STUDY ROUNDUP

Published in September 2013 Issue             


Preoperative Prediction of Type 2 Diabetes Remission After Roux-en-Y Gastric Bypass Surgery: A Retrospective Cohort Study


Christopher D. Still, DO, director of Geisinger Obesity Institute, Danville, Pennsylvania, and colleagues have developed an algorithm to predict the likelihood of type 2 diabetes remission after Roux-en-Y gastric bypass surgery, called the DiaRem score. The scoring system, which was developed from a retrospective, 690-patient cohort study, is based on four clinical variables, with points ranging from 0 to 22 – low scores predict higher remission rates, while high scores predict lower remission rates. The research on the scoring system was published online in The Lancet Diabetes & Endocrinology. The four variables identified were – insulin use, age, HbA1c concentration and type of diabetic drugs used. These were the most successful predictors of type 2 diabetes remission, with baseline insulin use the strongest predictor of remission.


Episodic Migraine and Obesity and the Influence of Age, Race and Sex


A large study published in the September 11 online edition of Neurology found episodic migraines (EM) are more likely to occur in obese patients younger than 50, white and female, as compared to non-obese patients. Researchers examined the results of 3,862 patients based on age, race, sex and EM-obesity association. The study demonstrated that EMs were twice as common among people with obesity as with normal-weight adults, and indicated obesity increased the risk of developing EM by 81 percent.


Gonadal Steroids and Body Composition, Strength and Sexual Function in Men


According to a study published in the New England Journal of Medicine (September 12), decreasing levels of testosterone and estrogen have different effects on males as they age. Researchers examined which hormones had an impact on body fat and lean mass. In the National Institutes of Health co-funded study, estrogen deficiency accounted for the majority of the patient’s increase in body fat. In addition, a decrease in lean mass, muscle size and strength were due to androgen deficiency.


Can Virtual Reality Simulators be a Certification Tool for Bariatric Surgeons?


A new study claims the Lap Mentor simulator may be used as a certification tool for bariatric surgeons in evaluating their technical skills in laparoscopic Roux-en-Y gastric bypass surgery. Surgeons were evaluated on three tasks: eye-hand coordination, creating a gastric pouch and gastrojejunal anastomosis. The 20-surgeon (10 general surgeons and 10 bariatric surgeons) study was published in Surgical Endoscopy (August 31).


Developing Criteria for Pediatric/Adolescent Bariatric Surgery Programs


Study authors recommended guidelines and criteria for assessing surgeons and installing programs within institutions for children undergoing bariatric surgery. Guidelines include an institution’s commitment to the program, adequate staffing for adolescent bariatric surgical procedure, the hospital’s engagement with advanced open and laparoscopic procedures, specialized equipment, the development of a multidisciplinary pediatric and adolescent bariatric surgery committee, clinical pathways, the installment of a long-term follow-up program of at least 75 percent at five years, and support groups. Authors also noted cardiovascular risk factors increasing in this population, leading to a rise in co-morbid conditions in adulthood. The recommendations were published in the September 1 edition
of PEDIATRICS.


Metabolically Healthy Obesity: Epidemiology, Mechanisms and Clinical Implications


A study published in The Lancet Diabetes & Endocrinology (August 30) examined a group of patients with obesity (>30kg/m2 and no major cardiovascular risk factors) who may not be at an increased risk for developing metabolic complications of obesity and can be categorized as “metabolically healthy obese,” and therefore “protected” from these complications or “might be at substantially lower at risk than expected for their obesity.” Study authors provided an overview of some observational studies and concluded that while this group is not new, recently it has become “recognized in the discipline.” Study researchers provided some indicators to differentiate it from other forms of obesity, including considering waist circumference measurement instead of BMI, the association between BMI and insulin resistance, lipid profiles, blood pressure, inflammation or physical fitness.