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వాల్యూమ్ 4, సమస్య 3 (2015)

కేసు నివేదిక

Re-sleeve Gastrectomy for Failure of Weight Loss After Primary Sleeve Gastrectomy; 3 Cases

Ji-Sun Hong and Sang-Moon Han

Laparoscopic sleeve gastrectomy (LSG) is the leading weight loss procedure for treatment of morbid obesity. However, as with all other bariatric procedures, failure of weight loss was observed. We report here 3 cases of resleeve gastrectomy (RSG) for failure of weight loss after primary sleeve gastrectomy (PSG). The first patient, with a body mass index (BMI) of 32.9 kg/m2, underwent PSG in August 2003. She showed an initial drop in BMI to 22.4 kg/m2 in 2007 and regained weight to BMI of 33.1 kg/m2 in 2013, but, after the RSG, her BMI was 21.9 kg/m2 at 12 months. The second patient, with a BMI of 32.6 kg/m2, underwent PSG in May 2004. She showed a drop in BMI of 27.4 kg/m2 in 2005 and regained weight to BMI of 31.4 kg/m2 in 2011, but, after the RSG, her BMI was 24.4 kg/m2 at 24 months. The third patient, with a BMI of 34.0 kg/m2, underwent PSG in July 2013. She had a drop in BMI of 28.0 kg/m2 in January 2014, but her weight did not change until July 2014. Her BMI had dropped to 21.2 at 6 month postoperatively after RSG. Therefore, RSG may be considered as a revision surgery for failure of weight loss after PSG.

పరిశోధన వ్యాసం

Prevalence of Metabolic Syndrome Diagnosed by Three Different Criteria in School-Aged Children from Rural and Urban Areas of Northwest Mexico

Cecilia Ramírez-Murillo, Elizabeth Guillot-Sánchez, Elizabeth Artalejo-Ochoa Q B, Alma E. Robles-Sardin, José A. Ponce-Martínez, María I Grijalva-Haro, Graciela Caire-Juvera, María I. Ortega-Vélez and Martha N. Ballestero

The International Diabetes Federation (IDF) does not justify the evaluation of metabolic syndrome (MetS) in children aged less than 10 years, unless they have a family history of risk factors. The prevalence of overweight and obesity in the Northwest of Mexico has increased in recent decades, making it possible to consider that MetS is already present in this group of population.
Objective: The primary objective of this study was to determine the prevalence of metabolic syndrome in children aged 6 to 9 years living in rural (RA) or urban (UA) areas of Northwest of Mexico. A secondary objective was to find adequate criteria to diagnose the prevalence of MS in children.
Methods: Participated 268 school-aged children in a random-selected cross sectional study. Anthropometric and blood pressure measurement were performed, and biochemical indicators were analyzed. MetS was defined as the presence of three or more risk factors and diagnosed using three different criteria. One of them according to what was proposed by the International Diabetes Federation (IDF) for children and two additional criteria proposed by this study considering suitable cutoffs for age for lipids and blood pressure.
Results: The general prevalence of MetS according to the three different criteria used was as follows.1) IDF criteria, 4.1%; 2) using cutoffs suggested for age for lipids and blood pressure and taking into account waist circumference as a criterion for MetS, 6.3%; and 3) cutoffs suggested for age, lipids and blood pressure without considering waist circumference as a criterion for MetS, 10.4%. Children living in the RA with a history of obesity and cardiovascular disease had higher waist circumference, triglycerides, and very low-density lipoprotein-C, and children from the UA had higher systolic and diastolic blood pressure, and higher levels of glucose and insulin.
Conclusion: MetS is present in children aged 6 to 9 years in the northwest region of Mexico, with higher proportions of the syndrome observed in overweight and obese children. The second criteria used in this study could be the most suitable for diagnosis of MetS, and the third criteria, for children at higher risk for cardiovascular disease and type 2 diabetes mellitus associated to heredity factors.

పరిశోధన వ్యాసం

Stimulation of Glycolysis in the Lens by Pyruvate. Implications in Protection against Oxidative Stress

Kavita R Hegde and Shambhu D Varma

Objective: We have previously demonstrated that pyruvate protects the lens against oxidative stress in vitro as well as prevents cataract formation in vivo induced by oxidative stress. The effects have been attributed to its property of scavenging various reactive oxygen species (ROS). Additionally we hypothesize that the preventive effect is also due to its effect of stimulating glycolysis.
Methods: This has been tested as follows: freshly isolated mice lenses were incubated for 4 hours in Tyrode medium containing 5-3H-glucose as a tracer in the presence and absence of 2 mM sodium pyruvate and determining generation of 3H2O and 3H-lactate separated by column chromatography in succession through homemade anion exchange column followed by the phenylboronate and formate mini-columns.
Results: the concentration of 3H2O in the medium at the end of incubation was 95 μM in the controls incubated without pyruvate. In the presence of pyruvate (2 mM) added to the medium, the concentration of 3H2O attained in the medium was 152 μM. The corresponding value expressed on the basis of lens weight was 46 nanomoles/lens in the control group vs. 88 nanomoles/lens with 2 mM pyruvate.
Conclusion: As hypothesized, pyruvate was found to stimulate glycolysis in the lens as indicated by the enhanced generation of both 3H2O and 3H-lactate in lenses incubated in its presence as compared to controls. The observed metabolic stimulation is attributed to recycling of NAD generated during the reduction of pyruvate to lactate, NAD being the required cofactor in the oxidation of glyceraldehyde-3-phosphate to 1,3-diphosphoglycerate. That such stimulation is involved in its protective effect is also apparent by our previous reports showing higher ATP levels in the lenses cultured in medium generating ROS in the presence of pyruvate than in its absence, the primary source of ATP in lens being glycolysis.

రాపిడ్ కమ్యూనికేషన్

Oral Aspects of Metabolic Disorders

Ankita Bohra

Metabolism is a complex process that involves a series of chemical reactions in the human body. Alterations in these metabolic processes constitute the disturbances of metabolism causing metabolic disorders. The breakdown of carbohydrate by the oral microorganisms has been the subject of numerous investigations. This review discusses the oral aspects of metabolic diseases.

పరిశోధన వ్యాసం

Association of Deoxyribonuclease I Gene Polymorphisms with Graves Disease in the Chinese Han Population

Jingyan Chen, Hua Zeng, Zhixian Zhang, Tingting Li, Lei Bi, Helin Ding and Jin Zhang

Background: This study aimed to investigate the association between the single nucleotide polymorphism (SNP) rs1053874 in the deoxyribonuclease I (DNASE1) gene and Graves’ disease (GD) in the Han Chinese population.
Methods: Polymerase chain reaction-restriction fragment length polymorphism analysis and direct sequencing were used to identify the distribution of the SNP rs1053874 in the DNASE1 genes from 284 GD patients and 203 healthy controls, and associations between clinical manifestations of GD and the observed genotype and allele frequencies at the DNASE1 gene were analyzed.
Results: In the Han Chinese population, there were significant differences between the GD groups and the controls with respect to genotype and allele frequencies associated with theSNPrs1053874. The risk of GD was greater among carriers of the G allele than non-carriers (OR=0.65, 95% CI: 0.49- 0.86). There were significant differences in genotype and allele frequencies between the GD patients with a history of relapse and the GD patients without history of relapse; furthermore, the G allele of the SNP rs1053874 was associated with relapse in GD patients.
Conclusion: This study confirmed that the DNASE1 gene may be a GD susceptibility gene in the in the Southern Chinese Han population. The G allele at the rs1053874 SNP would be a direct genetic risk factor for GD in this population. Furthermore, this allele may be associated with disease relapse.

పరిశోధన వ్యాసం

Treating Hyperinsulinemia with Momordica charantia

Frank Comhaire

Objectives: To assess the efficacy of a novel nutraceutical mainly containing the extract of bitter gourd (Momordica charantia) and α-lipoic acid for the treatment of patients with hyperinsulinemia.

Methods: Pilot prospective open-label cohort trial including 11 patients with hyperinsulinemia due to insulin resistance. The concentrations of insulin, C-peptide, glucose, haemoglobin A1c, total cholesterol, triglycerids, gamma- glutamyltransferase, and C-reactive protein were measured in blood take between 3 and 4 hours after dinner.

Results: One and 4 months after initiation of treatment there was a significant decrease of the concentrations of Insulin (to average 25% of initial value), C-peptide (to average 44% of initial value), glucose, hemoglobin A1c and gamma-glutamyl transpeptidase. Clinical significance: Treatment of patients with hyperinsulinemia, with or without diabetes or metabolic syndrome, using a novel nutraceutical containing Momordica charantia and α-lipoic acid dramatically reduced insulin resistance and may have improved non-alcoholic fatty liver disease.

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