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Article ; Online: Exercise training and DNA methylation profile in post-bariatric women: Results from an exploratory study.

Nicoletti, Carolina F / Roschel, Hamilton / Merege-Filho, Carlos / Lima, Alisson P / Gil, Saulo / Pinhel, Marcela A S / Noronha, Natalia Y / Santo, Marco A / Jacome, Amalia / Crujeiras, Ana B / Gualano, Bruno / Nonino, Carla B

Frontiers in sports and active living

2023 Volume 5, Page(s) 1092050

Abstract: Exercise training and bariatric surgery have been shown to independently modulate DNA methylation profile in clusters of genes related to metabolic and inflammatory pathways. This study aimed to investigate the effects of a 6-month exercise training ... ...

Abstract	Exercise training and bariatric surgery have been shown to independently modulate DNA methylation profile in clusters of genes related to metabolic and inflammatory pathways. This study aimed to investigate the effects of a 6-month exercise training program on DNA methylation profile in women who underwent bariatric surgery. In this exploratory, quasi-experimental study, we analyzed DNA methylation levels by array technology in eleven women who underwent Roux-en-Y Gastric Bypass and a 6-month, three-times-a-week, supervised exercise training program. Epigenome Wide Association Analysis showed 722 CpG sites with different methylation level equal to or greater than 5% (
Language	English
Publishing date	2023-02-08
Publishing country	Switzerland
Document type	Journal Article
ISSN	2624-9367
ISSN (online)	2624-9367
DOI	10.3389/fspor.2023.1092050
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Article ; Online: Cholecystectomy in Patients Submitted to Bariatric Procedure: A Systematic Review and Meta-analysis.

Tustumi, Francisco / Bernardo, Wanderley M / Santo, Marco A / Cecconello, Ivan

Obesity surgery

2018 Volume 28, Issue 10, Page(s) 3312–3320

Abstract: Weight loss following bariatric surgery increases risk for biliary stones. This study performed a meta-analysis evaluating cholecystectomy risks in bariatric patients. A systematic review and meta-analysis were performed. We evaluated the incidence rate ... ...

Abstract	Weight loss following bariatric surgery increases risk for biliary stones. This study performed a meta-analysis evaluating cholecystectomy risks in bariatric patients. A systematic review and meta-analysis were performed. We evaluated the incidence rate for biliary complications in patients followed after bariatric surgery. We compared the risks for mortality, complications, and in hospital stay among patient submitted to cholecystectomy before, concomitantly with or after bariatric surgery, as well as patients submitted to bariatric surgery and cholecystectomy, and patients submitted only to bariatric surgery in order to evaluate when to perform cholecystectomy in morbidly obese patients. The incidence rate of biliary complications was 5.54 cases/1000 patient year. The addition of cholecystectomy to bariatric surgery resulted in an increased risk for complications (RD = 0.02). The risk for complications (RD = - 0.09) and reoperation (RD = - 0.02) was lower when performed concomitantly with bariatric surgery compared to post-bariatric procedure. Prophylactic cholecystectomy may be avoided. Patients submitted to bariatric surgery have low incidence rate of biliary complications, and concomitant cholecystectomy increases the risk for postoperative complications and operative time. If cholecystectomy is not indicated, patients should be carefully followed with attention for biliary complications, once cholecystectomy performed post-bariatric surgery is at higher risk for complications and reoperations.
MeSH term(s)	Adult ; Bariatric Surgery/adverse effects ; Bariatric Surgery/methods ; Bariatric Surgery/statistics & numerical data ; Cholecystectomy/methods ; Cholecystectomy/statistics & numerical data ; Female ; Gallstones/epidemiology ; Gallstones/etiology ; Gallstones/surgery ; Humans ; Male ; Middle Aged ; Obesity, Morbid/complications ; Obesity, Morbid/epidemiology ; Obesity, Morbid/surgery ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Reoperation/adverse effects ; Reoperation/statistics & numerical data ; Weight Loss/physiology
Language	English
Publishing date	2018-08-10
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-018-3443-1
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Article: Large eddy simulation (LES) of wind‐driven circulation in a peri‐alpine lake: Detection of turbulent structures and implications of a complex surrounding orography

Santo, Marco A. / Toffolon, Marco / Zanier, Giulia / Giovannini, Lorenzo / Armenio, Vincenzo

Journal of geophysical research. 2017 June, v. 122, no. 6

2017

Abstract: We investigate wind‐driven circulation in a peri‐alpine lake (Lake Ledro ‐ Italy) using LES‐COAST. Lake Ledro is interesting because its own dimensions are suited for LES and it is surrounded by complex orography, affecting wind distribution. We consider ...

Abstract	We investigate wind‐driven circulation in a peri‐alpine lake (Lake Ledro ‐ Italy) using LES‐COAST. Lake Ledro is interesting because its own dimensions are suited for LES and it is surrounded by complex orography, affecting wind distribution. We consider the winter condition when stratification is nearly absent. Two types of time‐varying wind stress are used: spatially homogeneous and spatially inhomogeneous respectively. The analysis of the eddy viscosities shows substantial differences with respect to the ocean case characterized by absence of coastal boundaries and homogeneous, steady wind. The quantities exhibit a noticeable inhomogeneous behavior: the horizontal eddy viscosity is larger in the water body far from the boundaries, whereas the vertical one is larger close to the lateral boundaries due to the presence of a boundary layer. The energetic bottom boundary layer, typically occurring in lakes, is not present. This because of the intrinsic unsteadiness of the thermal wind blowing over the lake and due to the absence of large amplitude internal waves, the latter present only in case of stable stratification. In the inhomogeneous wind case, up‐welling and down‐welling areas are not confined along the shoreline only, but are also generated in the water body due to substantial horizontal velocity divergence, and turbulent mixing, quantified by eddy viscosities, TKE and its dissipation rate, appears enhanced with respect to the homogeneous wind case. Finally, downwelling/upwelling areas along the windward/leeward coastline respectively were observed, whose quantitative estimation may give explanation for the bloom of cyanobacteria at the lake surface observed in winter.
Keywords	coasts ; geophysics ; lakes ; research ; shorelines ; surface water ; viscosity ; wind ; wind stress ; winter ; Italy
Language	English
Dates of publication	2017-06
Size	p. 4704-4722.
Publishing place	John Wiley & Sons, Ltd
Document type	Article
Note	JOURNAL ARTICLE
ZDB-ID	161667-5
ISSN	2169-9291 ; 2169-9275 ; 0148-0227 ; 0196-2256
ISSN (online)	2169-9291
ISSN	2169-9275 ; 0148-0227 ; 0196-2256
DOI	10.1002/2016JC012284
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Article ; Online: Exercise modifies hypothalamic connectivity and brain functional networks in women after bariatric surgery: a randomized clinical trial.

Merege-Filho, Carlos A A / Gil, Saulo S / Kirwan, John P / Murai, Igor H / Dantas, Wagner S / Nucci, Mariana P / Pastorello, Bruno / de Lima, Alisson Padilha / Bazán, Paulo R / Pereira, Rosa M R / de Sá-Pinto, Ana L / Lima, Fernanda R / Brucki, Sonia M D / de Cleva, Roberto / Santo, Marco A / Leite, Claudia da Costa / Otaduy, Maria Concepción García / Roschel, Hamilton / Gualano, Bruno

International journal of obesity (2005)

2022 Volume 47, Issue 3, Page(s) 165–174

Abstract: Background: Obesity is a disease that may involve disrupted connectivity of brain networks. Bariatric surgery is an effective treatment for obesity, and the positive effects on obesity-related conditions may be enhanced by exercise. Herein, we aimed to ... ...

Abstract	Background: Obesity is a disease that may involve disrupted connectivity of brain networks. Bariatric surgery is an effective treatment for obesity, and the positive effects on obesity-related conditions may be enhanced by exercise. Herein, we aimed to investigate the possible synergistic effects of Roux-en-Y Gastric Bypass (RYGB) and exercise training on brain functional networks. Methods: Thirty women eligible for bariatric surgery were randomly assigned to a Roux-en-Y gastric bypass (RYGB: n = 15, age = 41.0 ± 7.3 years) or RYGB plus Exercise Training (RYGB + ET: n = 15, age = 41.9 ± 7.2 years). Clinical, laboratory, and brain functional connectivity parameters were assessed at baseline, and 3 (POST3) and 9 months (POST9) after surgery. The 6-month, three-times-a-week, exercise intervention (resistance plus aerobic exercise) was initiated 3 months post-surgery (for RYGB + ET). Results: Exercise superimposed on bariatric surgery (RYGB + ET) increased connectivity between hypothalamus and sensorial regions (seed-to-voxel analyses of hypothalamic connectivity), and decreased default mode network (DMN) and posterior salience (pSAL) network connectivity (ROI-to-ROI analyses of brain networks connectivity) when compared to RYGB alone (all p-FDR < 0.05). Increases in basal ganglia (BG) network connectivity were only observed in the exercised training group (within-group analyses). Conclusion: Exercise training is an important component in the management of post-bariatric patients and may improve the hypothalamic connectivity and brain functional networks that are involved in controlling food intake. Trial registration: Clinicaltrial.gov: NCT02441361.
MeSH term(s)	Humans ; Female ; Adult ; Middle Aged ; Obesity, Morbid/surgery ; Gastric Bypass ; Bariatric Surgery ; Exercise ; Obesity/surgery ; Brain ; Hypothalamus
Language	English
Publishing date	2022-12-30
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	752409-2
ISSN	1476-5497 ; 0307-0565
ISSN (online)	1476-5497
ISSN	0307-0565
DOI	10.1038/s41366-022-01251-8
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Article ; Online: Assessment of Weight Loss With the Intragastric Balloon in Patients With Different Degrees of Obesity.

Nunes, Gabriel C / Pajecki, Denis / de Melo, Maria E / Mancini, Marcio C / de Cleva, Roberto / Santo, Marco A

Surgical laparoscopy, endoscopy & percutaneous techniques

2017 Volume 27, Issue 4, Page(s) e83–e86

Abstract: Introduction: The intragastric balloon (IGB) is an endoscopic device for the treatment of obesity. Best results are observed in patients who follow a dietary program but few studies have assessed the results of this treatment in patients with different ... ...

Abstract	Introduction: The intragastric balloon (IGB) is an endoscopic device for the treatment of obesity. Best results are observed in patients who follow a dietary program but few studies have assessed the results of this treatment in patients with different degrees of obesity. Aim: The aim of this study is to compare the efficacy of IGB in patients with different degrees of obesity. Method: A total of 2002 patients with IGB were retrospectively evaluated and were divided into groups according to initial body mass index (BMI) range, as follows: group 1, 27 to 29.9 kg/m; group 2, 30 to 34.9 kg/m; group 3, 35 to 39.9 kg/m; group 4, 40 to 44.9 kg/m; group 5, ≥45 kg/m. Weight was assessed in 3 different times: before (T0), 1 month (T1), 6 months (T2), and 6 months after removal of the IGB (T3). Results: A total of 946 patients lost follow-up. Overall, 40 (3.78%) removed the device before programmed by intolerance, and 1016 patients completed the 6-month treatment. The mean weight loss was 18.9%, excess weight loss 60.1% and an BMI reduction of 6.76 points. 6 months after removal of the balloon 842 patients had continued follow-up (82.8%). At this time, weight loss was 19.84%, excess weight loss was 59.49%, and BMI reduction of 7.06 points. In all groups there was statistical difference between the times T0 and T1 and between T1 and T2 (P<0.001). There was no statistical difference between T2 and T3, in any group. Conclusion: IGB provided sustained weight loss in patients who remained in dietary follow-up for 1 year.
Language	English
Publishing date	2017-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	1475108-2
ISSN	1534-4908 ; 1530-4515 ; 1051-7200
ISSN (online)	1534-4908
ISSN	1530-4515 ; 1051-7200
DOI	10.1097/SLE.0000000000000440
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Article ; Online: Influence of Adherence to Social Distancing Due to the COVID-19 Pandemic on Physical Activity Level in Post-bariatric Patients.

Rezende, Diego A N / Pinto, Ana J / Goessler, Karla F / Nicoletti, Carolina F / Sieczkowska, Sofia M / Meireles, Kamila / Esteves, Gabriel P / Genario, Rafael / Oliveira Júnior, Gersiel N / Santo, Marco A / de Cleva, Roberto / Roschel, Hamilton / Gualano, Bruno

Obesity surgery

2020 Volume 31, Issue 3, Page(s) 1372–1375

Abstract: We assessed physical activity using accelerometers and a questionnaire in 33 post-bariatric patients who reported to be adherent (n = 15) or not (n = 18) to social distancing due to the COVID-19 pandemic. Patients adherent to social distancing spent more ...

Abstract	We assessed physical activity using accelerometers and a questionnaire in 33 post-bariatric patients who reported to be adherent (n = 15) or not (n = 18) to social distancing due to the COVID-19 pandemic. Patients adherent to social distancing spent more time in sedentary behavior (1.1 h/day, 0.1, 2.2; p = 0.045) and less time in moderate-to-vigorous physical activity (- 12.2 min/day, - 23.8, - 0.6; p = 0.040) vs. non-adherent ones. Bland-Altman analysis comparing objective and subjective physical activity estimates showed a bias for time spent in sedentary behavior and moderate-to-vigorous activity of 2.8 h/day and 8.5 min/day. In conclusion, post-bariatric patients who were adherent to social distancing measures were more inactive and sedentary than non-adherent ones. Strategies to increase physical activity in post-bariatric patients exposed to social distancing are necessary during the COVID-19 pandemic.
MeSH term(s)	Adult ; Bariatrics ; COVID-19/epidemiology ; Exercise ; Female ; Humans ; Male ; Medication Adherence ; Middle Aged ; Obesity, Morbid/surgery ; Pandemics ; Physical Distancing ; SARS-CoV-2 ; Sedentary Behavior ; Surveys and Questionnaires
Keywords	covid19
Language	English
Publishing date	2020-10-12
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-020-05044-8
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Article ; Online: Factors associated with complications or failure of endoscopic balloon dilation of anastomotic stricture secondary to Roux-en-Y gastric bypass surgery.

de Moura, Eduardo G H / Orso, Ivan R B / Aurélio, Eduardo F / de Moura, Eduardo T H / de Moura, Diogo T H / Santo, Marco A

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

2016 Volume 12, Issue 3, Page(s) 582–586

Abstract: Introduction: Roux-en-Y gastric bypass is a commonly used technique of bariatric surgery. One of the most important complications is gastrojejunal anastomotic stricture. Endoscopic balloon dilation appears to be well tolerated and effective, but well- ... ...

Abstract	Introduction: Roux-en-Y gastric bypass is a commonly used technique of bariatric surgery. One of the most important complications is gastrojejunal anastomotic stricture. Endoscopic balloon dilation appears to be well tolerated and effective, but well-designed randomized, controlled trials have not yet been conducted. Objective: Identify factors associated with complications or failure of endoscopic balloon dilation of anastomotic stricture secondary to Roux-en-Y gastric bypass surgery. Setting: Gastrointestinal endoscopy service, university hospital, Brazil. Methods: The records of 64 patients with anastomotic stricture submitted to endoscopic dilation with hydrostatic balloon dilation were reviewed. Information was collected on gastric pouch length, anastomosis diameter before dilation, number of dilation sessions, balloon diameter at each session, anastomosis diameter after the last dilation session, presence of postsurgical complications, endoscopic complications, and outcome of dilation. Comparisons were made among postsurgical and endoscopic complications; number of dilations, balloon diameter; anastomosis diameter before dilation; and dilation outcome. Results: Success of dilation treatment was 95%. Perforation was positively and significantly associated with the number of dilation sessions (P = .03). Highly significant associations were found between ischemic segment and perforation (P<.001) and between ischemic segment and bleeding (P = .047). Ischemic segment (P = .02) and fistula (P = .032) were also associated with dilation failure. Conclusion: Ischemic segment and fistula were found to be important risk factors for balloon dilation failure. The greater the number of dilation sessions, the greater the number of endoscopic complications.
MeSH term(s)	Adult ; Blood Loss, Surgical ; Constriction, Pathologic/etiology ; Dilatation/adverse effects ; Dilatation/methods ; Endoscopy, Gastrointestinal/adverse effects ; Endoscopy, Gastrointestinal/methods ; Female ; Gastric Balloon/adverse effects ; Gastric Bypass/adverse effects ; Gastric Bypass/methods ; Humans ; Intestinal Perforation/etiology ; Ischemia/etiology ; Jejunal Diseases/etiology ; Jejunum/blood supply ; Male ; Obesity, Morbid/surgery ; Postoperative Complications/etiology ; Recurrence ; Retrospective Studies ; Treatment Failure
Language	English
Publishing date	2016-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2274243-8
ISSN	1878-7533 ; 1550-7289
ISSN (online)	1878-7533
ISSN	1550-7289
DOI	10.1016/j.soard.2015.11.006
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Article ; Online: Erratum. Exercise-Induced Increases in Insulin Sensitivity After Bariatric Surgery Are Mediated By Muscle Extracellular Matrix Remodeling. Diabetes 2020;69:1675-1691.

Diabetes

2021 Volume 70, Issue 6, Page(s) 1415

Language	English
Publishing date	2021-05-11
Publishing country	United States
Document type	Journal Article ; Published Erratum
ZDB-ID	80085-5
ISSN	1939-327X ; 0012-1797
ISSN (online)	1939-327X
ISSN	0012-1797
DOI	10.2337/db21-er06b
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Article: Gut Microbiota Profile of Obese Diabetic Women Submitted to Roux-en-Y Gastric Bypass and Its Association with Food Intake and Postoperative Diabetes Remission

Nutrients. 2020 Jan. 21, v. 12, no. 2

2020

Abstract: Gut microbiota composition is influenced by environmental factors and has been shown to impact body metabolism. Objective: To assess the gut microbiota profile before and after Roux-en-Y gastric bypass (RYGB) and the correlation with food intake and ... ...

Abstract	Gut microbiota composition is influenced by environmental factors and has been shown to impact body metabolism. Objective: To assess the gut microbiota profile before and after Roux-en-Y gastric bypass (RYGB) and the correlation with food intake and postoperative type 2 diabetes remission (T2Dr). Design: Gut microbiota profile from obese diabetic women was evaluated before (n = 25) and 3 (n = 20) and 12 months (n = 14) after RYGB, using MiSeq Illumina-based V4 bacterial 16S rRNA gene profiling. Data on food intake (7-day record) and T2Dr (American Diabetes Association (ADA) criteria) were recorded. Results: Preoperatively, the abundance of five bacteria genera differed between patients with (57%) and without T2Dr (p < 0.050). Preoperative gut bacteria genus signature was able to predict the T2Dr status with 0.94 accuracy ROC curve (receiver operating characteristic curve). Postoperatively (vs. preoperative), the relative abundance of some gut bacteria genera changed, the gut microbial richness increased, and the Firmicutes to Bacteroidetes ratio (rFB) decreased (p < 0.05) regardless of T2Dr. Richness levels was correlated with dietary profile pre and postoperatively, mainly displaying positive and inverse correlations with fiber and lipid intakes, respectively (p < 0.05). Conclusions: Gut microbiota profile was influenced by RYGB and correlated with diet and T2Dr preoperatively, suggesting the possibility to assess its composition to predict postoperative T2Dr.
Keywords	Bacteroidetes ; Firmicutes ; accuracy ; bacteria ; bariatric surgery ; correlation ; design ; environmental factors ; food intake ; genes ; graphs ; intestinal microorganisms ; metabolism ; noninsulin-dependent diabetes mellitus ; nutrients ; patients ; remission ; women
Language	English
Dates of publication	2020-0121
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
Note	NAL-light
ZDB-ID	2518386-2
ISSN	2072-6643
ISSN	2072-6643
DOI	10.3390/nu12020278
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Article ; Online: Exercise Mitigates Bone Loss in Women With Severe Obesity After Roux-en-Y Gastric Bypass: A Randomized Controlled Trial.

Murai, Igor H / Roschel, Hamilton / Dantas, Wagner S / Gil, Saulo / Merege-Filho, Carlos / de Cleva, Roberto / de Sá-Pinto, Ana L / Lima, Fernanda / Santo, Marco A / Benatti, Fabiana B / Kirwan, John P / Pereira, Rosa M / Gualano, Bruno

The Journal of clinical endocrinology and metabolism

2019 Volume 104, Issue 10, Page(s) 4639–4650

Abstract: Context: Bone loss after bariatric surgery potentially could be mitigated by exercise.: Objective: To investigate the role of exercise training (ET) in attenuating bariatric surgery-induced bone loss.: Design: Randomized, controlled trial.: ... ...

Abstract	Context: Bone loss after bariatric surgery potentially could be mitigated by exercise. Objective: To investigate the role of exercise training (ET) in attenuating bariatric surgery-induced bone loss. Design: Randomized, controlled trial. Setting: Referral center for bariatric surgery. Patients: Seventy women with severe obesity, aged 25 to 55 years, who underwent Roux-en-Y gastric bypass (RYGB). Intervention: Supervised, 6-month, ET program after RYGB vs. standard of care (RYGB only). Outcomes: Areal bone mineral density (aBMD) was the primary outcome. Bone microarchitecture, bone turnover, and biochemical markers were secondary outcomes. Results: Surgery significantly decreased femoral neck, total hip, distal radius, and whole body aBMD (P < 0.001); and increased bone turnover markers, including collagen type I C-telopeptide (CTX), procollagen type I N-propeptide (P1NP), sclerostin, and osteopontin (P < 0.05). Compared with RYGB only, exercise mitigated the percent loss of aBMD at femoral neck [estimated mean difference (EMD), -2.91%; P = 0.007;], total hip (EMD, -2.26%; P = 0.009), distal radius (EMD, -1.87%; P = 0.038), and cortical volumetric bone mineral density at distal radius (EMD, -2.09%; P = 0.024). Exercise also attenuated CTX (EMD, -0.20 ng/mL; P = 0.002), P1NP (EMD, -17.59 ng/mL; P = 0.024), and sclerostin levels (EMD, -610 pg/mL; P = 0.046) in comparison with RYGB. Exercise did not affect biochemical markers (e.g., 25(OH)D, calcium, intact PTH, phosphorus, and magnesium). Conclusion: Exercise mitigated bariatric surgery-induced bone loss, possibly through mechanisms involving suppression in bone turnover and sclerostin. Exercise should be incorporated in postsurgery care to preserve bone mass.
MeSH term(s)	Adaptor Proteins, Signal Transducing/metabolism ; Adult ; Bone Density ; Bone Diseases, Metabolic/prevention & control ; Bone Remodeling ; Collagen Type I/metabolism ; Cortical Bone/diagnostic imaging ; Cortical Bone/pathology ; Exercise ; Exercise Therapy/methods ; Female ; Femur Neck/diagnostic imaging ; Gastric Bypass ; Humans ; Middle Aged ; Obesity/surgery ; Organ Size ; Osteopontin/metabolism ; Pelvic Bones/diagnostic imaging ; Peptide Fragments/metabolism ; Peptides/metabolism ; Postoperative Complications/prevention & control ; Procollagen/metabolism ; Radius/diagnostic imaging
Chemical Substances	Adaptor Proteins, Signal Transducing ; Collagen Type I ; Peptide Fragments ; Peptides ; Procollagen ; SOST protein, human ; SPP1 protein, human ; collagen type I trimeric cross-linked peptide ; procollagen Type I N-terminal peptide ; Osteopontin (106441-73-0)
Language	English
Publishing date	2019-07-19
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	3029-6
ISSN	1945-7197 ; 0021-972X
ISSN (online)	1945-7197
ISSN	0021-972X
DOI	10.1210/jc.2019-00074
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