Navegando por Palavras-chave "Bypass Gástrico"

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    Avaliação da influência da derivação gástrica em Y-de-Roux na função sexual feminina em obesas – Um estudo prospectivo
    (Universidade Federal de São Paulo (UNIFESP), 2020-04-30) Menezes, Mariano De Almeida [UNIFESP]; Fernandes, Fernando Augusto Mardiros Herbella [UNIFESP]; Universidade Federal de São Paulo
    Introduction: Obesity can affect female sexual function and lead to hyperandrogenia. This study aims to evaluate female sexual function and androgenic profile in obese women after Gastric Bypass (GB). Methods: Forty obese women with a mean age of 34 years were prospectively studied. Those with diabetes mellitus, psychiatric diseases, under medication that could interfere with sexual function and history of pelvic surgery were excluded. All patients underwent laparoscopic GB. Total and free testosterone, androstenedione and dehydroepiandrosterone (DHEA) and the application of a female sexual function questionnaire (QS-F) were evaluated, preoperatively and at 6 and 12 months after the operation. Results: Preoperative incidence of sexual dysfunction was 10% and hyperandrogenia was present in 40% of the individuals. After GB, there was an improvement in female sexual function (p = 0,02), mainly related to the improvement of desire and sexual interest (p = 0,002), and sexual comfort (p = 0,03) and there was not case of sexual dysfunction 12 months after the operation. The improvement of the sexual function did not happen in first six months of the surgery (QS-F 77.5 – 78.8 points, p = 0.812), however there was a decrease of the free testosterone levels (0.49 – 0.33 ng/dl, p < 0.001) and androstenedione (2.0 – 1.3 ng/dl, p < 0.001), but there was not alterations of de DHEA levels (3.4 – 3.2 ng/dl, p = 0.120). At 1 year of follow-up, there was a reduction in the incidence of hyperandrogenia (40% – 7.9%, p < 0.001), free testosterone levels, androstenedione and an increase in DHEA levels. Total testosterone levels did not change significantly. There was not statistic correlation between androgen levels and female sexual function, as also between the anthropometrics parameters and sexual function. Loss of excess BMI was 46% at 6 months and 85% at 1 year. Conclusion: Female sexual function in obese women improves in patients undergoing GB, especially in desire, interest and sexual comfort, and this happens after 6 months of surgery and may be related to improvement of androgenic profile, mainly improvement of DHEA, and loss of excess BMI of these patients.
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    Avaliação de hormônios gastrointestinais e leptina em pacientes com e sem reganho do peso após cinco anos da gastroplastia em y de roux
    (Universidade Federal de São Paulo (UNIFESP), 2019-11-28) Saboya Sobrinho, Carlos Jose [UNIFESP]; Lopes Filho, Gaspar De Jesus [UNIFESP]; Arasaki, Carlos Haruo [UNIFESP]; http://lattes.cnpq.br/8299360555227115; http://lattes.cnpq.br/3518607824692081; http://lattes.cnpq.br/7034900883648145; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To evaluate and compare the role of gastrointestinal hormones – GHRELIN, peptide YY 3-36 (PYY 3-36), glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide-2 (GLP-2) - and LEPTIN in patients with and without weight regain undergoing Roux-en-Y gastric bypass after five years of the surgical procedure. METHODS: This is an observational, cross-sectional study, where 72 individuals divided into 3 paired groups: Group WR (WITH WEIGHT REGAIN): 24 patients undergoing Roux-en-Y gastric bypass with weight regain; Group WWR (WITHOUT WEIGHT REGAIN): 24 patients undergoing Roux-en-Y gastric bypass without weight regain and Group NO-OP (NON-OPERATED OBESE): 24 obese patients who are candidates for bariatric surgery. Patients with weight regain, defined as the increase of 5kg/m2 in BMI, taking as reference the minimum BMI reached during the postoperative period and the current BMI. The overall patients underwent clinical, biochemical, anthropometric and endoscopic evaluation. Hormone evaluation was performed in four settings – fasting, 30, 60 and 120 minutes - after standard meal intake, considering that the secretion of gastrointestinal hormones is affected by nutrient intake. RESULTS: For GLP-1, GLP-2 and PYY, values in the control group (NO-OP) did not change significantly. In the WR and WWR there was a sharp elevation at 30 minutes followed by a decrease at 60 and 120 minutes, ending with mean values still higher than baseline. Variations in ghrelin were not considered statistically significant. For GIP, the three groups showed similar behavior, with an increase at 30 minutes and a decrease at 60 and 120 minutes; however, in the overall evaluation (baseline period up to 120min), the WWR was the group in which GIP reached its lowest variation compared to baseline, and a statistical difference was found compared to the NO-OP and the WR groups. For leptin, the RW was similar to control, while the WWR showed significantly lower mean values. CONCLUSIONS: Non-operated obese individuals showed a postprandial secretion profile of PYY, GLP-1 and GLP-2, distinct from patients undergoing Roux-en-Y gastric bypass. In patients with weight regain, leptin concentrations were significantly higher when compared to patients without weight regain, thus suggesting a probable resistance to the action of this hormone. Patients without weight regain showed less variation in GIP, which implies a possible relation to the restoration of the secretory process after glucose control. GLP-1, GLP-2, PYY and GHRELIN showed no correlation with weight regain. Further studies should be conducted to better identify the mechanisms responsible for the findings reported by the current investigation, as well as clarifications on other conditions induced by Roux-en-Y gastric bypass.