Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-four patients were studied 2--6 years after jejunoileal bypass for morbid obesity. The serum concentration of 25-hydroxyvitamin D (25-OHD) were reduced and related to the frequency fo stools and to the weight reduction. Fifteen patients were not able to normalize serum 25-OHD following a long-term regular vitamin D intake. The serum immunoreactive parathyroid hormone concentration (iPTH) and the alkaline phosphatase levels were elevated in this group, indicating a secondary hyperparathyroidism. The mean bone mineral content of the forearm was reduced 3--6 years after the operation, most severely in those with elevated serum iPTH. The desired weight reduction by jejunoileal shunt was obtained at the expense of a severely disturbed vitamin D metabolism. We suggest, that all patients with an intestinal bypass for obesity should receive regular vitamin D supplement, and serum 25-OHD should be measured in order to monitor the effect of therapy.
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PMID:Impairment of vitamin D and bone metabolism in patients with bypass operation for obesity. 28 17

After bypass operations for obesity many patients had signs of liver injury (SLI). It has not earlier been possible to correlate changes in the preoperative liver function test with occurrence of postoperative SLI. The present study shows that those patients who before the intestinal bypass operation had a moderate to significant change in serum activity of S-LD 5 (isoenzyme 5 of the enzyme lactate dehydrogenase) were at risk of developing SLI after the operation. All five patients with SLI, of whom three died, preoperatively had an increase in S-LD 5 exceeding five times the normal mean value. The pattern in the transaminases and serum alkaline phosphatase were not as conclusive.
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PMID:The value of preoperative S-LD 5 isoenzyme determination in predicting the risk of serious liver injury after bypass operations for treatment of obesity. 49 62

Detailed postmortem examination was carried out on five patients who died three months to four years after jejunoileal bypass for obesity. A spectrum of histological changes was observed in the liver, with pericentral fat deposition being a common feature. Evidence of previous and/or ongoing liver cell dropout with accompanying polymorphonuclear and mononuclear infiltration was seen in all cases, but Mallory hyalin was not detected. Liver function abnormalities included decreased plasma protein levels, decreased prothrombin activity, increased serum alkaline phosphatase levels, and variable elevations of the serum transaminases, bilirubin, and ammonia concentrations. The pattern of the hepatic disease does not resemble protein deficiency. An uncharacterized hepatotoxin or toxic effect of hepatic fat accumulation may play a significant role in the changes observed in these patients.
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PMID:Fatty metamorphosis of the liver associated with jejunoileal bypass. Report of five cases. 57 74

Circulating levels of 25-OH vitamin D were measured in 44 patients who had undergone small intestinal bypass for obesity. Sixty-one percent had low circulating levels of the metabolite, which tended to normalize with time. This adaptive response also occurred for circulating total calcium, magnesium, albumin, and alkaline phosphatase. Serum concentrations of 25-OH vitamin D were directly related to total serum calcium and albumin. Impaired intestinal absorption of 25-OH vitamin D was seen in two patients. Following correction of total serum calcium for attendant hypoalbuminemia, 27% of patients remained hypocalcemic. The bone densities of two of 32 patients were low. In addition, skeletal biopsies of three of six patients were abnormal. It is concluded that small intestinal bypass results in at least transient deficits of circulating 25-OH vitamin D. As this operation may be associated with abnormal bone morphology, clinically significant skeletal disease may become apparent with long-term follow-up.
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PMID:Abnormalities of circulating 25-OH vitamin D after jejunal-lleal bypass for obesity: evidence of an adaptive response. 84 87

The most serious adverse effect of standard intestinal bypass for obesity is the high incidence of hepatic dysfunction and death from hepatic failure. We therefore examined the long-term effects of a modified form of jejunoileal bypass (in which a greater continuous length of ileum is retained), on liver function in 120 patients. Substantial weight loss (119-0+/-SD 23-3 kg to 82-3+/-18-8 kg) occurred during the first nine months after surgery, accompanied by a significant rise in serum concentrations of bilirubin, alanine transferase, and alkaline phosphatase, and a significant reduction in albumin concentrations. Biochemical changes were unrelated to weight loss or halothane anaesthesia. After weight stabilisation liver function reverted to normal, and four years after bypass sulphobromophthalein retention and hepatic histology did not differ from those in obese controls. There were two postoperative deaths. Three other patients died during the period of rapid weight loss with severe hepatic steatosis. While transient mild impairment of liver function is common after modified jejunoileal bypass, clinically significant hepatic dysfunction is a rare and unexplained early complication.
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PMID:Hepatic structure and function after modified jejunoileal bypass surgery for obesity. 91 71

Jejunal biopsy in 33 patients before and after intestinal shunt operation for obesity has demonstrated that neither surface nor volume of the villi increase after surgery. Specific disaccharidase activity remained unchanged, and specific alkaline phosphatase activity increased slightly. There was a significant decrease in protein content in the postoperative biopsies. It is concluded that weight stabilization after the shunt operation is due to adaptive compensation in the ileal remnant.
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PMID:Jejunal morphology and mucosal enzyme activity following intestinal shunt operation for obesity. 126 30

Osteomalacia is characterized by large osteoid seams and a preserved volume of bone trabeculae. The mineralization of newly formed bone requires adequate concentrations of calcium and phosphate: the Ca.P product has been regarded as a useful, empirical diagnostic test of osteomalacia. It decreases in patients with osteomalacia mainly because they have very low plasma phosphate levels. At present total body bone mineral and total body bone density can be directly measured by whole body absorptiometry, which indicates the lowest total mineral content of the skeleton which can increase quickly after adequate treatment. The main symptoms of osteomalacia are: bone pain; muscular weakness (commonly as pelvic girdle myopathy); Looser-Milkman pseudofractures or more often a pattern of generalized demineralization at X-ray. The main biochemical parameters in osteomalacia include: defective calcium absorption with hypocalcemia and hypocalciuria; defective intestinal phosphate absorption with hypophosphatemia; there is often increased renal phosphate clearance due to hypocalcemia and secondary hyperparathyroidism; elevated alkaline phosphatase and osteocalcin levels; high bone turnover confirmed by kinetic studies carried out with radiocalcium or 99mTc-MDP. An etiological classification of the osteomalacias includes: 1) nutritional osteomalacia: a) inadequate exposure to sunlight and/or insufficient vitamin D intake; b) defective intestinal absorption of vitamin D because of malabsorption syndromes (e.g. jejuno-ileal bypass for obesity).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The osteomalacias. 166 41

We found that 17 out of 60 (28.3 percent) obese, otherwise healthy volunteers had elevated serum alanine aminotransferase (ALAT), aspartate aminotransferase (ASAT) or alkaline phosphatase (AP) at least once in the course of a 12 week clinical trial. ALAT was the most commonly elevated serum aminotransferase occurring in 16 out of the 17 participants. Its range of elevation, as a percentage of the upper limit of normal (ULN) at screening was 102-164 percent (mean +/- s.d.; 127 percent +/- 18.4). Three participants had slight elevations of AP (112 percent, 113 percent, 119 percent of ULN). One participant had a minor elevation of ASAT (107 percent of ULN at screening). Of the 17 participants with elevated aminotransferases and AP, six were randomized to placebo, seven were treated with the low dose and four with the high dose of the new medication. Study participants having elevated enzymes had higher ideal body weight (IBW) than the group with normal values at screening (162 +/- 10 percent IBW, 152 +/- 11 percent IBW respectively), and at week 8 (152 +/- 3 percent IBW, 146 +/- 2 percent respectively) (P less than 0.05). The corresponding body mass index (BMI) values are 36.8 +/- 2.8 for the participants with elevated liver enzymes vs 34.2 +/- 2.6 (P less than 0.001) for the participants with normal values at screening and 34.9 +/- 3.1 and 32.8 +/- 2.8 (P = 0.02) respectively at week 8. Males (46 percent) were more likely than females (21 percent) to have elevated aminotransferases. We found no evidence for hepatic disease during the study period. Slightly elevated and fluctuating serum aminotransferases and alkaline phosphatase concentrations are a more frequent finding in healthy obese populations than previously established. In studies of anti-obesity agents investigators should broaden the entry criteria since elevated aminotransferase levels rarely interfere with the safe conduct of clinical trials in obesity.
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PMID:Elevated serum liver enzymes in obesity: a dilemma during clinical trials. 179 21

Predictors of distal and proximal forearm bone density, measured by photon absorbtiometry, were investigated in 248 premenopausal women aged 39-56 years. Only one strong predictor of lower bone density was found--history of previous fracture at any site (P less than 0.001). Two other factors showed a weaker association with density, but only at the distal site--history of diuretic use showed a positive association (P less than 0.02) whereas alkaline phosphatase level was inversely correlated with density (P less than 0.01). Other factors were not significant predictors: these included age, calcium intake, level of exercise, anthropometric measures of obesity, serum calcium level, parity, lactation history, a menopausal symptom history, use of the contraceptive pill, smoking and alcohol intake. These results contrast with the far stronger predictors found for postmenopausal women and suggest that genetic endowment rather than lifestyle may be the major determinant of bone density before the menopause.
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PMID:Determinants of forearm bone density in premenopausal women: a study in one general practice. 187 69

Serum osteocalcin and alkaline phosphatase levels, as indexes of bone formation, and urinary calcium and hydroxyproline excretions relative to creatinine, as indexes of bone resorption, were measured in 10 obese women before and after two months of hypocaloric diet. In basal condition, serum osteocalcin, but not alkaline phosphatase levels, were higher in obese than in controls (7 +/- 0.4 vs 5.3 +/- 0.2 ng/ml). Urinary calcium/creatinine and hydroxyproline/creatinine ratios were also significantly higher than those in normals (0.37 +/- 0.05 vs 0.2 +/- 0.01 and 0.035 +/- 0.004 vs 0.02 +/- 0.002, respectively). After weight loss, serum osteocalcin significantly increased (9.5 +/- 0.5 ng/ml), while urinary calcium/creatinine and hydroxyproline/creatinine ratios fell to the normal values (0.23 +/- 0.03 and 0.026 +/- 0.001). In conclusion, it appears that obesity, at least in young women, is associated with a high bone turnover, which seems to be reversible with weight loss.
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PMID:[Assessment of bone resorption/neoformation indexes in obese women before and after weight loss]. 209 52


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