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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Metabolic parameters were studied in 6 patients before and for 18 months after jejunoileal bypass for obesity. The postoperative changes in plasma concentration of amino acids were characterized by a decrease in essential amino acids, while the non-essential amino acids were unchanged or elevated, indicating a state of protein-caloric malnutrition. The pattern of fatty acids in serum the first year after operation: an unchanged sum of unsaturated and saturated fatty acids accompanied by a significant fall in linoleic acid and a corresponding increase in oleic acid, showed that even during this period the patients were in a state of essential fatty acid deficiency. The oral glucose tolerance test and the levels of serum immunoreactive insulin activity indicated a general improvement in glucose tolerance and a normalization of preoperative hyperinsulinism. A 40-50% reduction was found both in serum triglycerides and cholesterol levels. Serum iron was reduced by approximately 30%, whereas TIBC levels remained unchanged. The Schilling test showed a significant fall in vitamin B12 absorption postoperatively with subnormal values at 6 and 12 months. Vitamin B12 in serum dropped, but remained within the normal range, suggesting that the preservation of 25 cm of distal ileum is sufficient to secure adequate absorption of vitamin B12. Folic acid levels in serum fell after the bypass, demanding supplementation in 5 of the 6 patients at 6 months postoperatively.
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PMID:Metabolic changes after jejuno-ileal bypass for obesity. 63 57

Food intake was measured in 22 obese patients before and after jejunioleostomy for obesity. Most of the weight loss could be accounted for by the observed reduction of caloric intake. Malabsorption was also present as indicated by increased loss of fat in the stools, and decreased absorption of D-xylose and vitamin B12. A dislike for sweet tastes developed after surgery in most patients. Preferences for concentrated solutions of sucrose and glucose were reduced after patients showed a depression of food intake by a 440-calorie preload which had not been detected before surgery. These studies show a decrease in food intake after intestinal bypass surgery and suggest a role for taste or other gastrointestinal factors in regulating food intake.
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PMID:Intestinal bypass surgery for obesity decreases food intake and taste preferences. 93 32

The experimental series by dogs and pigs show no specific absorption place in the small intestine--except the high selective absorption of vitamin B12 in the last ileum loop. Potassium absorption is better in the upper jejunum. For all other substances the conditions for absorption are the same in the jejunum as in the ileum. Calcium, carotin and cholesterol need a sufficiently extensive surface and show therefore a direct relation to the length of the small intestine. For the treatment of the extreme obesity we perform the jejunoileostomy with different lengths of jejunum and ileum. The hypercholesterinaemia type II can be treated by a partial ileum bypass. By the diminished absorption of the bile salts a sufficient decrease of the cholesterol level is possible, which amounts to about half the earlier value. The jejunoileostomy reduces not only overweight, but also improves the carbohydrate metabolism and lowers the increased fat levels.
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PMID:[Surgical therapy of obesity]. 122 97

A variety of immunological, endocrinological, and virological abnormalities have been implicated in the etiopathogenesis of spontaneous autoimmune thyroiditis (SAT) of Obese strain (OS) chickens, e.g., a general T cell hyperreactivity, an increased uptake of iodine into the thyroid gland, a diminution of the glucocorticoid tonus, and an OS-specific endogenous virus. In crosses of the close-bred OS B15/B15 subline with the inbred normal CB B12/B12 strain we have studied the mode of inheritance of these aberrations and their putative association with SAT. The results indicate that none of these OS-specific characteristics alone is an absolute prerequisite for the development of thyroid infiltration, which appears to be governed by one autosomal recessive gene.
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PMID:Immunogenetic analysis of spontaneous autoimmune thyroiditis of obese strain chickens. 278 82

In this study we investigated the genetic background of primary abnormalities found in the thyroid gland of Obese strain (OS) chickens with spontaneous autoimmune thyroiditis (SAT), i.e., susceptibility to passively transferred antibodies to thyroglobulin (TgAb) and incomplete suppression of iodine uptake by thyroxine (T4). Several crosses between the B15/B15 subline of OS chickens and the inbred CB line (B12/B12) were done and the progeny was analyzed for thyroiditis after injection of OS serum containing high titers of TgAb. It was found that passive transfer of TgAb increased the lymphoid infiltration in the thyroids of OS chickens, but had no effect on CB birds. A genetic analysis of backcrosses revealed that this trait is, in the case of simple Mendelian inheritance, encoded by at least three recessive genes. The thyroidal 131I uptake of these crosses under T4 was also determined and we found that this trait is most probably encoded by only one recessive gene.
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PMID:Spontaneous autoimmune thyroiditis in obese strain chickens: a genetic analysis of target organ abnormalities. 405 27

We studied 41 patients who had gastric bypass for obesity from 1974-1979. The procedure was well received by patients and most achieved adequate weight loss, but most subjects consumed inadequate diets and many developed iron and/or vitamin B12 deficiencies. Ten were anemic and 13 had been treated previously for postbypass anemia. Severely vitamin B12-deficient subjects did not respond to 50 micrograms oral vitamin B12 tablets, but those with milder deficiencies usually did. Schilling tests were usually abnormal and corrected when intrinsic factor was given. Many subjects developed manifestations compatible with osteoporosis due to inadequate calcium intake and absorption, and some also developed abnormal laboratory tests suggesting coexisting osteomalacia. Hematopoietic complications of gastric bypass can usually be prevented and are relatively easy to treat, but musculoskeletal complications may be more difficult to prevent and treat.
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PMID:Late effects of gastric bypass for obesity. 650 7

To counter the paucity of documention on thromboembolic disorders caused by oral contraceptives (OC), a case study is presented describing the incidence of occlusion of arteria centralis retinae in a 24-year old woman after prolonged use of an OC, Bisecurin. She had taken Bisecurin for 4.5 years and had gained 20 kg during that time, but stopped usage 1 month before admission. She was hospitalized with severe deterioration of vision in the left eye. An eye examination indicated an edematous condition of the retina and reddening of the macula. Acuity of vision value for the left eye was .01 vs. 1.0 for the right, which was confirmed by fluorescein fundus angiography. Moderately decreased antithrombin III (AT III) activity was also ascertained. Treatment consisted of immediate retrobulbar injection with Tolazolin followed by Rheomacrodex, Cavinton infusions, B1 and B12 injections, Oradexon subconjunctival injection as well as vitamin B complex, Cavinton, and Colfarit tablets and a fat-free diet. Significant improvement of the left eye condition appeared 4 weeks later. Periodic follow-ups showed the healing of the condition around the macula; however, the patient suffered permanent damage to the retina due to the arterial occlusion above and below the macula. The disturbed lipid values of metabolism were also returned to normal, as borne out by normal dextrose loading results 8 months later (glucose tolerance was abnormal during examination at admission). The estrogen and progesterone components of OCs have been shown to reduce AT III levels, shorten heparin-thrombin coagulation time, increase fibrinogen levels, decrease HDL cholesterol levels, and produce excess TXA2 (thromboxan) resulting in vasoconstriction and thrombocyte aggregation. The risk of thrombosis is 6 times higher in OC users than in nonusers, although other susceptibility factors (obesity, diabetes, hypertension) also contribute to thrombosis.
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PMID:[Arterial occlusion in the ocular fundus induced by oral contraceptives]. 651 54

A megaloblastic anemia occurred in a middle-aged woman 6 years after a gastric bypass performed for obesity. Marked deficiencies of both vitamin B12 and folic acid were demonstrated. The Schilling test revealed that the vitamin B12 deficiency was due primarily to inadequate intrinsic factor. Vitamin and mineral deficiencies are relatively common long-term complications in gastric bypass patients, and result from multiple factors including restricted food intake, inadequate gastric digestion, and inadequate intrinsic factor. Bypass patients should receive vitamin-mineral supplements routinely and should have long-term periodic clinical and laboratory evaluation in order to prevent late hematological complications.
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PMID:Megaloblastic anemia after gastric bypass for obesity. 686 50

1. An unsupplemented 4200 kJ (1000 kcal) diet emphasizing large quantities of relatively unrefined complex carbohydrates was evaluated among sixty obese adults for its effectiveness and nutritional adequacy in a long-term weight-control programme. Patients were followed individually as outpatients by a physician and dietician-an average of thirteen visits over 26 weeks. Assessment of health indices included anthropometric measurements, blood pressure, lipid levels and assays for seven vitamins, beta-carotene and iron. 2. Weight loss averaged 8.2 kg or 24% of excess weight during the 6 months of active treatment. Over an average of 17 months of post-treatment follow-up, 44% of patients continued to lose weight and 92% remained below pretreatment levels. 3. Average skinfold thickness fell 7 mm (P less than 0.001) whereas muscle mass was maintained (arm muscle circumference + 10 mm, not significant; creatinine-height index + 3% of standard (Bistrian et al. 1975; not significant). Systolic and diastolic blood pressure fell 7 and 5 mmHg respectively (P less than 0.01). Total serum cholesterol and triglycerides fell 200 and 660 mg/1 respectively (P less than 0.01), while high-density-lipoprotein-cholesterol remained statistically unchanged. Mean serum levels of retinol, beta-carotene, folate, vitamin B12, ascorbic acid, Fe and transferrin saturation, and activity coefficients for thiamin, riboflavin and pyridoxine were within normal limits after periods of treatment ranging from 5 to 84 weeks. 4. An earlier age of onset of obesity tended to be associated with greater weight loss during treatment and lesser weight rebound during follow-up. 5. The results indicate that the experimental diet, without supplementation, was nutritionally adequate as well as effective for long-term weight control.
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PMID:Dietary management of obesity: evaluation of the time-energy displacement diet in terms of its efficacy and nutritional adequacy for long-term weight control. 708 11

Six patients subjected to jejuno-ileal bypass surgery for obesity were studied for vitamin B12 absorption by the use of the Schilling test, together with measurement of the serum B12 level preoperatively and at 2, 6, 12, 18 and 24 months after the operation. During the follow-up period of 2 years, the serum vitamin B12 level gradually declined to abnormally low values. A postoperative fall of the originally normal vitamin B12 absorption to abnormal values was found. Oral administration of tetracycline resulted in a transitory improvement of the results by the Schilling test, but after its discontinuation serve vitamin-B12 malabsorption was again demonstrable. The importance of parenteral vitamin B12 administration after jejuno-ileal bypass surgery is emphasized.
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PMID:Vitamin B12 malabsorption after jejuno-ileal bypass surgery. 718 Mar 63


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