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- Beamish, A. J., et al.
(författare)
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Changes in adipose tissue distribution and relation to cardiometabolic risk factors after Roux-en-Y in adolescents
- 2023
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Ingår i: Surgery for Obesity and Related Diseases. - : ELSEVIER SCIENCE INC. - 1550-7289 .- 1878-7533. ; 19:10, s. 1154-1161
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Tidskriftsartikel (refereegranskat)abstract
- Background: Roux-en-Y gastric bypass (RYGB) among adolescents with obesity results in signif-icant weight loss; however, depot-specific changes have been understudied.Objective: We hypothesized that visceral adipose tissue (VAT) reduction in adolescents undergoing RYGB would be greater than other depots and associated with improvement in cardiometabolic risk factors.Setting: Three specialized treatment centers in Sweden. Methods: Fifty-nine adolescents underwent dual x-ray absorptiometry before surgery and at 1, 2, and 5 years after RYGB. Changes in body composition in multiple depots (total fat, lean body, gynoid fat, android fat, subcutaneous adipose tissue, and VAT) and cardiometabolic risk factors were assessed using multiple linear regression analysis and generalized estimating equations adjusting for age, sex, and baseline risk factor levels. Data are presented as percent change (95% CI) with regression models showing slopes and estimated P values.Results: At 1 year post-RYGB, a significant reduction was observed across all body composition measures (P , .001) with the greatest reduction observed in VAT (-65.1% [-68.7, -61.8]). From year 1 to 5 years post-RYGB, a regain was observed in all depots except lean body mass (1.2% [.3, 2.7], P 5 .105). A sex-specific difference in overall trajectories was only observed in lean body mass with males consistently having higher mean levels. Change in VAT at 1 year correlated with change in triglycerides (slope: .21 mg/dL/kg, P = .034) and fasting plasma insulin (slope: 44 pmol/L/kg, P = .027). Conclusions: Adiposity measures all decreased after RYGB but poorly predicted change in cardio-metabolic risk. Despite significant reductions at 1 year, a steady regain was observed out to 5 years, with values still well below baseline. Further research should consider control group comparison and extended follow-up.
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| 2. |
- Brissman, M., et al.
(författare)
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Physical Fitness and Body Composition Two Years after Roux-En-Y Gastric Bypass in Adolescents
- 2017
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Ingår i: Obesity Surgery. - : Springer Science and Business Media LLC. - 0960-8923 .- 1708-0428. ; 27:2, s. 330-337
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Tidskriftsartikel (refereegranskat)abstract
- We have previously shown promising results 2 years after Roux-en-Y gastric bypass surgery, within the Adolescence Morbid Obesity Surgery study (AMOS). The aim of the current study was to describe the 2-year outcome in cardiorespiratory fitness, body composition, and functional capacity in the Stockholm subset of the AMOS study. Forty-one adolescents (10 male, 31 female, age 14-18 years, body mass index 35-69 kg center dot m(-2)) were included. In addition to anthropometric measurements, participants performed a submaximal bicycle test, 6-min walk test, dual-energy X-ray absorptiometry, and a short interview at baseline, 1 and 2 years after surgery. Relative improvements in maximal oxygen consumption (VO(2)max) per kilogram body mass (+62 %) and per kilogram fat-free mass (+21 %), as well as walking distance (+13 %) were observed after 1 year, and persisted 2 years after surgery. Despite a reduction of fat-free mass (-15 %), absolute VO(2)max was maintained across the full group (+8 %, p = ns) and significantly increased in non-smokers. Body mass and fat mass were significantly decreased (-45.4 and -33.3 kg, respectively). Self-reported physical activity was significantly increased, and pain associated with movement was reduced. In adolescents with obesity, Roux-en-Y gastric bypass improved VO(2)max more than could be explained by fat mass loss alone. In combination with improved functional capacity and body composition, these results suggest that surgery in adolescence might add specific benefits of importance for future health.
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| 3. |
- Beamish, Andrew J., et al.
(författare)
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Body composition and bone health in adolescents after Roux-en-Y gastric bypass for severe obesity
- 2017
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Ingår i: Pediatric Obesity. - : Wiley. - 2047-6310 .- 2047-6302. ; 12:3, s. 239-246
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (RYGB) causes changes in body composition and bone metabolism, yet little is known about effects in adolescents. OBJECTIVES: The objective of this study was to report dual-energy X-ray absorptiometry measures and serum bone markers, hypothesizing that bone turnover increases after surgery. METHODS: Inclusion criteria included the following: age 13-18 years and body mass index (BMI) >35 kg/m2 . Seventy-two adolescents (22 boys; mean age 16.5 years; BMI 44.8 kg/m2 ) undergoing RYGB underwent dual-energy X-ray absorptiometry and serum bone marker analyses preoperatively and annually for 2 years. RESULTS: Mean BMI reduction at 2 years was 15.1 kg/m2 . Body composition changes included a reduction in fat mass (51.8% to 39.6%, p < 0.001) and relative increase in lean mass (47.0% to 58.1%, p < 0.001). In contrast to previous studies in adults, adolescent boys lost a greater percentage of their body fat than girls (-17.3% vs. -9.5%, p < 0.001). Individual bone mineral density Z-scores (BMD-Z) at baseline were within or above the normal range. The mean (SD) BMD-Z was 2.02 (1.2) at baseline, decreasing to 0.52 (1.19) at 2 years. Higher concentrations of serum CTX (p < 0.001) and osteocalcin (p < 0.001) were observed in boys throughout the study period. Levels rose in the first year, before decreasing modestly in the second. Levels of serum markers of bone synthesis and resorption were higher in boys, whose skeletal maturity occurs later than girls'. CONCLUSIONS: Differences in body fat and lean mass proportions were observed according to sex following RYGB. Bone turnover increased, and BMD decreased to levels approaching a norm for age. Long-term outcome will determine the clinical relevance.
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| 6. |
- Flodmark, C-E., et al.
(författare)
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Behandling av barnfetma.
- 2007
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Ingår i: boken Fetma. - : Studentlitteratur. ; , s. 309-332
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 7. |
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| 8. |
- Henfridsson, Pia, et al.
(författare)
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Micronutrient intake and biochemistry in adolescents adherent or nonadherent to supplements 5 years after Roux-en-Y gastric bypass surgery
- 2019
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Ingår i: Surgery for Obesity and Related Diseases. - : Elsevier BV. - 1550-7289 .- 1878-7533. ; 15:9, s. 1494-1502
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Tidskriftsartikel (refereegranskat)abstract
- Background: Roux-en-Y gastric bypass (RYGB) is an effective obesity treatment in adults and has become established in adolescents. Lower adherence to supplementation in adolescents confers a risk for long-term nutritional deficiencies. Objectives: To assess adherence to supplementation, micronutrient intake, and biochemistry in adolescents through 5 years after RYGB. Setting: University hospitals, multicenter study, Sweden. Methods: Micronutrient intake and adherence to supplementation were assessed by diet history interviews and biochemistry preoperatively, 1, 2, and 5 years after RYGB in 85 adolescents (67% females), aged 16.5 years (± 1.2) with a body mass index of 45.5 kg/m2 (± 6.0). Adherence was defined as taking prescribed supplements ≥3 times a week. Micronutrient intake and biochemistry were compared with matched controls at 5 years. Results: Over 75% completed the dietary assessments across 5 years after RYGB. Adherence ranged between 44–61% through 5 years. At 5 years, ferritin and hemoglobin decreased (P < .04) and 61% had iron deficiency (P ≤ .001). Among females with iron deficiency, most did not adhere to supplementation (P = .005), and 59% of these had anemia (P < .001). Vitamin D insufficiency continued after surgery and 80% of participants who did not adhere to supplementation had insufficiency (P = .002). Adolescents not adhering had lower levels of vitamin D, B12, and ferritin (females) compared with both adhering adolescents and the control group (all P < .04). Conclusions: Half of adolescents after RYGB reported sufficient long-term adherence to supplementation. Adhering to supplements and reporting a higher micronutrient intake were associated with more favorable biochemistry. Results support the recommendations for monitoring micronutrient intake and biochemistry in all patients who have undergone RYGB surgery, and the recommendation of higher preventive supplementation of vitamin D and iron in both sexes. As hypothesized, adolescents not adhering had a higher prevalence of long-term micronutrient deficiencies. © 2019 American Society for Bariatric Surgery
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| 9. |
- Järvholm, Kajsa, et al.
(författare)
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5-year mental health and eating pattern outcomes following bariatric surgery in adolescents: a prospective cohort study
- 2020
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Ingår i: Lancet Child & Adolescent Health. - : Elsevier BV. - 2352-4642. ; 4:3, s. 210-219
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Tidskriftsartikel (refereegranskat)abstract
- Background Mental health problems are prevalent among adolescents with severe obesity, but long-term mental health outcomes after adolescent bariatric surgery are not well known. We aimed to assess mental health outcomes over 5 years of follow-up after Roux-en-Y gastric bypass surgery in adolescents who participated in the Adolescent Morbid Obesity Surgery (AMOS) study. Methods This was a non-randomised matched-control study in adolescents aged 13-18 years who had a BMI of 40 kg/m(2) or higher, or 35 kg/m(2) or higher in addition to obesity-related comorbidity; who had previously undergone failed comprehensive conservative treatment; and were of pubertal Tanner stage III or higher, with height growth velocity beyond peak. A contemporary control group, matched for BMI, age, and sex, who underwent conventional obesity treatment, was obtained from the Swedish Childhood Obesity Treatment Register. Data on dispensed psychiatric drugs and specialist treatment for mental disorders were retrieved from national registers with complete coverage. In the surgical group only, questionnaires were used to assess self-esteem (Rosenberg Self-Esteem [RSE] score), mood (Mood Adjective Checklist [MACL]), and eating patterns (Binge Eating Scale [BES] and Three-Factor Eating Questionnaire-R21 [TFEQ]). This study is registered with ClinicalTrials.gov (NCT00289705). Findings Between April 10, 2006, and May 20, 2009, 81 adolescents (53 [65%] female) underwent Roux-en-Y gastric bypass surgery, and 80 control participants received conventional treatment. The proportion of participants prescribed psychiatric drugs did not differ between groups in the years before study inclusion (pre-baseline; absolute risk difference 5% [95% CI -7 to 16], p=0.4263) or after intervention (10% [-6 to 24], p=0.2175). Treatment for mental and behavioural disorders did not differ between groups before baseline (2% [-10 to 14], p=0.7135); however, adolescents in the surgical group had more specialised psychiatric treatment in the 5 years after obesity treatment than did the control group (15% [1 to 28], p=0.0410). There were few patients who discontinued psychiatric treatment post-surgery (three [4%] receiving psychiatric drug treatment and six [7%] receiving specialised care for a mental disorder before surgery). In the surgical group, self-esteem (RSE score) was improved after 5 years (mixed model mean 21.6 [95% CI 19.9 to 23.4]) relative to baseline (18.9 [17.4 to 20.4], p=0.0059), but overall mood (MACL score) was not (2.8 [2.7 to 2.9] at 5 years vs 2.7 [2.6 to 2.8] at baseline, p=0.0737). Binge eating was improved at 5 years (9.3 [7.4 to 11.2]) relative to baseline (15.0 [13.5 to 16.5], p<0.0001). Relative changes in BMI were not associated with the presence or absence of binge eating at baseline. Interpretation Mental health problems persist in adolescents 5 years after bariatric surgery despite substantial weight loss. Although bariatric surgery can improve many aspects of health, alleviation of mental health problems should not be expected, and a multidisciplinary bariatric team should offer long-term mental health support after surgery. Copyright (C) 2020 Elsevier Ltd. All rights reserved.
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