Dramatic Reversal of Derangements in Muscle Metabolism and Left Ventricular Function After Bariatric Surgery
Abstract Objective The study objective was to define muscle metabolic and cardiovascular changes after surgical intervention in clinically severe obese patients. Methods Obesity is a state of metabolic dysregulation that can lead to maladaptive changes in heart and skeletal muscle, including insulin...
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| Veröffentlicht in: | The American journal of medicine 2008-11, Vol.121 (11), p.966-973 |
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| creator | Leichman, Joshua G., MD Wilson, Erik B., MD Scarborough, Terry, MD Aguilar, David, MD Miller, Charles C., PhD Yu, Sherman, MD Algahim, Mohamed F., BSc Reyes, Manuel, MD Moody, Frank G., MD Taegtmeyer, Heinrich, MD, DPhil |
| description | Abstract Objective The study objective was to define muscle metabolic and cardiovascular changes after surgical intervention in clinically severe obese patients. Methods Obesity is a state of metabolic dysregulation that can lead to maladaptive changes in heart and skeletal muscle, including insulin resistance and heart failure. In a prospective longitudinal study, 43 consecutive patients underwent metabolic profiling, skeletal muscle biopsies, and resting echocardiograms at baseline and 3 and 9 months after bariatric surgery. Results Body mass index decreased (mean changes, 95% confidence interval [CI]): 7.7 kg/m2 (95% CI, 6.70-8.89) at 3 months and 5.6 kg/m2 (95% CI, 4.45-6.80; P < .0001) at 9 months after surgery, with restoration of insulin sensitivity and decreases in plasma leptin at the same time points. Concurrent with these changes were dramatic decreases in skeletal muscle transcript levels of stearoyl coenzyme-A desaturase and pyruvate dehydrogenase kinase-4 at 3 and 9 months ( P < .0001, for both) and a significant decrease in peroxisome proliferation activated receptor-α–regulated genes at 9 months. Left ventricular relaxation impairment, assessed by tissue Doppler imaging, normalized 9 months after surgery. Conclusion Weight loss results in the reversal of systemic and muscle metabolic derangements and is accompanied by a normalization of left ventricular diastolic function. |
| doi_str_mv | 10.1016/j.amjmed.2008.06.033 |
| format | Article |
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Methods Obesity is a state of metabolic dysregulation that can lead to maladaptive changes in heart and skeletal muscle, including insulin resistance and heart failure. In a prospective longitudinal study, 43 consecutive patients underwent metabolic profiling, skeletal muscle biopsies, and resting echocardiograms at baseline and 3 and 9 months after bariatric surgery. Results Body mass index decreased (mean changes, 95% confidence interval [CI]): 7.7 kg/m2 (95% CI, 6.70-8.89) at 3 months and 5.6 kg/m2 (95% CI, 4.45-6.80; P < .0001) at 9 months after surgery, with restoration of insulin sensitivity and decreases in plasma leptin at the same time points. Concurrent with these changes were dramatic decreases in skeletal muscle transcript levels of stearoyl coenzyme-A desaturase and pyruvate dehydrogenase kinase-4 at 3 and 9 months ( P < .0001, for both) and a significant decrease in peroxisome proliferation activated receptor-α–regulated genes at 9 months. Left ventricular relaxation impairment, assessed by tissue Doppler imaging, normalized 9 months after surgery. Conclusion Weight loss results in the reversal of systemic and muscle metabolic derangements and is accompanied by a normalization of left ventricular diastolic function.</description><identifier>ISSN: 0002-9343</identifier><identifier>EISSN: 1555-7162</identifier><identifier>DOI: 10.1016/j.amjmed.2008.06.033</identifier><identifier>PMID: 18954843</identifier><identifier>CODEN: AJMEAZ</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Bariatric Surgery ; Biological and medical sciences ; Echocardiography ; Electrocardiography ; Female ; Gastrointestinal surgery ; Gene Expression ; General aspects ; Hemodynamics ; Humans ; Internal Medicine ; Kinases ; Leptin ; Longitudinal Studies ; Male ; Medical sciences ; Metabolism ; Middle Aged ; Obesity ; Obesity - metabolism ; Obesity - pathology ; Obesity - surgery ; Prospective Studies ; Pyruvate dehydrogenase kinase-4 ; Quadriceps Muscle - metabolism ; Quadriceps Muscle - pathology ; Stearoyl Co-A desaturase ; Treatment Outcome ; Ventricular Function, Left ; Weight Loss</subject><ispartof>The American journal of medicine, 2008-11, Vol.121 (11), p.966-973</ispartof><rights>Elsevier Inc.</rights><rights>2008 Elsevier Inc.</rights><rights>2008 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. Nov 2008</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c518t-c3c865e5d2d396acf3d0ae9e6e91c324877d59069669cc053fde06a3b93138ce3</citedby><cites>FETCH-LOGICAL-c518t-c3c865e5d2d396acf3d0ae9e6e91c324877d59069669cc053fde06a3b93138ce3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.amjmed.2008.06.033$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27922,27923,45993</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20837332$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18954843$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Leichman, Joshua G., MD</creatorcontrib><creatorcontrib>Wilson, Erik B., MD</creatorcontrib><creatorcontrib>Scarborough, Terry, MD</creatorcontrib><creatorcontrib>Aguilar, David, MD</creatorcontrib><creatorcontrib>Miller, Charles C., PhD</creatorcontrib><creatorcontrib>Yu, Sherman, MD</creatorcontrib><creatorcontrib>Algahim, Mohamed F., BSc</creatorcontrib><creatorcontrib>Reyes, Manuel, MD</creatorcontrib><creatorcontrib>Moody, Frank G., MD</creatorcontrib><creatorcontrib>Taegtmeyer, Heinrich, MD, DPhil</creatorcontrib><title>Dramatic Reversal of Derangements in Muscle Metabolism and Left Ventricular Function After Bariatric Surgery</title><title>The American journal of medicine</title><addtitle>Am J Med</addtitle><description>Abstract Objective The study objective was to define muscle metabolic and cardiovascular changes after surgical intervention in clinically severe obese patients. Methods Obesity is a state of metabolic dysregulation that can lead to maladaptive changes in heart and skeletal muscle, including insulin resistance and heart failure. In a prospective longitudinal study, 43 consecutive patients underwent metabolic profiling, skeletal muscle biopsies, and resting echocardiograms at baseline and 3 and 9 months after bariatric surgery. Results Body mass index decreased (mean changes, 95% confidence interval [CI]): 7.7 kg/m2 (95% CI, 6.70-8.89) at 3 months and 5.6 kg/m2 (95% CI, 4.45-6.80; P < .0001) at 9 months after surgery, with restoration of insulin sensitivity and decreases in plasma leptin at the same time points. Concurrent with these changes were dramatic decreases in skeletal muscle transcript levels of stearoyl coenzyme-A desaturase and pyruvate dehydrogenase kinase-4 at 3 and 9 months ( P < .0001, for both) and a significant decrease in peroxisome proliferation activated receptor-α–regulated genes at 9 months. Left ventricular relaxation impairment, assessed by tissue Doppler imaging, normalized 9 months after surgery. Conclusion Weight loss results in the reversal of systemic and muscle metabolic derangements and is accompanied by a normalization of left ventricular diastolic function.</description><subject>Adult</subject><subject>Bariatric Surgery</subject><subject>Biological and medical sciences</subject><subject>Echocardiography</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Gastrointestinal surgery</subject><subject>Gene Expression</subject><subject>General aspects</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Kinases</subject><subject>Leptin</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metabolism</subject><subject>Middle Aged</subject><subject>Obesity</subject><subject>Obesity - metabolism</subject><subject>Obesity - pathology</subject><subject>Obesity - surgery</subject><subject>Prospective Studies</subject><subject>Pyruvate dehydrogenase kinase-4</subject><subject>Quadriceps Muscle - metabolism</subject><subject>Quadriceps Muscle - pathology</subject><subject>Stearoyl Co-A desaturase</subject><subject>Treatment Outcome</subject><subject>Ventricular Function, Left</subject><subject>Weight Loss</subject><issn>0002-9343</issn><issn>1555-7162</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkkFv1DAQhSMEotvCP0DIQqK3hHEcO_YFqbQUkLZCosDV8jqTyovjtHZSaf89DrvaQy-cLOt98zyeN0XxhkJFgYoP28oM2wG7qgaQFYgKGHtWrCjnvGypqJ8XKwCoS8UadlKcprTNV1BcvCxOqFS8kQ1bFf4qmsFMzpIf-IgxGU_GnlxhNOEOBwxTIi6QmzlZj-QGJ7MZvUsDMaEja-wn8jsz0dnZm0iu52AnNwZy0U8YyScTnVlEcjvHO4y7V8WL3viErw_nWfHr-vPPy6_l-vuXb5cX69JyKqfSMisFR97VHVPC2J51YFChQEUtqxvZth1XIJQQylrgrO8QhGEbxSiTFtlZcb73vY_jw4xp0oNLFr03Acc5aaFaSmtWZ_DdE3A7zjHk3vQi1w1nMkPNHrJxTClir--jG0zcaQp6iUJv9T4KvUShQegcRS57e_CeN4t2LDrMPgPvD4BJ1vg-j9y6dORqkKxl_5r8uOcwj-zRYdTJOgwWOxfRTrob3f86eWpgvQsuv_kHd5iOX6Y61Rr07bI2y9aABGi5APYXdZ29tw</recordid><startdate>20081101</startdate><enddate>20081101</enddate><creator>Leichman, Joshua G., MD</creator><creator>Wilson, Erik B., MD</creator><creator>Scarborough, Terry, MD</creator><creator>Aguilar, David, MD</creator><creator>Miller, Charles C., PhD</creator><creator>Yu, Sherman, MD</creator><creator>Algahim, Mohamed F., BSc</creator><creator>Reyes, Manuel, MD</creator><creator>Moody, Frank G., MD</creator><creator>Taegtmeyer, Heinrich, MD, DPhil</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Sequoia S.A</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7TO</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20081101</creationdate><title>Dramatic Reversal of Derangements in Muscle Metabolism and Left Ventricular Function After Bariatric Surgery</title><author>Leichman, Joshua G., MD ; Wilson, Erik B., MD ; Scarborough, Terry, MD ; Aguilar, David, MD ; Miller, Charles C., PhD ; Yu, Sherman, MD ; Algahim, Mohamed F., BSc ; Reyes, Manuel, MD ; Moody, Frank G., MD ; Taegtmeyer, Heinrich, MD, DPhil</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c518t-c3c865e5d2d396acf3d0ae9e6e91c324877d59069669cc053fde06a3b93138ce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adult</topic><topic>Bariatric Surgery</topic><topic>Biological and medical sciences</topic><topic>Echocardiography</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Gastrointestinal surgery</topic><topic>Gene Expression</topic><topic>General aspects</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Kinases</topic><topic>Leptin</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metabolism</topic><topic>Middle Aged</topic><topic>Obesity</topic><topic>Obesity - metabolism</topic><topic>Obesity - pathology</topic><topic>Obesity - surgery</topic><topic>Prospective Studies</topic><topic>Pyruvate dehydrogenase kinase-4</topic><topic>Quadriceps Muscle - metabolism</topic><topic>Quadriceps Muscle - pathology</topic><topic>Stearoyl Co-A desaturase</topic><topic>Treatment Outcome</topic><topic>Ventricular Function, Left</topic><topic>Weight Loss</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leichman, Joshua G., MD</creatorcontrib><creatorcontrib>Wilson, Erik B., MD</creatorcontrib><creatorcontrib>Scarborough, Terry, MD</creatorcontrib><creatorcontrib>Aguilar, David, MD</creatorcontrib><creatorcontrib>Miller, Charles C., PhD</creatorcontrib><creatorcontrib>Yu, Sherman, MD</creatorcontrib><creatorcontrib>Algahim, Mohamed F., BSc</creatorcontrib><creatorcontrib>Reyes, Manuel, MD</creatorcontrib><creatorcontrib>Moody, Frank G., MD</creatorcontrib><creatorcontrib>Taegtmeyer, Heinrich, MD, DPhil</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leichman, Joshua G., MD</au><au>Wilson, Erik B., MD</au><au>Scarborough, Terry, MD</au><au>Aguilar, David, MD</au><au>Miller, Charles C., PhD</au><au>Yu, Sherman, MD</au><au>Algahim, Mohamed F., BSc</au><au>Reyes, Manuel, MD</au><au>Moody, Frank G., MD</au><au>Taegtmeyer, Heinrich, MD, DPhil</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dramatic Reversal of Derangements in Muscle Metabolism and Left Ventricular Function After Bariatric Surgery</atitle><jtitle>The American journal of medicine</jtitle><addtitle>Am J Med</addtitle><date>2008-11-01</date><risdate>2008</risdate><volume>121</volume><issue>11</issue><spage>966</spage><epage>973</epage><pages>966-973</pages><issn>0002-9343</issn><eissn>1555-7162</eissn><coden>AJMEAZ</coden><abstract>Abstract Objective The study objective was to define muscle metabolic and cardiovascular changes after surgical intervention in clinically severe obese patients. Methods Obesity is a state of metabolic dysregulation that can lead to maladaptive changes in heart and skeletal muscle, including insulin resistance and heart failure. In a prospective longitudinal study, 43 consecutive patients underwent metabolic profiling, skeletal muscle biopsies, and resting echocardiograms at baseline and 3 and 9 months after bariatric surgery. Results Body mass index decreased (mean changes, 95% confidence interval [CI]): 7.7 kg/m2 (95% CI, 6.70-8.89) at 3 months and 5.6 kg/m2 (95% CI, 4.45-6.80; P < .0001) at 9 months after surgery, with restoration of insulin sensitivity and decreases in plasma leptin at the same time points. Concurrent with these changes were dramatic decreases in skeletal muscle transcript levels of stearoyl coenzyme-A desaturase and pyruvate dehydrogenase kinase-4 at 3 and 9 months ( P < .0001, for both) and a significant decrease in peroxisome proliferation activated receptor-α–regulated genes at 9 months. Left ventricular relaxation impairment, assessed by tissue Doppler imaging, normalized 9 months after surgery. Conclusion Weight loss results in the reversal of systemic and muscle metabolic derangements and is accompanied by a normalization of left ventricular diastolic function.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>18954843</pmid><doi>10.1016/j.amjmed.2008.06.033</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Bariatric Surgery Biological and medical sciences Echocardiography Electrocardiography Female Gastrointestinal surgery Gene Expression General aspects Hemodynamics Humans Internal Medicine Kinases Leptin Longitudinal Studies Male Medical sciences Metabolism Middle Aged Obesity Obesity - metabolism Obesity - pathology Obesity - surgery Prospective Studies Pyruvate dehydrogenase kinase-4 Quadriceps Muscle - metabolism Quadriceps Muscle - pathology Stearoyl Co-A desaturase Treatment Outcome Ventricular Function, Left Weight Loss |
| title | Dramatic Reversal of Derangements in Muscle Metabolism and Left Ventricular Function After Bariatric Surgery |
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