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Bariatric surgery and long-term nutritional issues 预览
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作者 Roberta Lupoli Erminia Lembo +3 位作者 Gennaro Saldalamacchia Claudia Kesia Avola Luigi Angrisani Brunella Capaldo 《世界糖尿病杂志:英文版(电子版)》 2017年第11期464-474,共11页
Bariatric surgery is recognized as a highly effective therapy for obesity since it accomplishes sustained weight loss, reduction of obesity-related comorbidities and mortality, and improvement of quality of life. Over... Bariatric surgery is recognized as a highly effective therapy for obesity since it accomplishes sustained weight loss, reduction of obesity-related comorbidities and mortality, and improvement of quality of life. Overall, bariatric surgery is associated with a 42% reduction of the cardiovascular risk and 30% reduction of all-cause mortality. This review focuses on some nutritional consequences that can occur in bariatric patients that could potentially hinder the clinical benefits of this therapeutic option. All bariatric procedures, to variable degrees, alter the anatomy and physiology of the gastrointestinal tract; this alteration makes these patients more susceptible to developing nutritional complications, namely, deficiencies of macro-and micro-nutrients, which could lead to disabling diseases such as anemia, osteoporosis, protein malnutrition. Of note is the evidence that most obese patients present a number of nutritional deficits already prior to surgery, the most important being vitamin D and iron deficiencies. This finding prompts the need for a complete nutritional assessment and, eventually, an adequate correction of pre-existing deficits before surgery. Another critical issue that follows bariatric surgery is post-operative weight regain, which is commonly associated with the relapse of obesity-related comorbidities. Nu-tritional complications associated with bariatric surgery can be prevented by life-long nutritional monitoring with the administration of multivitamins and mineral supplements according to the patient’s needs. 展开更多
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Bariatric surgery and diabetes remission: Sleeve gastrectomy or mini-gastric bypass? 预览
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作者 Marco Milone Matteo Nicola Dario Di Minno +8 位作者 Maddalena Leongito Paola Maietta Paolo Bianco Caterina Taffuri Dario Gaudioso Roberta Lupoli Silvia Savastano Francesco Milone Mario Musella 《世界胃肠病学杂志:英文版(电子版)》 SCIE CAS 2013年第39期6590-6597,共8页
AIM:To investigate the weight loss and glycemic control status[blood glucose,hemoglobin A1c(HbA1c)and hypoglycaemic treatment].METHODS:The primary risk factor for type 2 diabetes is obesity,and 90%of all patients wit... AIM:To investigate the weight loss and glycemic control status[blood glucose,hemoglobin A1c(HbA1c)and hypoglycaemic treatment].METHODS:The primary risk factor for type 2 diabetes is obesity,and 90%of all patients with type 2 diabetes are overweight or obese.Although a remarkable effect of bariatric surgery is the profound and durable resolution of type 2 diabetes clinical manifestations,little is known about the difference among various weight loss surgical procedures on diabetes remission.Data from patients referred during a 3-year period(from January2009 to December 2011)to the University of Naples'FedericoⅡ'diagnosed with obesity and diabetes were retrieved from a prospective database.The patients were split into two groups according to the surgical intervention performed[sleeve gastrectomy(SG)and mini-gastric bypass(MGB)].Weight loss and glycemic control status(blood glucose,HbA1c and hypoglycaemic treatment)were evaluated.RESULTS:A total of 53 subjects who underwent sleeve gastrectomy or mini-gastric bypass for obesity and diabetes were screened for the inclusion in this study.Of these,4 subjects were excluded because of surgical complications,7 subjects were omitted because young surgeons conducted the operations and 11 subjects were removed because of the lack of follow-up.Thirtyone obese patients were recruited for this study.A total of 15 subjects underwent SG(48.4%),and 16underwent MGB(51.6%).After adjusting for various clinical and demographic characteristics in a multivariate logistic regression analysis,high hemoglobin A1c was determined to be a negative predictor of diabetes remission at 12 mo(OR=0.366,95%CI:0.152-0.884).Using the same regression model,MGB showed a clear trend toward higher diabetes remission rates relative to SG(OR=3.780,95%CI:0.961-14.872).CONCLUSION:Although our results are encouraging regarding the effectiveness of mini-gastric bypass on diabetes remission,further studies are needed to provide definitive conclusions in selecting the ideal procedure for diabetes remission. 展开更多
关键词 BARIATRIC surgery SLEEVE BYPASS OBESITY and DIABETES
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Omega-3 fatty acids for the treatment of non-alcoholic fatty liver disease 预览 被引量:1
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作者 Matteo Nicola Dario Di Minno Anna Russolillo +3 位作者 Roberta Lupoli Pasquale Ambrosino Alessandro Di Minno Giovanni Tarantino 《世界胃肠病学杂志:英文版》 SCIE CAS CSCD 2012年第41期5839-5847,共9页
非酒精的脂肪肝疾病(NAFLD ) 作为主要健康负担被认出了。它是长期的肝疾病和一个主要独立心血管的风险因素的最重要的原因。缺乏明确的治疗因为在物理活动的 NAFLD,一本特定的食谱和增加表示大多数通常使用了治疗学的途径。在这评论... 非酒精的脂肪肝疾病(NAFLD ) 作为主要健康负担被认出了。它是长期的肝疾病和一个主要独立心血管的风险因素的最重要的原因。缺乏明确的治疗因为在物理活动的 NAFLD,一本特定的食谱和增加表示大多数通常使用了治疗学的途径。在这评论,主修关于 omega-3 多元不堡和的使用的文学数据丰满的酸(n-3 PUFA ) 被描述了为 NAFLD 的潜在的治疗。 n-3 PUFA ,而且由调整基因抄写因素在大多数cardio新陈代谢的风险因素(高血压, hyperlipidemia , endothelial 机能障碍和动脉粥样硬化)上有有益的影响[即, peroxisome 激活proliferator 的受体( PPAR ), PPAR ,甾醇规章的元素绑定 protein-1 ,糖类应答的元素绑定蛋白质],影响两类脂化合物新陈代谢并且上胰岛素敏感。除了肝的贝它氧化的改进和内长的类脂化合物生产的减少, n-3 PUFA 能决定支持 inflammatory 分子(肿瘤坏死 factor-6) 和 interleukin-6 ) 并且氧的表示的重要减小反应种类。进一步加强结果在里面 vitro 研究,两个动物模型和人的干预试用,在由实验室参数和成像大小表示了的 NAFLD 的严厉上显示出 n-3 PUFA 的有益的效果。尽管有可得到的结果,在人作为 NAFLD 的一个处理关于 n-3 PUFA 的功效鼓励数据提供,与组织学的端点,足够的尺寸和持续时间的设计得好的使随机化的控制试用被需要估计 PUFA ,以及另外的治疗的长期的安全和功效,为 NAFLD 和非酒精的 steatohepatitis 病人的治疗。认为 n-3 PUFA 不能被人的身体综合并且必须从外长的来源被导出是值得的(鱼油,亚麻,橄榄油)它是地中海食谱的典型食物,在阻止肥胖为它的有益的效果知道,糖尿病并且,接着心血管的事件。根据这些数据,认为大多数 n-3 PUFA 的有益的效果能被一个 equilibrate 营养节目也获得是重要的。 展开更多
关键词 Ω-3脂肪酸 酒精性 过氧化物酶体增殖物激活受体 N-3多不饱和脂肪酸 肝疾病 治疗 固醇调节元件结合蛋白 Ω-3多不饱和脂肪酸
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