[Treatment of severe obesity by calibrated vertical gastroplasty. 55 cases]. / Traitement de l'obésité sévère par gastroplastie verticale calibrée. 55 observations.

OBJECTIVES: Evaluate short-term outcome of calibrated vertical gastroplasty in obese subjects. METHODS: Calibrated vertical gastroplasty was performed in 55 obese subjects (BMI 43 +/- 1; age range 20-59 year). There were no post-operative complications. All the subjects were followed for 6 months and thirty one for a year. RESULTS: Weight loss reached 28 kg at 6 months and 36 kg at 1 year with an improvement in functional manifestations, especially for dyspnoea and, in half of the subjects, for signs of depression. New or worsened psychiatric problems were observed in 4 subjects. Post-prandial vomiting persisted for 1 year in 28 patients. Dietary intake was lowered (946 +/- 61 kcal/day) as was protein intake (43 +/- 3 g/24 hr). Impaired glucose tolerance, raised serum insulin, triglyceride and androgen levels were corrected in patients with abnormal levels before surgery. Serum vitamin B1 declined. CONCLUSION: These favourable results in the weight curve, functional problems and metabolic data should not mask the disadvantages and potential risks involved. Long-term prospective studies are required to determine the precise indications for this technique.

[Hyperandrogenism in hirsute and obese women. Effects of a low calorie diet]. / Hyperandrogénie de la femme hirsute et obèse. Effets d'un régime hypocalorique.

To investigate the relationship between overweight and hyperandrogenism, a 1500 kcal/day diet was prescribed for 4 months to 23 hirsute and obese patients. This diet decreased body mass index from 29.9 +/- 4.9 to 27.2 +/- 4.4 kg/m2 (P < 0.008), but had no significant effect on fasting insulin levels (18.9 +/- 14.2 vs. 21.1 +/- 9.6 mlU/l). Weight lost increased significantly (P < 0.008) the plasma concentration of sex-hormone binding-globulin (SHBG) from 21.2 +/- 10.6 to 26.2 +/- 13.5 nmol/l and decreased significantly (P < 0.04) the SHBG-unbound testosterone concentration from 9.3 +/- 6.2 to 7.2 +/- 4.8 ng/dl, without changing the concentrations of the main androgens measured in this study. Moreover, during diet 5 patients in amenorrhea and 8 among 13 patients with irregular menstrual cycle recovered regular menses. We concluded that the control of excess body weight in hirsute women is effective but not sufficient to improve hyperandrogenism.