurgia , Neoplasias das Glândulas Suprarrenais/diagnóstico , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética , Feocromocitoma/diagnóstico , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios XRESUMO
La cirugía bariátrica da lugar a una pérdida de peso que perdura y mejora las comorbilidades de la obesidad mórbida. Pueden darse complicaciones tras ella, la mayoría nutricionales y de carácter leve, pero en algunos casos pueden ser graves y comprometer la vida del paciente. Se presenta el caso de una mujer de 50 años en quien se desarrolló desnutrición caloricoproteínica grave tras cirugía bariátrica y que precisó que se revirtiera la intervención. Se discuten los factores que dieron lugar a la desnutrición y las opciones de tratamiento (AU)
Bariatric surgery achieves lasting weight loss and improves the comorbidities associated with morbid obesity. After surgery, patients can develop complications, mainly mild nutritional alterations. However, in some patients, complications can be serious and life-threatening. We present the case of a 50-year-old woman who developed severe protein-calorie malnutrition after bariatric surgery, which required surgical reversion. The factors leading to malnutrition in this patient and the treatment options are discussed (AU)
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Obesidade Mórbida/cirurgia , Complicações Pós-Operatórias/etiologia , Desnutrição Proteico-Calórica/complicações , Desnutrição Proteico-Calórica/terapia , Abdome , Tomografia Computadorizada por Raios XRESUMO
Bariatric surgery achieves lasting weight loss and improves the comorbidities associated with morbid obesity. After surgery, patients can develop complications, mainly mild nutritional alterations. However, in some patients, complications can be serious and lifethreatening. We present the case of a 50-year-old woman who developed severe protein-calorie malnutrition after bariatric surgery, which required surgical reversion. The factors leading to malnutrition in this patient and the treatment options are discussed.
RESUMO
Un 10 por ciento de los feocromocitomas son bilaterales.Además el 10 por ciento es familiar y puede asociarse de forma más frecuente con el síndrome MEN 2a o 2b, o bien con la enfermedad de Von Hippel-Lindau, la enfermedad de Von Recklinghausen y el síndrome de Sturge-Weber. Presentamos el caso de una mujer de 18 años con dos tumoraciones dependientes de ambas glándulas adrenales que se visualizan en una resonancia magnética (RM). Se realiza una adrenalectomía bilateral, así como un estudio genético de la paciente, en el que se detecta una mutación en el exón 3 del gen VHL. El estudio genético de los progenitores fue negativo (AU)
