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1. 30-day morbidity and mortality of sleeve gastrectomy, Roux-en-Y gastric bypass and one anastomosis gastric bypass: a propensity score-matched analysis of the GENEVA data

Author

Singhal R., Cardoso V. R., Wiggins T., Super J., Ludwig C., Gkoutos G. V., Mahawar K., Pedziwiatr M., Major P., Zarzycki P., Pantelis A., Lapatsanis D. P., Stravodimos G., Matthys C., Focquet M., Vleeschouwers W., Spaventa A. G., Zerrweck C., Vitiello A., Berardi G., Musella M., Sanchez-Meza A., Cantu F. J., Mora F., Cantu M. A., Katakwar A., Reddy D. N., Elmaleh H., Hassan M., Elghandour A., Elbanna M., Osman A., Khan A., layani L., Kiran N., Velikorechin A., Solovyeva M., Melali H., Shahabi S., Agrawal A., Shrivastava A., Sharma A., Narwaria B., Narwaria M., Raziel A., Sakran N., Susmallian S., Karagoz L., Akbaba M., Piskin S. Z., Balta A. Z., Senol Z., Manno E., Iovino M. G., Qassem M., Arana-Garza S., Povoas H. P., Vilas-Boas M. L., Naumann D., Li A., Ammori B. J., Balamoun H., Salman M., Nasta A. M., Goel R., Sanchez-Aguilar H., Herrera M. F., Abou-mrad A., Cloix L., Mazzini G. S., Kristem L., Lazaro A., Campos J., Bernardo J., Gonzalez J., Trindade C., Viveiros O., Ribeiro R., Goitein D., Hazzan D., Segev L., Beck T., Reyes H., Monterrubio J., Garcia P., Benois M., Kassir R., Contine A., Elshafei M., Aktas S., Weiner S., Heidsieck T., Level L., Pinango S., Ortega P. M., Moncada R., Valenti V., Vlahovic I., Boras Z., Liagre A., Martini F., Juglard G., Motwani M., Saggu S. S., Momani H. A., Lopez L. A. A., Cortez M. A. C., Zavala R. A., D'Haese RN C., Kempeneers I., Himpens J., Lazzati A., Paolino L., Bathaei S., Bedirli A., Yavuz A., Buyukkasap C., Ozaydin S., Kwiatkowski A., Bartosiak K., Waledziak M., Santonicola A., Angrisani L., Iovino P., Palma R., Iossa A., Boru C. E., De Angelis F., Silecchia G., Hussain A., Balchandra S., Coltell I. B., Perez J. L., Bohra A., Awan A. K., Madhok B., Leeder P. C., Awad S., Al-Khyatt W., Shoma A., Elghadban H., Ghareeb S., Mathews B., Kurian M., Larentzakis A., Vrakopoulou G. Z., Albanopoulos K., Bozdag A., Lale A., Kirkil C., Dincer M., Bashir A., Haddad A., Hijleh L. A., Zilberstein B., de Marchi D. D., Souza W. P., Broden C. M., Gislason H., Shah K., Ambrosi A., Pavone G., Tartaglia N., Kona S. L. K., Kalyan K., Perez C. E. G., Botero M. A. F., Covic A., Timofte D., Maxim M., Faraj D., Tseng L., Liem R., Oren G., Dilektasli E., Yalcin I., AlMukhtar H., Hadad M. A., Mohan R., Arora N., Bedi D., Rives-Lange C., Chevallier J. -M., Poghosyan T., Sebbag H., Zinai L., Khaldi S., Mauchien C., Mazza D., Dinescu G., Rea B., Perez-Galaz F., Zavala L., Besa A., Curell A., Balibrea J. M., Vaz C., Galindo L., Silva N., Caballero J. L. E., Sebastian S. O., Marchesini J. C. D., da Fonseca Pereira R. A., Sobottka W. H., Fiolo F. E., Turchi M., Coelho A. C. J., Zacaron A. L., Barbosa A., Quinino R., Menaldi G., Paleari N., Martinez-Duartez P., de Esparza G. M. A. R., Esteban V. S., Torres A., Garcia-Galocha J. L., Josa M., Pacheco-Garcia J. M., Mayo-Ossorio M. A., Chowbey P., Soni V., de Vasconcelos Cunha H. A., Castilho M. V., Ferreira R. M. A., Barreiro T. A., Charalabopoulos A., Sdralis E., Davakis S., Bomans B., Dapri G., Van Belle K., Takieddine M., Vaneukem P., Karaca E. S. A., Karaca F. C., Sumer A., Peksen C., Savas O. A., Chousleb E., Elmokayed F., Fakhereldin I., Aboshanab H. M., Swelium T., Gudal A., Gamloo L., Ugale A., Ugale S., Boeker C., Reetz C., Hakami I. A., Mall J., Alexandrou A., Baili E., Bodnar Z., Maleckas A., Gudaityte R., Guldogan C. E., Gundogdu E., Ozmen M. M., Thakkar D., Dukkipati N., Shah P. S., Shah S. S., Adil M. T., Jambulingam P., Mamidanna R., Whitelaw D., Jain V., Veetil D. K., Wadhawan R., Torres M., Tinoco T., Leclercq W., Romeijn M., van de Pas K., Alkhazraji A. K., Taha S. A., Ustun M., Yigit T., Inam A., Burhanulhaq M., Pazouki A., Eghbali F., Kermansaravi M., Jazi A. H. D., Mahmoudieh M., Mogharehabed N., Tsiotos G., Stamou K., Rodriguez F. J. B., Navarro M. A. R., Torres O. M., Martinez S. L., Tamez E. R. M., Cornejo G. A. M., Flores J. E. G., Mohammed D. A., Elfawal M. H., Shabbir A., Guowei K., So J. B., Kaplan E. T., Kaplan M., Kaplan T., Pham D. T., Rana G., Kappus M., Gadani R., Kahitan M., Pokharel K., Osborne A., Pournaras D., Hewes J., Napolitano E., Chiappetta S., Bottino V., Dorado E., Schoettler A., Gaertner D., Fedtke K., Aguilar-Espinosa F., Aceves-Lozano S., Balani A., Nagliati C., Pennisi D., Rizzi A., Frattini F., Foschi D., Benuzzi L., Parikh C., Shah H., Pinotti E., Montuori M., Borrelli V., Dargent J., Copaescu C. A., Hutopila I., Smeu B., Witteman B., Hazebroek E., Deden L., Heusschen L., Okkema S., Aufenacker T., den Hengst W., Vening W., van der Burgh Y., Ghazal A., Ibrahim H., Niazi M., Alkhaffaf B., Altarawni M., Cesana G. C., Anselmino M., Uccelli M., Olmi S., Stier C., Akmanlar T., Sonnenberg T., Schieferbein U., Marcolini A., Awruch D., Vicentin M., de Souza Bastos E. L., Gregorio S. A., Ahuja A., Mittal T., Bolckmans R., Baratte C., Wisnewsky J. A., Genser L., Chong L., Taylor L., Ward S., Hi M. W., Heneghan H., Fearon N., Plamper A., Rheinwalt K., Geoghegan J., Ng K. C., Kaseja K., Kotowski M., Samarkandy T. A., Leyva-Alvizo A., Corzo-Culebro L., Wang C., Yang W., Dong Z., Riera M., Jain R., Hamed H., Said M., Zarzar K., Garcia M., Turkcapar A. G., Sen O., Baldini E., Conti L., Wietzycoski C., Lopes E., Pintar T., Salobir J., Aydin C., Atici S. D., Ergin A., Ciyiltepe H., Bozkurt M. A., Kizilkaya M. C., Onalan N. B. D., Zuber M. N. B. A., Wong W. J., Garcia A., Vidal L., Beisani M., Pasquier J., Vilallonga R., Sharma S., Parmar C., Lee L., Sufi P., Sinan H., Saydam M., Singhal, R., Cardoso, V. R., Wiggins, T., Super, J., Ludwig, C., Gkoutos, G. V., Mahawar, K., Pedziwiatr, M., Major, P., Zarzycki, P., Pantelis, A., Lapatsanis, D. P., Stravodimos, G., Matthys, C., Focquet, M., Vleeschouwers, W., Spaventa, A. G., Zerrweck, C., Vitiello, A., Berardi, G., Musella, M., Sanchez-Meza, A., Cantu, F. J., Mora, F., Cantu, M. A., Katakwar, A., Reddy, D. N., Elmaleh, H., Hassan, M., Elghandour, A., Elbanna, M., Osman, A., Khan, A., Layani, L., Kiran, N., Velikorechin, A., Solovyeva, M., Melali, H., Shahabi, S., Agrawal, A., Shrivastava, A., Sharma, A., Narwaria, B., Narwaria, M., Raziel, A., Sakran, N., Susmallian, S., Karagoz, L., Akbaba, M., Piskin, S. Z., Balta, A. Z., Senol, Z., Manno, E., Iovino, M. G., Qassem, M., Arana-Garza, S., Povoas, H. P., Vilas-Boas, M. L., Naumann, D., Li, A., Ammori, B. J., Balamoun, H., Salman, M., Nasta, A. M., Goel, R., Sanchez-Aguilar, H., Herrera, M. F., Abou-mrad, A., Cloix, L., Mazzini, G. S., Kristem, L., Lazaro, A., Campos, J., Bernardo, J., Gonzalez, J., Trindade, C., Viveiros, O., Ribeiro, R., Goitein, D., Hazzan, D., Segev, L., Beck, T., Reyes, H., Monterrubio, J., Garcia, P., Benois, M., Kassir, R., Contine, A., Elshafei, M., Aktas, S., Weiner, S., Heidsieck, T., Level, L., Pinango, S., Ortega, P. M., Moncada, R., Valenti, V., Vlahovic, I., Boras, Z., Liagre, A., Martini, F., Juglard, G., Motwani, M., Saggu, S. S., Momani, H. A., Lopez, L. A. A., Cortez, M. A. C., Zavala, R. A., D'Haese RN, C., Kempeneers, I., Himpens, J., Lazzati, A., Paolino, L., Bathaei, S., Bedirli, A., Yavuz, A., Buyukkasap, C., Ozaydin, S., Kwiatkowski, A., Bartosiak, K., Waledziak, M., Santonicola, A., Angrisani, L., Iovino, P., Palma, R., Iossa, A., Boru, C. E., De Angelis, F., Silecchia, G., Hussain, A., Balchandra, S., Coltell, I. B., Perez, J. L., Bohra, A., Awan, A. K., Madhok, B., Leeder, P. C., Awad, S., Al-Khyatt, W., Shoma, A., Elghadban, H., Ghareeb, S., Mathews, B., Kurian, M., Larentzakis, A., Vrakopoulou, G. Z., Albanopoulos, K., Bozdag, A., Lale, A., Kirkil, C., Dincer, M., Bashir, A., Haddad, A., Hijleh, L. A., Zilberstein, B., de Marchi, D. D., Souza, W. P., Broden, C. M., Gislason, H., Shah, K., Ambrosi, A., Pavone, G., Tartaglia, N., Kona, S. L. K., Kalyan, K., Perez, C. E. G., Botero, M. A. F., Covic, A., Timofte, D., Maxim, M., Faraj, D., Tseng, L., Liem, R., Oren, G., Dilektasli, E., Yalcin, I., Almukhtar, H., Hadad, M. A., Mohan, R., Arora, N., Bedi, D., Rives-Lange, C., Chevallier, J. -M., Poghosyan, T., Sebbag, H., Zinai, L., Khaldi, S., Mauchien, C., Mazza, D., Dinescu, G., Rea, B., Perez-Galaz, F., Zavala, L., Besa, A., Curell, A., Balibrea, J. M., Vaz, C., Galindo, L., Silva, N., Caballero, J. L. E., Sebastian, S. O., Marchesini, J. C. D., da Fonseca Pereira, R. A., Sobottka, W. H., Fiolo, F. E., Turchi, M., Coelho, A. C. J., Zacaron, A. L., Barbosa, A., Quinino, R., Menaldi, G., Paleari, N., Martinez-Duartez, P., de Esparza, G. M. A. R., Esteban, V. S., Torres, A., Garcia-Galocha, J. L., Josa, M., Pacheco-Garcia, J. M., Mayo-Ossorio, M. A., Chowbey, P., Soni, V., de Vasconcelos Cunha, H. A., Castilho, M. V., Ferreira, R. M. A., Barreiro, T. A., Charalabopoulos, A., Sdralis, E., Davakis, S., Bomans, B., Dapri, G., Van Belle, K., Takieddine, M., Vaneukem, P., Karaca, E. S. A., Karaca, F. C., Sumer, A., Peksen, C., Savas, O. A., Chousleb, E., Elmokayed, F., Fakhereldin, I., Aboshanab, H. M., Swelium, T., Gudal, A., Gamloo, L., Ugale, A., Ugale, S., Boeker, C., Reetz, C., Hakami, I. A., Mall, J., Alexandrou, A., Baili, E., Bodnar, Z., Maleckas, A., Gudaityte, R., Guldogan, C. E., Gundogdu, E., Ozmen, M. M., Thakkar, D., Dukkipati, N., Shah, P. S., Shah, S. S., Adil, M. T., Jambulingam, P., Mamidanna, R., Whitelaw, D., Jain, V., Veetil, D. K., Wadhawan, R., Torres, M., Tinoco, T., Leclercq, W., Romeijn, M., van de Pas, K., Alkhazraji, A. K., Taha, S. A., Ustun, M., Yigit, T., Inam, A., Burhanulhaq, M., Pazouki, A., Eghbali, F., Kermansaravi, M., Jazi, A. H. D., Mahmoudieh, M., Mogharehabed, N., Tsiotos, G., Stamou, K., Rodriguez, F. J. B., Navarro, M. A. R., Torres, O. M., Martinez, S. L., Tamez, E. R. M., Cornejo, G. A. M., Flores, J. E. G., Mohammed, D. A., Elfawal, M. H., Shabbir, A., Guowei, K., So, J. B., Kaplan, E. T., Kaplan, M., Kaplan, T., Pham, D. T., Rana, G., Kappus, M., Gadani, R., Kahitan, M., Pokharel, K., Osborne, A., Pournaras, D., Hewes, J., Napolitano, E., Chiappetta, S., Bottino, V., Dorado, E., Schoettler, A., Gaertner, D., Fedtke, K., Aguilar-Espinosa, F., Aceves-Lozano, S., Balani, A., Nagliati, C., Pennisi, D., Rizzi, A., Frattini, F., Foschi, D., Benuzzi, L., Parikh, C., Shah, H., Pinotti, E., Montuori, M., Borrelli, V., Dargent, J., Copaescu, C. A., Hutopila, I., Smeu, B., Witteman, B., Hazebroek, E., Deden, L., Heusschen, L., Okkema, S., Aufenacker, T., den Hengst, W., Vening, W., van der Burgh, Y., Ghazal, A., Ibrahim, H., Niazi, M., Alkhaffaf, B., Altarawni, M., Cesana, G. C., Anselmino, M., Uccelli, M., Olmi, S., Stier, C., Akmanlar, T., Sonnenberg, T., Schieferbein, U., Marcolini, A., Awruch, D., Vicentin, M., de Souza Bastos, E. L., Gregorio, S. A., Ahuja, A., Mittal, T., Bolckmans, R., Baratte, C., Wisnewsky, J. A., Genser, L., Chong, L., Taylor, L., Ward, S., Hi, M. W., Heneghan, H., Fearon, N., Plamper, A., Rheinwalt, K., Geoghegan, J., Ng, K. C., Kaseja, K., Kotowski, M., Samarkandy, T. A., Leyva-Alvizo, A., Corzo-Culebro, L., Wang, C., Yang, W., Dong, Z., Riera, M., Jain, R., Hamed, H., Said, M., Zarzar, K., Garcia, M., Turkcapar, A. G., Sen, O., Baldini, E., Conti, L., Wietzycoski, C., Lopes, E., Pintar, T., Salobir, J., Aydin, C., Atici, S. D., Ergin, A., Ciyiltepe, H., Bozkurt, M. A., Kizilkaya, M. C., Onalan, N. B. D., Zuber, M. N. B. A., Wong, W. J., Garcia, A., Vidal, L., Beisani, M., Pasquier, J., Vilallonga, R., Sharma, S., Parmar, C., Lee, L., Sufi, P., Sinan, H., Saydam, M., İstinye Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Sumer, Aziz, Peksen, Caghan, and Savas, Osman Anil

Subjects
Nutrition and Dietetics, Endocrinology, Diabetes and Metabolism, Gastric Bypass, Medicine (miscellaneous), nutritional and metabolic diseases, COVID-19, Gastrectomy, Humans, Morbidity, Propensity Score, Retrospective Studies, Treatment Outcome, Diabetes Mellitus, Type 2, Obesity, Morbid, Article, Diabetes Mellitus, Obesity, Morbid, Type 2
Abstract

Background There is a paucity of data comparing 30-day morbidity and mortality of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and one anastomosis gastric bypass (OAGB). This study aimed to compare the 30-day safety of SG, RYGB, and OAGB in propensity score-matched cohorts. Materials and methods This analysis utilised data collected from the GENEVA study which was a multicentre observational cohort study of bariatric and metabolic surgery (BMS) in 185 centres across 42 countries between 01/05/2022 and 31/10/2020 during the Coronavirus Disease-2019 (COVID-19) pandemic. 30-day complications were categorised according to the Clavien–Dindo classification. Patients receiving SG, RYGB, or OAGB were propensity-matched according to baseline characteristics and 30-day complications were compared between groups. Results In total, 6770 patients (SG 3983; OAGB 702; RYGB 2085) were included in this analysis. Prior to matching, RYGB was associated with highest 30-day complication rate (SG 5.8%; OAGB 7.5%; RYGB 8.0% (p = 0.006)). On multivariate regression modelling, Insulin-dependent type 2 diabetes mellitus and hypercholesterolaemia were associated with increased 30-day complications. Being a non-smoker was associated with reduced complication rates. When compared to SG as a reference category, RYGB, but not OAGB, was associated with an increased rate of 30-day complications. A total of 702 pairs of SG and OAGB were propensity score-matched. The complication rate in the SG group was 7.3% (n = 51) as compared to 7.5% (n = 53) in the OAGB group (p = 0.68). Similarly, 2085 pairs of SG and RYGB were propensity score-matched. The complication rate in the SG group was 6.1% (n = 127) as compared to 7.9% (n = 166) in the RYGB group (p = 0.09). And, 702 pairs of OAGB and RYGB were matched. The complication rate in both groups was the same at 7.5 % (n = 53; p = 0.07). Conclusions This global study found no significant difference in the 30-day morbidity and mortality of SG, RYGB, and OAGB in propensity score-matched cohorts.

Published
2021
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2. 30-Day morbidity and mortality of bariatric metabolic surgery in adolescence during the COVID-19 pandemic – The GENEVA study

Author

Singhal R., Wiggins T., Super J., Alqahtani A., Nadler E. P., Ludwig C., Tahrani A., Mahawar K., Pedziwiatr M., Major P., Zarzycki P., Pantelis A., Lapatsanis D. P., Stravodimos G., Matthys C., Focquet M., Vleeschouwers W., Spaventa A. G., Zerrweck C., Vitiello A., Berardi G., Musella M., Sanchez-Meza A., Cantu F. J., Mora F., Cantu M. A., Katakwar A., Reddy D. N., Elmaleh H., Hassan M., Elghandour A., Elbanna M., Osman A., Khan A., Layani L., Kiran N., Velikorechin A., Solovyeva M., Melali H., Shahabi S., Agrawal A., Shrivastava A., Sharma A., Narwaria B., Narwaria M., Raziel A., Sakran N., Susmallian S., Karagoz L., Akbaba M., Piskin S. Z., Ziya A., Senol Z., Manno E., Iovino M. G., Qassem M., Arana-Garza S., Povoas H. P., Vilas-Boas M. L., Naumann D., Li A., Ammori B. J., Balamoun H., Salman M., Nasta A. M., Goel R., Sanchez-Aguilar H., Herrera M. F., Abou-Mrad A., Cloix L., Mazzini G. S., Kristem L., Lazaro A., Campos J., Bernardo J., Gonzalez J., Trindade C., Viveiros O., Ribeiro R., Goitein D., Hazzan D., Segev L., Beck T., Reyes H., Monterrubio J., Garcia P., Benois M., Kassir R., Contine A., Elshafei M., Aktas S., Weiner S., Heidsieck T., Level L., Pinango S., Ortega P. M., Moncada R., Valenti V., Vlahovic I., Boras Z., Liagre A., Martini F., Juglard G., Motwani M., Saggu S. S., Al Momani H., Lopez L. A. A., Cortez M. A. C., Zavala R. A., D'Haese C., Kempeneers I., Himpens J., Lazzati A., Paolino L., Bathaei S., Bedirli A., Yavuz A., Buyukkasap C., Ozaydin S., Kwiatkowski A., Bartosiak K., Waledziak M., Santonicola A., Angrisani L., Iovino P., Palma R., Iossa A., Boru C. E., De Angelis F., Silecchia G., Hussain A., Balchandra S., Coltell I. B., Perez J. L., Bohra A., Awan A. K., Madhok B., Leeder P. C., Awad S., Al-Khyatt W., Shoma A., Elghadban H., Ghareeb S., Mathews B., Kurian M., Larentzakis A., Vrakopoulou G. Z., Albanopoulos K., Bozdag A., Lale A., Kirkil C., Dincer M., Bashir A., Haddad A., Hijleh L. A., Zilberstein B., de Marchi D. D., Souza W. P., Broden C. M., Gislason H., Shah K., Ambrosi A., Pavone G., Tartaglia N., Kona S. L. K., Kalyan K., Perez C. E. G., Botero M. A. F., Covic A., Timofte D., Maxim M., Faraj D., Tseng L., Liem R., Oren G., Dilektasli E., Yalcin I., AlMukhtar H., Al Hadad M., Mohan R., Arora N., Bedi D., Rives-Lange C., Chevallier J. -M., Poghosyan T., Sebbag H., Zinai L., Khaldi S., Mauchien C., Mazza D., Dinescu G., Rea B., Perez-Galaz F., Zavala L., Besa A., Curell A., Balibrea J. M., Vaz C., Galindo L., Silva N., Caballero J. L. E., Sebastian S. O., Marchesini J. C. D., da Fonseca Pereira R. A., Sobottka W. H., Fiolo F. E., Turchi M., Coelho A. C. J., Zacaron A. L., Barbosa A., Quinino R., Menaldi G., Paleari N., Martinez-Duartez P., Aragon Ramirez de Esparza D. G. M., Esteban V. S., Torres A., Garcia-Galocha J. L., Josa M. I., Pacheco-Garcia J. M., Mayo-Ossorio M. A., Chowbey P., Soni V., de Vasconcelos Cunha H. A., Castilho M. V., Ferreira R. M. A., Barreiro T. A., Charalabopoulos A., Sdralis E., Davakis S., Bomans B., Dapri G., Van Belle K., MazenTakieddine, Vaneukem P., Karaca E. S. A., Karaca F. C., Sumer A., Peksen C., Savas O. A., Chousleb E., Elmokayed F., Fakhereldin I., Aboshanab H. M., Swelium T., Gudal A., Gamloo L., Ugale A., Ugale S., Boeker C., Reetz C., Hakami I. A., Mall J., Alexandrou A., Baili E., Bodnar Z., Maleckas A., Gudaityte R., Guldogan C. E., Gundogdu E., Ozmen M. M., Thakkar D., Dukkipati N., Shah P. S., Shah S. S., Adil M. T., Jambulingam P., Mamidanna R., Whitelaw D., Jain V., Veetil D. K., Wadhawan R., Torres M., Tinoco T., Leclercq W., Romeijn M., van de Pas K., Alkhazraji A. K., Taha S. A., Ustun M., Yigit T., Inam A., Burhanulhaq M., Pazouki A., Eghbali F., Kermansaravi M., Jazi A. H. D., Mahmoudieh M., Mogharehabed N., Tsiotos G., Stamou K., Barrera Rodriguez F. J., Rojas Navarro M. A., Torres O. M. O., Martinez S. L., Tamez E. R. M., Millan Cornejo G. A., Flores J. E. G., Mohammed D. A., Elfawal M. H., Shabbir A., Guowei K., So J. B. Y., Kaplan E. T., Kaplan M., Kaplan T., Pham D. T., Rana G., Kappus M., Gadani R., Kahitan M., Pokharel K., Osborne A., Pournaras D., Hewes J., Napolitano E., Chiappetta S., Bottino V., Dorado E., Schoettler A., Gaertner D., Fedtke K., Aguilar-Espinosa F., Aceves-Lozano S., Balani A., Nagliati C., Pennisi D., Rizzi A., Frattini F., Foschi D., Benuzzi L., Parikh C. H. I. R. A. G., Shah H. A. R. S. H. I. L., Pinotti E., Montuori M., Borrelli V., Dargent J., Copaescu C. A., Hutopila I., Smeu B., Witteman B., Hazebroek E., Deden L., Heusschen L., Okkema S., Aufenacker T., den Hengst W., Vening W., van der Burgh Y., Ghazal A., Ibrahim H., Niazi M., Alkhaffaf B., Altarawni M., Cesana G. C., Anselmino M., Uccelli M., Olmi S., Stier C., Akmanlar T., Sonnenberg T., Schieferbein U., Marcolini A., Awruch D., Vicentin M., de Souza Bastos E. L., Gregorio S. A., Ahuja A., Mittal T., Bolckmans R., Baratte C., Wisnewsky J. A., Genser L., Chong L., Taylor L., Ward S., Hi M. W., Heneghan H., Fearon N., Plamper A., Rheinwalt K., Geoghegan J., Ng K. C., Kaseja K., Kotowski M., Samarkandy T. A., Leyva-Alvizo A., Corzo-Culebro L., Wang C., Yang W., Dong Z., Riera M., Jain R., Hamed H., Said M., Zarzar K., Garcia M., Turkcapar A. G., Sen O., Baldini E., Conti L., Wietzycoski C., Lopes E., Pintar T., Salobir J., Aydin C., Atici S. D., Ergin A., Ciyiltepe H., Bozkurt M. A., Kizilkaya M. C., Onalan N. B. D., Zuber M. N. B. A., Wong W. J., Garcia A., Vidal L., Beisani M., Pasquier J., Vilallonga R., Sharma S., Parmar C., Lee L., Sufi P., Sinan H., Saydam M., Singhal, R., Wiggins, T., Super, J., Alqahtani, A., Nadler, E. P., Ludwig, C., Tahrani, A., Mahawar, K., Pedziwiatr, M., Major, P., Zarzycki, P., Pantelis, A., Lapatsanis, D. P., Stravodimos, G., Matthys, C., Focquet, M., Vleeschouwers, W., Spaventa, A. G., Zerrweck, C., Vitiello, A., Berardi, G., Musella, M., Sanchez-Meza, A., Cantu, F. J., Mora, F., Cantu, M. A., Katakwar, A., Reddy, D. N., Elmaleh, H., Hassan, M., Elghandour, A., Elbanna, M., Osman, A., Khan, A., Layani, L., Kiran, N., Velikorechin, A., Solovyeva, M., Melali, H., Shahabi, S., Agrawal, A., Shrivastava, A., Sharma, A., Narwaria, B., Narwaria, M., Raziel, A., Sakran, N., Susmallian, S., Karagoz, L., Akbaba, M., Piskin, S. Z., Ziya, A., Senol, Z., Manno, E., Iovino, M. G., Qassem, M., Arana-Garza, S., Povoas, H. P., Vilas-Boas, M. L., Naumann, D., Li, A., Ammori, B. J., Balamoun, H., Salman, M., Nasta, A. M., Goel, R., Sanchez-Aguilar, H., Herrera, M. F., Abou-Mrad, A., Cloix, L., Mazzini, G. S., Kristem, L., Lazaro, A., Campos, J., Bernardo, J., Gonzalez, J., Trindade, C., Viveiros, O., Ribeiro, R., Goitein, D., Hazzan, D., Segev, L., Beck, T., Reyes, H., Monterrubio, J., Garcia, P., Benois, M., Kassir, R., Contine, A., Elshafei, M., Aktas, S., Weiner, S., Heidsieck, T., Level, L., Pinango, S., Ortega, P. M., Moncada, R., Valenti, V., Vlahovic, I., Boras, Z., Liagre, A., Martini, F., Juglard, G., Motwani, M., Saggu, S. S., Al Momani, H., Lopez, L. A. A., Cortez, M. A. C., Zavala, R. A., D'Haese, C., Kempeneers, I., Himpens, J., Lazzati, A., Paolino, L., Bathaei, S., Bedirli, A., Yavuz, A., Buyukkasap, C., Ozaydin, S., Kwiatkowski, A., Bartosiak, K., Waledziak, M., Santonicola, A., Angrisani, L., Iovino, P., Palma, R., Iossa, A., Boru, C. E., De Angelis, F., Silecchia, G., Hussain, A., Balchandra, S., Coltell, I. B., Perez, J. L., Bohra, A., Awan, A. K., Madhok, B., Leeder, P. C., Awad, S., Al-Khyatt, W., Shoma, A., Elghadban, H., Ghareeb, S., Mathews, B., Kurian, M., Larentzakis, A., Vrakopoulou, G. Z., Albanopoulos, K., Bozdag, A., Lale, A., Kirkil, C., Dincer, M., Bashir, A., Haddad, A., Hijleh, L. A., Zilberstein, B., de Marchi, D. D., Souza, W. P., Broden, C. M., Gislason, H., Shah, K., Ambrosi, A., Pavone, G., Tartaglia, N., Kona, S. L. K., Kalyan, K., Perez, C. E. G., Botero, M. A. F., Covic, A., Timofte, D., Maxim, M., Faraj, D., Tseng, L., Liem, R., Oren, G., Dilektasli, E., Yalcin, I., Almukhtar, H., Al Hadad, M., Mohan, R., Arora, N., Bedi, D., Rives-Lange, C., Chevallier, J. -M., Poghosyan, T., Sebbag, H., Zinai, L., Khaldi, S., Mauchien, C., Mazza, D., Dinescu, G., Rea, B., Perez-Galaz, F., Zavala, L., Besa, A., Curell, A., Balibrea, J. M., Vaz, C., Galindo, L., Silva, N., Caballero, J. L. E., Sebastian, S. O., Marchesini, J. C. D., da Fonseca Pereira, R. A., Sobottka, W. H., Fiolo, F. E., Turchi, M., Coelho, A. C. J., Zacaron, A. L., Barbosa, A., Quinino, R., Menaldi, G., Paleari, N., Martinez-Duartez, P., Aragon Ramirez de Esparza, D. G. M., Esteban, V. S., Torres, A., Garcia-Galocha, J. L., Josa, M. I., Pacheco-Garcia, J. M., Mayo-Ossorio, M. A., Chowbey, P., Soni, V., de Vasconcelos Cunha, H. A., Castilho, M. V., Ferreira, R. M. A., Barreiro, T. A., Charalabopoulos, A., Sdralis, E., Davakis, S., Bomans, B., Dapri, G., Van Belle, K., Mazentakieddine, Vaneukem, P., Karaca, E. S. A., Karaca, F. C., Sumer, A., Peksen, C., Savas, O. A., Chousleb, E., Elmokayed, F., Fakhereldin, I., Aboshanab, H. M., Swelium, T., Gudal, A., Gamloo, L., Ugale, A., Ugale, S., Boeker, C., Reetz, C., Hakami, I. A., Mall, J., Alexandrou, A., Baili, E., Bodnar, Z., Maleckas, A., Gudaityte, R., Guldogan, C. E., Gundogdu, E., Ozmen, M. M., Thakkar, D., Dukkipati, N., Shah, P. S., Shah, S. S., Adil, M. T., Jambulingam, P., Mamidanna, R., Whitelaw, D., Jain, V., Veetil, D. K., Wadhawan, R., Torres, M., Tinoco, T., Leclercq, W., Romeijn, M., van de Pas, K., Alkhazraji, A. K., Taha, S. A., Ustun, M., Yigit, T., Inam, A., Burhanulhaq, M., Pazouki, A., Eghbali, F., Kermansaravi, M., Jazi, A. H. D., Mahmoudieh, M., Mogharehabed, N., Tsiotos, G., Stamou, K., Barrera Rodriguez, F. J., Rojas Navarro, M. A., Torres, O. M. O., Martinez, S. L., Tamez, E. R. M., Millan Cornejo, G. A., Flores, J. E. G., Mohammed, D. A., Elfawal, M. H., Shabbir, A., Guowei, K., So, J. B. Y., Kaplan, E. T., Kaplan, M., Kaplan, T., Pham, D. T., Rana, G., Kappus, M., Gadani, R., Kahitan, M., Pokharel, K., Osborne, A., Pournaras, D., Hewes, J., Napolitano, E., Chiappetta, S., Bottino, V., Dorado, E., Schoettler, A., Gaertner, D., Fedtke, K., Aguilar-Espinosa, F., Aceves-Lozano, S., Balani, A., Nagliati, C., Pennisi, D., Rizzi, A., Frattini, F., Foschi, D., Benuzzi, L., Parikh, C. H. I. R. A. G., Shah, H. A. R. S. H. I. L., Pinotti, E., Montuori, M., Borrelli, V., Dargent, J., Copaescu, C. A., Hutopila, I., Smeu, B., Witteman, B., Hazebroek, E., Deden, L., Heusschen, L., Okkema, S., Aufenacker, T., den Hengst, W., Vening, W., van der Burgh, Y., Ghazal, A., Ibrahim, H., Niazi, M., Alkhaffaf, B., Altarawni, M., Cesana, G. C., Anselmino, M., Uccelli, M., Olmi, S., Stier, C., Akmanlar, T., Sonnenberg, T., Schieferbein, U., Marcolini, A., Awruch, D., Vicentin, M., de Souza Bastos, E. L., Gregorio, S. A., Ahuja, A., Mittal, T., Bolckmans, R., Baratte, C., Wisnewsky, J. A., Genser, L., Chong, L., Taylor, L., Ward, S., Hi, M. W., Heneghan, H., Fearon, N., Plamper, A., Rheinwalt, K., Geoghegan, J., Ng, K. C., Kaseja, K., Kotowski, M., Samarkandy, T. A., Leyva-Alvizo, A., Corzo-Culebro, L., Wang, C., Yang, W., Dong, Z., Riera, M., Jain, R., Hamed, H., Said, M., Zarzar, K., Garcia, M., Turkcapar, A. G., Sen, O., Baldini, E., Conti, L., Wietzycoski, C., Lopes, E., Pintar, T., Salobir, J., Aydin, C., Atici, S. D., Ergin, A., Ciyiltepe, H., Bozkurt, M. A., Kizilkaya, M. C., Onalan, N. B. D., Zuber, M. N. B. A., Wong, W. J., Garcia, A., Vidal, L., Beisani, M., Pasquier, J., Vilallonga, R., Sharma, S., Parmar, C., Lee, L., Sufi, P., Sinan, H., and Saydam, M.

Subjects
Male, Pediatrics, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Adolescent, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), bariatric surgery, Context (language use), Pandemic, Medicine, Humans, Pandemics, COVID-19, pandemic, SARS-CoV-2, Nutrition and Dietetics, Manchester Cancer Research Centre, business.industry, Health Policy, ResearchInstitutes_Networks_Beacons/mcrc, Public Health, Environmental and Occupational Health, medicine.disease, Obesity, Obesity, Morbid, Treatment Outcome, Pediatrics, Perinatology and Child Health, Cohort, Female, Morbidity, business, Body mass index, Cohort study, Human
Abstract

Background: Metabolic and bariatric surgery (MBS) is an effective treatment for adolescents with severe obesity. Objectives: This study examined the safety of MBS in adolescents during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This was a global, multicentre and observational cohort study of MBS performed between May 01, 2020, and October 10,2020, in 68 centres from 24 countries. Data collection included in-hospital and 30-day COVID-19 and surgery-specific morbidity/mortality. Results: One hundred and seventy adolescent patients (mean age: 17.75 ± 1.30 years), mostly females (n=122, 71.8%), underwent MBS during the study period. The mean pre-operative weight and body mass index were 122.16 ± 15.92 kg and 43.7± 7.11 kg/m2, respectively. Although majority of patients had pre-operative testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (n=146; 85.9%), only 42.4% (n=72) of the patients were asked to self-isolate pre-operatively. Two patients developed symptomatic SARS-CoV-2 infection post-operatively (1.2%). The overall complication rate was 5.3% (n=9). There was no mortality in this cohort. Conclusions: MBS in adolescents with obesity is safe during the COVID-19 pandemic when performed within the context of local precautionary procedures (such as pre-operative testing). The 30-day morbidity rates were similar to those reported pre-pandemic. These data will help facilitate the safe re-introduction of MBS services for this group of patients.

Published
2021
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3. 30-day morbidity and mortality of sleeve gastrectomy, Roux-en-Y gastric bypass and one anastomosis gastric bypass: a propensity score-matched analysis of the GENEVA data

Author

Singhal, R. Cardoso, V.R. Wiggins, T. Super, J. Ludwig, C. Gkoutos, G.V. Mahawar, K. Pędziwiatr, M. Major, P. Zarzycki, P. Pantelis, A. Lapatsanis, D.P. Stravodimos, G. Matthys, C. Focquet, M. Vleeschouwers, W. Spaventa, A.G. Zerrweck, C. Vitiello, A. Berardi, G. Musella, M. Sanchez-Meza, A. Cantu, F.J., Jr Mora, F. Cantu, M.A. Katakwar, A. Reddy, D.N. Elmaleh, H. Hassan, M. Elghandour, A. Elbanna, M. Osman, A. Khan, A. layani, L. Kiran, N. Velikorechin, A. Solovyeva, M. Melali, H. Shahabi, S. Agrawal, A. Shrivastava, A. Sharma, A. Narwaria, B. Narwaria, M. Raziel, A. Sakran, N. Susmallian, S. Karagöz, L. Akbaba, M. Pişkin, S.Z. Balta, A.Z. Senol, Z. Manno, E. Iovino, M.G. Osman, A. Qassem, M. Arana-Garza, S. Povoas, H.P. Vilas-Boas, M.L. Naumann, D. Li, A. Ammori, B.J. Balamoun, H. Salman, M. Nasta, A.M. Goel, R. Sánchez-Aguilar, H. Herrera, M.F. Abou-mrad, A. Cloix, L. Mazzini, G.S. Kristem, L. Lazaro, A. Campos, J. Bernardo, J. González, J. Trindade, C. Viveiros, O. Ribeiro, R. Goitein, D. Hazzan, D. Segev, L. Beck, T. Reyes, H. Monterrubio, J. García, P. Benois, M. Kassir, R. Contine, A. Elshafei, M. Aktas, S. Weiner, S. Heidsieck, T. Level, L. Pinango, S. Ortega, P.M. Moncada, R. Valenti, V. Vlahović, I. Boras, Z. Liagre, A. Martini, F. Juglard, G. Motwani, M. Saggu, S.S. Momani, H.A. López, L.A.A. Cortez, M.A.C. Zavala, R.A. D’Haese RN, C. Kempeneers, I. Himpens, J. Lazzati, A. Paolino, L. Bathaei, S. Bedirli, A. Yavuz, A. Büyükkasap, Ç. Özaydın, S. Kwiatkowski, A. Bartosiak, K. Walędziak, M. Santonicola, A. Angrisani, L. Iovino, P. Palma, R. Iossa, A. Boru, C.E. De Angelis, F. Silecchia, G. Hussain, A. Balchandra, S. Coltell, I.B. Pérez, J.L. Bohra, A. Awan, A.K. Madhok, B. Leeder, P.C. Awad, S. Al-Khyatt, W. Shoma, A. Elghadban, H. Ghareeb, S. Mathews, B. Kurian, M. Larentzakis, A. Vrakopoulou, G.Z. Albanopoulos, K. Bozdag, A. Lale, A. Kirkil, C. Dincer, M. Bashir, A. Haddad, A. Hijleh, L.A. Zilberstein, B. de Marchi, D.D. Souza, W.P. Brodén, C.M. Gislason, H. Shah, K. Ambrosi, A. Pavone, G. Tartaglia, N. Kona, S.L.K. Kalyan, K. Perez, C.E.G. Botero, M.A.F. Covic, A. Timofte, D. Maxim, M. Faraj, D. Tseng, L. Liem, R. Ören, G. Dilektasli, E. Yalcin, I. AlMukhtar, H. Hadad, M.A. Mohan, R. Arora, N. Bedi, D. Rives-Lange, C. Chevallier, J.-M. Poghosyan, T. Sebbag, H. Zinaï, L. Khaldi, S. Mauchien, C. Mazza, D. Dinescu, G. Rea, B. Pérez-Galaz, F. Zavala, L. Besa, A. Curell, A. Balibrea, J.M. Vaz, C. Galindo, L. Silva, N. Caballero, J.L.E. Sebastian, S.O. Marchesini, J.C.D. da Fonseca Pereira, R.A. Sobottka, W.H. Fiolo, F.E. Turchi, M. Coelho, A.C.J. Zacaron, A.L. Barbosa, A. Quinino, R. Menaldi, G. Paleari, N. Martinez-Duartez, P. de Esparza, G.M.A.R. Esteban, V.S. Torres, A. Garcia-Galocha, J.L. Josa, M. Pacheco-Garcia, J.M. Mayo-Ossorio, M.A. Chowbey, P. Soni, V. de Vasconcelos Cunha, H.A. Castilho, M.V. Ferreira, R.M.A. Barreiro, T.A. Charalabopoulos, A. Sdralis, E. Davakis, S. Bomans, B. Dapri, G. Van Belle, K. Takieddine, M. Vaneukem, P. Karaca, E.S.A. Karaca, F.C. Sumer, A. Peksen, C. Savas, O.A. Chousleb, E. Elmokayed, F. Fakhereldin, I. Aboshanab, H.M. Swelium, T. Gudal, A. Gamloo, L. Ugale, A. Ugale, S. Boeker, C. Reetz, C. Hakami, I.A. Mall, J. Alexandrou, A. Baili, E. Bodnar, Z. Maleckas, A. Gudaityte, R. Guldogan, C.E. Gundogdu, E. Ozmen, M.M. Thakkar, D. Dukkipati, N. Shah, P.S. Shah, S.S. Shah, S.S. Adil, M.T. Jambulingam, P. Mamidanna, R. Whitelaw, D. Adil, M.T. Jain, V. Veetil, D.K. Wadhawan, R. Torres, A. Torres, M. Tinoco, T. Leclercq, W. Romeijn, M. van de Pas, K. Alkhazraji, A.K. Taha, S.A. Ustun, M. Yigit, T. Inam, A. Burhanulhaq, M. Pazouki, A. Eghbali, F. Kermansaravi, M. Jazi, A.H.D. Mahmoudieh, M. Mogharehabed, N. Tsiotos, G. Stamou, K. Rodriguez, F.J.B. Navarro, M.A.R. Torres, O.M. Martinez, S.L. Tamez, E.R.M. Cornejo, G.A.M. Flores, J.E.G. Mohammed, D.A. Elfawal, M.H. Shabbir, A. Guowei, K. So, J.B. Kaplan, E.T. Kaplan, M. Kaplan, T. Pham, D.T. Rana, G. Kappus, M. Gadani, R. Kahitan, M. Pokharel, K. Osborne, A. Pournaras, D. Hewes, J. Napolitano, E. Chiappetta, S. Bottino, V. Dorado, E. Schoettler, A. Gaertner, D. Fedtke, K. Aguilar-Espinosa, F. Aceves-Lozano, S. Balani, A. Nagliati, C. Pennisi, D. Rizzi, A. Frattini, F. Foschi, D. Benuzzi, L. Parikh, C. Shah, H. Pinotti, E. Montuori, M. Borrelli, V. Dargent, J. Copaescu, C.A. Hutopila, I. Smeu, B. Witteman, B. Hazebroek, E. Deden, L. Heusschen, L. Okkema, S. Aufenacker, T. den Hengst, W. Vening, W. van der Burgh, Y. Ghazal, A. Ibrahim, H. Niazi, M. Alkhaffaf, B. Altarawni, M. Cesana, G.C. Anselmino, M. Uccelli, M. Olmi, S. Stier, C. Akmanlar, T. Sonnenberg, T. Schieferbein, U. Marcolini, A. Awruch, D. Vicentin, M. de Souza Bastos, E.L. Gregorio, S.A. Ahuja, A. Mittal, T. Bolckmans, R. Wiggins, T. Baratte, C. Wisnewsky, J.A. Genser, L. Chong, L. Taylor, L. Ward, S. Hi, M.W. Heneghan, H. Fearon, N. Plamper, A. Rheinwalt, K. Heneghan, H. Geoghegan, J. Ng, K.C. Fearon, N. Kaseja, K. Kotowski, M. Samarkandy, T.A. Leyva-Alvizo, A. Corzo-Culebro, L. Wang, C. Yang, W. Dong, Z. Riera, M. Jain, R. Hamed, H. Said, M. Zarzar, K. Garcia, M. Türkçapar, A.G. Şen, O. Baldini, E. Conti, L. Wietzycoski, C. Lopes, E. Pintar, T. Salobir, J. Aydin, C. Atici, S.D. Ergin, A. Ciyiltepe, H. Bozkurt, M.A. Kizilkaya, M.C. Onalan, N.B.D. Zuber, M.N.B.A. Wong, W.J. Garcia, A. Vidal, L. Beisani, M. Pasquier, J. Vilallonga, R. Sharma, S. Parmar, C. Lee, L. Sufi, P. Sinan, H. Saydam, M. GENEVA Collaborators

Subjects
nutritional and metabolic diseases
Abstract

Background: There is a paucity of data comparing 30-day morbidity and mortality of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and one anastomosis gastric bypass (OAGB). This study aimed to compare the 30-day safety of SG, RYGB, and OAGB in propensity score-matched cohorts. Materials and methods: This analysis utilised data collected from the GENEVA study which was a multicentre observational cohort study of bariatric and metabolic surgery (BMS) in 185 centres across 42 countries between 01/05/2022 and 31/10/2020 during the Coronavirus Disease-2019 (COVID-19) pandemic. 30-day complications were categorised according to the Clavien–Dindo classification. Patients receiving SG, RYGB, or OAGB were propensity-matched according to baseline characteristics and 30-day complications were compared between groups. Results: In total, 6770 patients (SG 3983; OAGB 702; RYGB 2085) were included in this analysis. Prior to matching, RYGB was associated with highest 30-day complication rate (SG 5.8%; OAGB 7.5%; RYGB 8.0% (p = 0.006)). On multivariate regression modelling, Insulin-dependent type 2 diabetes mellitus and hypercholesterolaemia were associated with increased 30-day complications. Being a non-smoker was associated with reduced complication rates. When compared to SG as a reference category, RYGB, but not OAGB, was associated with an increased rate of 30-day complications. A total of 702 pairs of SG and OAGB were propensity score-matched. The complication rate in the SG group was 7.3% (n = 51) as compared to 7.5% (n = 53) in the OAGB group (p = 0.68). Similarly, 2085 pairs of SG and RYGB were propensity score-matched. The complication rate in the SG group was 6.1% (n = 127) as compared to 7.9% (n = 166) in the RYGB group (p = 0.09). And, 702 pairs of OAGB and RYGB were matched. The complication rate in both groups was the same at 7.5 % (n = 53; p = 0.07). Conclusions: This global study found no significant difference in the 30-day morbidity and mortality of SG, RYGB, and OAGB in propensity score-matched cohorts. © 2021, The Author(s).

Published
2021

5. Systematic Brain Natriuretic Peptide Measurement for Cardiac Screening in Patients with Severe Obesity: The OLECOEUR Study.

Author

Carette C, Okamba-Belle D, Hirlemann M, Wack M, Domenge O, Jannot AS, Czernichow S, Rives-Lange C, Fayol A, and Hulot JS

Subjects
Humans, Middle Aged, Male, Female, Prospective Studies, Adult, Biomarkers blood, Mass Screening methods, Body Mass Index, Ventricular Remodeling, France, Natriuretic Peptide, Brain blood, Obesity, Morbid blood, Obesity, Morbid complications, Obesity, Morbid physiopathology, Heart Failure blood, Heart Failure physiopathology, Echocardiography
Abstract

Introduction: Heart failure (HF) is difficult to diagnose in obese patients because of cardiovascular and pulmonary comorbidities associated with physical deconditioning, all of which lead to dyspnea., Methods: The OLECOEUR study is a prospective screening for HF using systematic brain natriuretic peptide (BNP) measurement in ambulatory patients with obesity from a department of Nutrition (Paris, France). Clinical, biological, and echocardiographic data were extracted from electronic medical records., Results: We included 1,506 patients middle-aged (mean age: 47.2 ± 14.6 years old) with severe obesity (mean body mass index: 40.4 ± 6.6 kg/m2). Patients with BNP ≥35 pg/mL had left heart remodeling including thicker interventricular septum (10.4 ± 2.0 vs. 9.6 ± 1.8 mm; p = 0.0008), higher left ventricular mass (89.9 ± 24.3 vs. 77.2 ± 20.0 g/m2; p = 0.0009), and significant changes in both left and right atria consistent with a higher proportion of prior atrial fibrillation. Markers of right heart remodeling on echocardiography were also significantly higher (pulmonary artery systolic pressure: 33.3 ± 17.3 vs. 24.5 ± 6.3 mm Hg; p = 0.0002)., Conclusion: The OLECOEUR study shows left and right subclinical cardiac remodeling in obese patients screened for HF with systematic dosing of BNP with usual cut-off of 35 pg/mL., (© 2024 The Author(s). Published by S. Karger AG, Basel.)

Published
2024
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6. Association of Healthy Lifestyle Factors and Obesity-Related Diseases in Adults in the UK.

Author

Rassy N, Van Straaten A, Carette C, Hamer M, Rives-Lange C, and Czernichow S

Subjects
Adult, Humans, Male, Female, Middle Aged, Cohort Studies, Risk Factors, United Kingdom epidemiology, Obesity epidemiology, Obesity complications, Healthy Lifestyle
Abstract

Importance: A healthy lifestyle is associated with a reduced risk of cardiovascular disease in adults with obesity. Little is known about the associations between a healthy lifestyle and the risk of other obesity-attributable diseases in this population., Objective: To examine the association between healthy lifestyle factors and the incidence of major obesity-related diseases in adults with obesity compared with those with normal weight., Design, Setting, and Participants: This cohort study evaluated UK Biobank participants aged 40 to 73 years and free of major obesity-attributable disease at baseline. Participants were enrolled from 2006 to 2010 and prospectively followed up for disease diagnosis., Exposures: A healthy lifestyle score was constructed using information on not smoking, exercising regularly, no or moderate alcohol consumption, and eating a healthy diet. For each lifestyle factor, participants scored 1 if they met the criterion for a healthy lifestyle and 0 otherwise., Main Outcomes and Measures: The risk of outcomes according to the healthy lifestyle score in adults with obesity compared with those with normal weight were examined using multivariable Cox proportional hazards models with Bonferroni correction for multiple testing. The data analysis was performed between December 1, 2021, and October 31, 2022., Results: A total of 438 583 adult participants in the UK Biobank were evaluated (female, 55.1%; male, 44.9%; mean [SD] age, 56.5 [8.1] years), of whom 107 041 (24.4%) had obesity. During a mean (SD) follow-up of 12.8 (1.7) years, 150 454 participants (34.3%) developed at least 1 of the studied diseases. Compared with adults with obesity and 0 healthy lifestyle factors, individuals with obesity who met all 4 healthy lifestyle factors were at lower risk of hypertension (HR, 0.84; 95% CI, 0.78-0.90), ischemic heart disease (HR, 0.72; 95% CI, 0.65-0.80), arrhythmias (HR, 0.71; 95% 0.61-0.81), heart failure (HR, 0.65; 95% CI, 0.53-0.80), arteriosclerosis (HR, 0.19; 95% CI, 0.07-0.56), kidney failure (HR, 0.73; 95% CI, 0.63-0.85), gout (HR, 0.51; 95% CI, 0.38-0.69), sleep disorders (HR, 0.68; 95% CI, 0.56-0.83), and mood disorders (HR, 0.66; 95% CI, 0.56-0.78). The lifestyle profiles associated with the lowest risks included a healthy diet and at least 1 of the 2 healthy behaviors of physical activity and never smoking. Compared with adults with normal weight, those with obesity were at higher risk of several outcomes, irrespective of the lifestyle score (adjusted HRs ranged from 1.41 [95% CI, 1.27-1.56] for arrhythmias to 7.16 [95% CI, 6.36-8.05] for diabetes for adults with obesity and 4 healthy lifestyle factors)., Conclusion and Relevance: In this large cohort study, adherence to a healthy lifestyle was associated with reduced risk of a wide range of obesity-related diseases, but this association was modest in adults with obesity. The findings suggest that although a healthy lifestyle seems to be beneficial, it does not entirely offset the health risks associated with obesity.

Published
2023
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7. Patients' and caregivers' perceptions of bariatric surgery: A France and United States comparative infodemiology study using social media data mining.

Author

Czernichow S, Rassy N, Malaab J, Loussikian P, Mebarki A, Khadhar M, Poghosyan T, Fagherrazi G, Carette C, Schück S, and Rives-Lange C

Abstract

Background: People are conversing about bariatric surgery on social media, but little is known about the main themes being discussed., Objective: To analyze discussions regarding bariatric surgery on social media platforms and to establish a cross-cultural comparison of posts geolocated in France and the United States., Methods: Posts were retrieved between January 2015 and April 2021 from general, publicly accessed sites and health-related forums geolocated in both countries. After processing and cleaning the data, posts of patients and caregivers about bariatric surgery were identified using a supervised machine learning algorithm., Results: The analysis dataset contained a total of 10,800 posts from 4,947 web users in France and 51,804 posts from 40,278 web users in the United States. In France, post-operative follow-up ( n  = 3,251, 30.1% of posts), healthcare pathways ( n  = 2,171, 20.1% of the posts), and complementary and alternative weight loss therapies ( n  = 1,652, 15.3% of the posts) were among the most discussed topics. In the United States, the experience with bariatric surgery ( n  = 11,138, 21.5% of the posts) and the role of physical activity and diet in weight-loss programs before surgery ( n  = 9,325, 18% of the posts) were among the most discussed topics., Conclusion: Social media analysis provides a valuable toolset for clinicians to help them increase patient-centered care by integrating the patients' and caregivers' needs and concerns into the management of bariatric surgery., Competing Interests: JM, PL, AM, and SS are employed by Kapcode. SC: Personal fees from Novonordisk, Lilly, Astra Zeneca, Fresenius Kabi, Janssen-cilag, Servier, Novartis. Co-founder of MyGoodLife and Alifert. Scientific Advisory Board: BARIATEK. TP: Consultancy: Novo Nordisk, Honoraria for speaker for Gore, scientific board: BARIATEK. CC: Consultancy: Novo Nordisk, Astra Zeneca, Lilly, Novartis Pharma, MSD France, IPSEN Pharma, Pfizer, Publicis Health/support for attending meetings and or travel: Astra Zeneca, Novo Nordisk, Lilly, Vitalaire, MSD France, Sanofi. CR-L: Nestlé Health science: conferences, Nestlé home care and Fit for me: congress. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Czernichow, Rassy, Malaab, Loussikian, Mebarki, Khadhar, Poghosyan, Fagherrazi, Carette, Schück and Rives-Lange.)

Published
2023
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8. MyGood Trip, a Telemedicine Intervention for Physical Activity Recovery After Bariatric Surgery: Randomized Controlled Trial.

Author

Lurbe I Puerto K, Bruzzi M, Rives-Lange C, Poghosyan T, Bretault M, Chatellier G, Vilfaillot A, Chevallier JM, Czernichow S, and Carette C

Abstract

Background: Despite bariatric surgery showing significant weight loss trajectories for many patients, a substantial proportion regain weight after the first year following surgery. The addition of telemedicine to standard care could support patients with engaging in a more active lifestyle and thus improve clinical outcomes., Objective: Our aim was to evaluate a telemedicine intervention program dedicated to the promotion of physical activity including digital devices, teleconsultation, and telemonitoring the first 6 months following bariatric surgery., Methods: This study employed a mixed methods design based on an open-label randomized controlled trial. Patients were included during the first week after bariatric surgery; then, they were randomized into 2 intervention groups: The TelePhys group received a monthly telemedicine consultation focusing on physical activity coaching, while the TeleDiet group received a monthly telemedicine consultation involving diet coaching. Data were collected using a watch pedometer and body weight scale, both of which were connected wirelessly. The primary outcome was the difference between the 2 groups in the mean numbers of steps at the first and sixth postoperative months. Weight change was also evaluated, and focus groups and interviews were conducted to enrich the results and capture perceptions of the telemedicine provided., Results: Among the 90 patients (mean age 40.6, SD 10.4 years; 73/90, 81% women; 62/90, 69% gastric bypass), 70 completed the study until the sixth month (n=38 TelePhys; n=32 TeleDiet), and 18 participants agreed to be interviewed (n=8 Telephys; n=10 TeleDiet). An increase in the mean number of steps between the first and sixth months was found in both groups, but this change was significant only in the TeleDiet group (P=.01). No difference was found when comparing both intervention groups. Interviewed participants reported having appreciated the teleconsultations, as the individualized tailored counseling helped them to make better choices about behaviors that could increase their likelihood of a daily life in better health. Weight loss followed by social factors (such as social support) were identified as the main facilitators to physical activity. Family responsibilities, professional constraints as well as poor urban policies promoting physical activity, and lack of accessibility to sport infrastructure were their major barriers to postoperative lifestyle adherence., Conclusions: Our study did not show any difference in mobility recovery after bariatric surgery related to a telemedicine intervention dedicated to physical activity. The early postoperative timing for our intervention may explain the null findings. eHealth interventions aiming to change behaviors and carried out by clinicians require support from structured public health policies that tackle patients' obesogenic environment in order to be efficient in their struggle against sedentary lifestyle-related pathologies. Further research will need to focus on long-term interventions., Trial Registration: ClinicalTrials.gov NCT02716480, https://clinicaltrials.gov/ct2/show/NCT02716480., (©Katia Lurbe i Puerto, Matthieu Bruzzi, Claire Rives-Lange, Tigran Poghosyan, Marion Bretault, Gilles Chatellier, Aurelie Vilfaillot, Jean-Marc Chevallier, Sebastien Czernichow, Claire Carette. Originally published in JMIR Formative Research (https://formative.jmir.org), 28.03.2023.)

Published
2023
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9. EUS-Guided Gastroenterostomy in Malignant Gastric Outlet Obstruction: A Comparative Study between First- and Second-Line Approaches after Enteral Stent Placement.

Author

Perez-Cuadrado-Robles E, Alric H, Aidibi A, Bronswijk M, Vanella G, Gallois C, Benosman H, Ragot E, Rives-Lange C, Rahmi G, and Cellier C

Abstract

Introduction: Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is increasingly used in the setting of malignant gastric outlet obstruction (GOO). However, little is known about the role of primary EUS-GE. The aim of the present study is to compare the outcomes of EUS-GE by using the freehand technique as a first- and second-line approach after enteral stenting (ES)., Methods: This is an observational single-center study using a prospectively collected database. All consecutive patients who underwent an EUS-GE using the freehand technique due to malignant GOO were included. Patients with previous gastric surgery, a wire-guided EUS-GE technique, or those presenting without GOO were excluded. The primary outcome was the clinical success, defined as a solid oral intake at 1 week after the procedure (GOO Score, GOOSS ≥ 2). The secondary outcomes were technical success and adverse event (AE) rates. The impact on nutritional parameters was also assessed., Results: Forty-five patients underwent an EUS-GE for all indications. Finally, 28 patients (mean age: 63 ± 17.2 years, 57.1% male) with ( n = 13, 46.4%) and without ( n = 15, 53.6%) a previous ES were included. The technical success was achieved in 25 cases (89.3%), with no differences between the two groups (92.3% vs. 86.7%, p = 1). The median limb diameter and procedure time were 27 mm (range:15-48) and 37 min. Overall, clinical success was achieved in 22 cases (88%), with three failures due to AEs ( n = 2) or peritoneal carcinomatosis ( n = 1). The diet progression was quicker in patients with a previous ES (GOOSS at 48 h, 2 vs. 1, p = 0.023), but the GOOSS at 1 week ( p = 0.299), albumin gain ( p = 0.366), and BMI gain (0.257) were comparable in the two groups. The AE rate was 7.1%., Conclusions: EUS-GE achieves a high technical and clinical success in patients with GOO regardless of the presence of a previous ES. Patients with previous ES may have a quicker progression of their diet, but the GOOSS and nutritional status in the long term at 1 week or 1 month are comparable. Primary EUS-GE might require fewer procedures and less discontinuation of chemotherapy to achieve a comparable result.

Published
2022
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10. Health care use by adults with obesity: A French cohort study.

Author

Feral-Pierssens AL, Matta J, Rives-Lange C, Goldberg M, Zins M, Carette C, and Czernichow S

Subjects
Adult, Cohort Studies, Delivery of Health Care, Emergency Service, Hospital, Humans, Hospitalization, Obesity epidemiology, Obesity therapy
Abstract

Objective: Studies on obesity costs have focused on global costs of people with obesity but scarcely investigated their precise use of health care. The aim of this study is to document real-life health care use across obesity classes., Methods: Data of participants with obesity and enrolled in the CONSTANCES cohort were analyzed. Health care use was defined as ≥1 visit to general practitioners, specialists, emergency departments, and inpatient hospital admissions versus none over a 3-year period prior to enrollment and was obtained from the Universal Health Insurance database. Multivariate regression models were conducted and adjusted for comorbidities and social deprivation markers with medical visits as the outcome variables and compared people with class II and III obesity versus class I obesity., Results: Out of the 10,774 participants with obesity, 613 (5.7%) had class III obesity, and 2,076 (19.3%) had class II obesity. Compared with participants with class I obesity, class III obesity participants had higher odds of visiting emergency departments (OR = 1.31; 95% CI: 1.07-1.61) and various specialist physicians (pneumologists, endocrinologists, cardiologists) but lower odds of visiting gynecologists (OR = 0.69; 95% CI 0.55-0.87). Participants with class II obesity had lower odds of visiting general practitioners, dentists, and psychiatrists. There was no difference with regard to hospital admissions., Conclusion: Health care use by people with obesity differs across classes., (© 2022 The Obesity Society.)

Published
2022
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11. Evolution of the prevalence of obesity in the adult population in France, 2013-2016: the Constances study.

Author

Czernichow S, Renuy A, Rives-Lange C, Carette C, Airagnes G, Wiernik E, Ozguler A, Kab S, Goldberg M, Zins M, and Matta J

Subjects
Adolescent, Adult, Aged, Body Mass Index, Educational Status, Exercise, Female, France epidemiology, Health Surveys, Humans, Income, Logistic Models, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Prevalence, Smoking, Young Adult, Obesity epidemiology
Abstract

This study provides trends in obesity prevalence in adults from 2013 to 2016 in France. 63,582 men and women from independent samples upon inclusion from the Constances cohort were included. Anthropometrics were measured at Health Screening Centers and obesity defined as a Body mass index (BMI) ≥ 30 kg/m 2 ; obesity classes according to BMI are as follows: class 1 [30-34.9]; class 2 [35-39.9]; class 3 [≥ 40 kg/m 2 ]. Linear trends across obesity classes by sex and age groups were examined in regression models and percentage point change from 2013 to 2016 for each age category calculated. All analyses accounted for sample weights for non-response, age and sex-calibrated to the French population. Prevalence of obesity ranged from 14.2 to 15.2% and from 14 to 15.3% in women and men respectively from 2013 to 2016. Class 1 obesity category prevalence was the only one to increase significantly across survey years in both men and women (p for linear trend = 0.04 and 0.01 in women and men respectively). The only significant increase for obesity was observed in the age group 18-29 y in both women and men (+ 2.71% and + 3.26% point increase respectively, equivalent to an approximate rise of 50% in women and 93% in men, p = 0.03 and 0.02 respectively). After adjustment for survey non-response and for age and sex distribution, the results show that class 1 obesity prevalence has significantly increased in both women and men from 2013 to 2016, and only in young adults in a representative sample of the French population aged 18-69 years old.

Published
2021
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12. Differential association between inflammatory cytokines and multiorgan dysfunction in COVID-19 patients with obesity.

Author

Dragon-Durey MA, Chen X, Kirilovsky A, Ben Hamouda N, El Sissy C, Russick J, Charpentier E, Binois Y, Marliot F, Meylan M, Granier C, Pere H, Saldmann A, Rance B, Jannot AS, Baron S, Chebbi M, Fayol A, Josseaume N, Rives-Lange C, Tharaux PL, Cholley B, Diehl JL, Arlet JB, Azizi M, Karras A, Czernichow S, Smadja DM, Hulot JS, Cremer I, Tartour E, Mousseaux E, and Pagès F

Subjects
Aged, Biomarkers metabolism, Body Mass Index, COVID-19 complications, COVID-19 virology, Chemokines blood, Chemokines metabolism, Cytokines blood, Endothelium, Vascular metabolism, Endothelium, Vascular physiopathology, Female, Hospitalization statistics & numerical data, Humans, Intensive Care Units, Liver diagnostic imaging, Lung diagnostic imaging, Male, Middle Aged, Obesity complications, Prospective Studies, RNA, Viral blood, SARS-CoV-2 genetics, SARS-CoV-2 isolation & purification, Severity of Illness Index, COVID-19 pathology, Cytokines metabolism, Liver physiopathology, Lung physiopathology, Obesity pathology
Abstract

To investigate the mechanisms underlying the SARS-CoV-2 infection severity observed in patients with obesity, we performed a prospective study of 51 patients evaluating the impact of multiple immune parameters during 2 weeks after admission, on vital organs' functions according to body mass index (BMI) categories. High-dimensional flow cytometric characterization of immune cell subsets was performed at admission, 30 systemic cytokines/chemokines levels were sequentially measured, thirteen endothelial markers were determined at admission and at the zenith of the cytokines. Computed tomography scans on admission were quantified for lung damage and hepatic steatosis (n = 23). Abnormal BMI (> 25) observed in 72.6% of patients, was associated with a higher rate of intensive care unit hospitalization (p = 0.044). SARS-CoV-2 RNAaemia, peripheral immune cell subsets and cytokines/chemokines were similar among BMI groups. A significant association between inflammatory cytokines and liver, renal, and endothelial dysfunctions was observed only in patients with obesity (BMI > 30). In contrast, early signs of lung damage (ground-glass opacity) correlated with Th1/M1/inflammatory cytokines only in normal weight patients. Later lesions of pulmonary consolidation correlated with BMI but were independent of cytokine levels. Our study reveals distinct physiopathological mechanisms associated with SARS-CoV-2 infection in patients with obesity that may have important clinical implications., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: HP reports personal fees from MSD, Janssen, and Biomerieux. ET reports research grants from Servier and Vaxeal; reports honorarium fees from BMS and Merck-MSD; reports honorarium fees for participation on advisory boards from BMS and Astra-Zeneca. PLT reports honorarium fees for participation on advisory boards for Retrophin Inc not related to this work. JBA reports consultancy/expert testimony and honoraria from Novartis and Pfizer. BC reports receiving consulting fees and honoraria for lectures at symposia from Edwards Life Sciences, Orion Pharma, Amomed, and Nordic Pharma. MZ reports research grants from the French Ministry of Health, Quantum Genomics, and the European Horizon 2020 program; reports grant support and nonfinancial support from ReCor Medical and Idorsia; and reports personal fees from CVRx. JSH reports grants from Bioserenity, Sanofi, Servier and Novo Nordisk. J.S.H; reports speaker, advisory board or consultancy fees from Amgen, Astra Zeneca, Bayer, Bristol-Myers Squibb, Novartis, Novo Nordisk. SC reports personal fees from Novonordisk, Lilly, Kabi, Janssen-Cilag, Servier, outside the submitted work; reports other from MyGoodLife. FP reported receiving grants from Bristol-Myers and Squibb and HalioDx outside the submitted work; participation in Scientific Advisory Boards & Meetings for Bristol-Myers Squibb, Roche, Janssen, Merck, and Gilead. DMS received consulting fees or travels expenses from Boehringer Ingelheim, Léo Pharma, Aspen and Carmat. None of them are related to the work described here. M-ADD reported having received speaker fees from BMS, Gilead and Roche outside the submitted work. The remaining authors declared no conflict of interest. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Published
2021
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13. Obesity Doubles Mortality in Patients Hospitalized for Severe Acute Respiratory Syndrome Coronavirus 2 in Paris Hospitals, France: A Cohort Study on 5,795 Patients.

Author

Czernichow S, Beeker N, Rives-Lange C, Guerot E, Diehl JL, Katsahian S, Hulot JS, Poghosyan T, Carette C, and Jannot AS

Subjects
Adolescent, Adult, Aged, Body Mass Index, Cohort Studies, Female, France, Humans, Male, Middle Aged, Odds Ratio, Paris, Prospective Studies, Retrospective Studies, Risk Factors, Severity of Illness Index, Young Adult, COVID-19 mortality, Hospital Mortality, Obesity mortality, SARS-CoV-2
Abstract

Objective: Preliminary data from different cohorts of small sample size or with short follow-up indicate poorer prognosis in people with obesity compared with other patients. This study aims to precisely describe the strength of association between obesity in patients hospitalized with coronavirus disease 2019 (COVID-19) and mortality and to clarify the risk according to usual cardiometabolic risk factors in a large cohort., Methods: This is a prospective cohort study including 5,795 patients aged 18 to 79 years hospitalized from February 1 to April 30, 2020, in the Paris area, with confirmed infection by severe acute respiratory syndrome coronavirus 2. Adjusted regression models were used to estimate the odds ratios (ORs) and 95% CIs for the mortality rate at 30 days across BMI classes, without and with imputation for missing BMI values., Results: Eight hundred ninety-one deaths had occurred at 30 days. Mortality was significantly raised in people with obesity, with the following ORs for BMI of 30 to 35 kg/m 2 , 35 to 40 kg/m 2 , and >40 kg/m 2 : 1.89 (95% CI: 1.45-2.47), 2.79 (95% CI: 1.95-3.97), and 2.55 (95% CI: 1.62-3.95), respectively (18.5-25 kg/m 2 was used as the reference class). This increase holds for all age classes., Conclusions: Obesity doubles mortality in patients hospitalized with COVID-19., (© 2020 The Obesity Society.)

Published
2020
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14. Forgoing health care under universal health insurance: the case of France.

Author

Feral-Pierssens AL, Rives-Lange C, Matta J, Rodwin VG, Goldberg M, Juvin P, Zins M, Carette C, and Czernichow S

Subjects
Adolescent, Adult, Aged, Bayes Theorem, Female, France, Humans, Logistic Models, Male, Middle Aged, Prospective Studies, Reproducibility of Results, Surveys and Questionnaires, Young Adult, Health Services Accessibility organization & administration, Health Services Accessibility statistics & numerical data, Office Visits statistics & numerical data, Office Visits trends, Patient Acceptance of Health Care statistics & numerical data, Universal Health Insurance organization & administration, Universal Health Insurance statistics & numerical data
Abstract

Objectives: We investigate the reliability of a survey question on forgone healthcare services for financial reasons, based on analysis of actual healthcare use over the 3-year period preceding response to the question. We compare the actual use of different health services by patients who report having forgone health care to those who do not., Methods: Based on a prospective cohort study (CONSTANCES), we link survey data from enrolled participants to the Universal Health Insurance (UHI) claims database and compare use of health services of those who report having forgone health care to controls. We present multivariable logistic regression models and assess the odds of using different health services., Results: Compared to controls, forgoing care participants had lower odds of consulting GPs (OR = 0.83; 95% CI 0.73, 0.93), especially specialists outside hospitals (gynecologists: 0.74 (0.69, 0.78); dermatologists: 0.81 (0.78-0.85); pneumologists 0.82 (0.71-0.94); dentists 0.71 (0.68, 0.75)); higher odds of ED visits (OR = 1.25; 95% CI 1.19, 1.31); and no difference in hospital admissions (OR = 1.02; 95% CI 0.97, 1.09). Participants with lower occupational status and income had higher odds of forgoing health care., Conclusions: The perception of those who report having forgone health care for financial reasons is consistent with their lower actual use of community-based ambulatory care (CBAC). While UHI may be necessary to improve healthcare access, it does not address the social factors associated with the population forgoing health care for financial reasons.

Published
2020
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15. Micronutrients Deficiencies in 374 Severely Malnourished Anorexia Nervosa Inpatients.

Author

Hanachi M, Dicembre M, Rives-Lange C, Ropers J, Bemer P, Zazzo JF, Poupon J, Dauvergne A, and Melchior JC

Subjects
Adult, Cohort Studies, Female, Humans, Male, Retrospective Studies, Young Adult, Anorexia Nervosa complications, Malnutrition complications, Micronutrients deficiency
Abstract

Introduction: Anorexia nervosa (AN) is a complex psychiatric disorder, which can lead to specific somatic complications. Undernutrition is a major diagnostic criteria of AN and it can be associated with several micronutrients deficiencies., Objectives: This study aimed to determinate the prevalence of micronutrients deficiencies and to compare the differences between the two subtypes of AN (restricting type (AN-R) and binge-eating/purging type (AN-BP))., Methods: We report a large retrospective, monocentric study of patients that were hospitalized in a highly specialized AN inpatient unit between January 2011 and August 2017 for severe malnutrition treatment in the context of anorexia nervosa., Results: Three hundred and seventy-four patients were included, at inclusion, with a mean Body Mass Index (BMI) of 12.5 ± 1.7 kg/m². Zinc had the highest deficiency prevalence 64.3%, followed by vitamin D (54.2%), copper (37.1%), selenium (20.5%), vitamin B1 (15%), vitamin B12 (4.7%), and vitamin B9 (8.9%). Patients with AN-BP type had longer disease duration history, were older, and had a lower left ventricular ejection fraction (LVEF) ( p < 0.001, p = 0.029, p = 0.009) when compared with AN-R type patients who, instead, had significantly higher Alanine Aminotransferase (ALT) and Brain Natriuretic Peptide (BNP) levels ( p < 0.001, p < 0.021). In the AN-BP subgroup, as compared to AN-R, lower selenium ( p < 0.001) and vitamin B12 plasma concentration ( p < 0.036) was observed, whereas lower copper plasma concentration was observed in patients with AN-R type ( p < 0.022). No significant differences were observed for zinc, vitamin B9, vitamin D, and vitamin B1 concentrations between the two types of AN patients., Conclusion: Severely malnourished AN patients have many micronutrient deficiencies. Micronutrients status must be monitored and supplemented to prevent deficiency related complications and to improve nutritional status. Prospective studies are needed to explore the symptoms and consequences of each deficiency, which can aggravate the prognosis during recovery.

Published
2019
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16. Obesity and emergency care in the French CONSTANCES cohort.

Author

Feral-Pierssens AL, Carette C, Rives-Lange C, Matta J, Goldberg M, Juvin P, Zins M, and Czernichow S

Subjects
Adolescent, Adult, Aged, Body Mass Index, Cardiovascular Diseases complications, Cohort Studies, Databases, Factual, Female, France epidemiology, Humans, Logistic Models, Male, Middle Aged, Obesity complications, Obesity epidemiology, Odds Ratio, Risk Factors, Social Class, Young Adult, Emergency Medical Services, Obesity pathology
Abstract

Context: Obese patients are raising specific questions in emergency care such as equipment issues or urgent procedures. Even though obesity prevalence and subsequent health expenditure are increasing worldwide, there is scarce literature about their specific resource utilization of Emergency Departments (ED). These few studies do not take into account both socio-economic situation and comorbidities which are well-known factors influencing healthcare use. Our objective was to assess the emergency care resource utilization of obese individuals (Body Mass Index (BMI) ≥ 30kg.m-2) compared to normal-weight individuals taking into account comorbidities and social-economic situations., Methods: The French CONSTANCES epidemiologic cohort is a randomly selected sample of French adults. Participants data are linked to the National Health Insurance Database collecting all medical acts. The rate of ED visits of obese (and each obesity class) and normal-weight participants were compared considering confounding factors (comorbidities, various socio-economic data). The primary endpoint was to have visited the ED between 2010 and 2013. Sex-separated analysis and multivariate logistic regression models were performed and adjusted odds-ratios [OR] (95% Confidence Intervals [CI]) were calculated., Results: We included 21,035 normal-weight and 5,003 obese participants. Obese participants visited the ED more often than normal-weight participants (men: 30.5% vs. 26.7%; women: 30.3% vs. 24.4%, P<0.001). Obese participants presented more comorbidities and a lower socio-economic situation than normal-weight participants. After adjustment, obese participants had a higher risk of visiting ED (men: OR = 1.18; 95% CI: 1.04-1.33; and women: OR = 1.36; 95% CI: 1.22-1.52), with a higher risk for class III participants (BMI ≥ 40 kg.m-2) (men: OR = 2.18; CI 95%: 1.32-3.63; and women: OR = 1.85; 95% CI: 1.38-2.49)., Conclusion: Obese individuals have a higher level of emergency care resource utilization than normal-weight individuals and it increases with severe obesity. Further studies are needed to better understand their healthcare pathways leading to EDs.

Published
2018
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17. A 78-Year-Old Man With Historical Goiter.

Author

Ait Boudaoud A, Rives-Lange C, Radu A, Rubin F, Carette C, Barsamian C, and Czernichow S

Abstract

The purpose of this paper is to provide description of the natural evolution of an initially operable goitre into unmesurable form in a context of deeply unknown psychiatric disorders initially unknown.

Published
2018
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