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Article: Gut Microbiome and Metabolites in Patients with NAFLD and after Bariatric Surgery: A Comprehensive Review.

Hoozemans, Jacqueline / de Brauw, Maurits / Nieuwdorp, Max / Gerdes, Victor

2021 Volume 11, Issue 6

Abstract: The prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing, as are other manifestations of metabolic syndrome such as obesity and type 2 diabetes. NAFLD is currently the number one cause of chronic liver disease worldwide. The ... ...

Abstract	The prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing, as are other manifestations of metabolic syndrome such as obesity and type 2 diabetes. NAFLD is currently the number one cause of chronic liver disease worldwide. The pathophysiology of NAFLD and disease progression is poorly understood. A potential contributing role for gut microbiome and metabolites in NAFLD is proposed. Currently, bariatric surgery is an effective therapy to prevent the progression of NAFLD and other manifestations of metabolic syndrome such as obesity and type 2 diabetes. This review provides an overview of gut microbiome composition and related metabolites in individuals with NAFLD and after bariatric surgery. Causality remains to be proven. Furthermore, the clinical effects of bariatric surgery on NAFLD are illustrated. Whether the gut microbiome and metabolites contribute to the metabolic improvement and improvement of NAFLD seen after bariatric surgery has not yet been proven. Future microbiome and metabolome research is necessary for elucidating the pathophysiology and underlying metabolic pathways and phenotypes and providing better methods for diagnostics, prognostics and surveillance to optimize clinical care.
Language	English
Publishing date	2021-05-31
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662251-8
ISSN	2218-1989
ISSN	2218-1989
DOI	10.3390/metabo11060353
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Mapping Conscience: Network Analysis Into the Differences in Maturation of Offending and Non-Offending Adolescents.

de Brauw, Maurits / Popma, Arne / Peen, Jaap / Peters, Carel / Schalkwijk, Frans

International journal of offender therapy and comparative criminology

2022 , Page(s) 6624X221132233

Abstract: Conscience is a diagnostically relevant concept in forensic psychiatry, but often misinterpreted as an all-or-none phenomenon. We conceptualize the conscience as a psychic function in which elements like empathy, self-conscience emotions such as shame, ... ...

Abstract	Conscience is a diagnostically relevant concept in forensic psychiatry, but often misinterpreted as an all-or-none phenomenon. We conceptualize the conscience as a psychic function in which elements like empathy, self-conscience emotions such as shame, guilt and pride, and moral orientation work together. The differences in conscience functioning can be described in terms of developmental levels of integration. We conducted network analyses on data collected via a questionnaire survey held among 52 offending and 243 non-offending juveniles. We displayed two networks: One representing the non-offenders' normative and one representing the offenders' defiantly maturing conscience. As was hypothesized, in the non-offenders network, almost all elements clustered into one clinically meaningful network, indicating integration of the different elements of the normative maturing conscience. In the offenders network, the correlations between the elements were sporadic, indicating a lack of integration of the defiantly maturing conscience. The difference between the two networks was more prominent for empathy and moral orientation than for self-conscious emotions. This research supports the theory of differences in maturation of conscience instead of being an all-or-none phenomenon and calls for further research, taking a deeper look at the significance of integration of the conscience and its implications for offending behaviour.
Language	English
Publishing date	2022-12-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	218274-9
ISSN	1552-6933 ; 0306-624X
ISSN (online)	1552-6933
ISSN	0306-624X
DOI	10.1177/006624X221132233
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Article ; Online: Efficacy and safety of revisional treatments for weight regain or insufficient weight loss after Roux-en-Y gastric bypass: A systematic review and meta-analysis.

Franken, Rutger J / Franken, Josephine / Sluiter, Nina R / de Vries, Ralph / Euser, Sjoerd / Gerdes, Victor E A / de Brauw, Maurits

Obesity reviews : an official journal of the International Association for the Study of Obesity

2023 Volume 24, Issue 10, Page(s) e13607

Abstract: Weight regain or inadequate weight loss following Roux-en-Y gastric bypass poses a significant clinical challenge. Our objective was to evaluate various revisional techniques for addressing weight regain and insufficient weight loss after Roux-en-Y ... ...

Abstract	Weight regain or inadequate weight loss following Roux-en-Y gastric bypass poses a significant clinical challenge. Our objective was to evaluate various revisional techniques for addressing weight regain and insufficient weight loss after Roux-en-Y gastric bypass through a systematic review and meta-analysis. We performed a literature search (in PubMed and Embase) on revisional interventions in collaboration with a medical information specialist. Measured outcomes included body mass index at intervention, total weight loss during follow-up, and complications. Random effects models were used to determine pooled effect size and corresponding 95% confidence intervals. Thirty-nine studies were included: four studies reported on argon plasma coagulation, four studies on transoral outlet reduction, nine studies on transoral outlet reduction + argon plasma coagulation, four studies on pouch/gastrojejunal anastomosis revision, five on laparoscopic gastric banding, two studies on laparoscopic gastric banding + pouch resizing, 10 on distalization-RYGB, and one on duodenal switch. All techniques resulted in short-term clinically relevant weight loss. Endoscopic procedures had a short follow-up and resulted in modest and temporary weight loss. Surgical revision techniques were successful for weight loss in longer term follow-up, at the expense of high complication rates.
MeSH term(s)	Humans ; Gastric Bypass/methods ; Obesity, Morbid/surgery ; Bariatric Surgery ; Reoperation/methods ; Laparoscopy/methods ; Weight Loss ; Weight Gain ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2023-07-28
Publishing country	England
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	2147980-X
ISSN	1467-789X ; 1467-7881
ISSN (online)	1467-789X
ISSN	1467-7881
DOI	10.1111/obr.13607
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Article ; Online: Efficacy and safety of revisional treatments for weight regain or insufficient weight loss after Roux‐en‐Y gastric bypass: A systematic review and meta‐analysis

Franken, Rutger J. / Franken, Josephine / Sluiter, Nina R. / De Vries, Ralph / Euser, Sjoerd / Gerdes, Victor E. A. / de Brauw, Maurits

Obesity Reviews. 2023 Oct., v. 24, no. 10 p.e13607-

2023

Abstract: Weight regain or inadequate weight loss following Roux‐en‐Y gastric bypass poses a significant clinical challenge. Our objective was to evaluate various revisional techniques for addressing weight regain and insufficient weight loss after Roux‐en‐Y ... ...

Abstract	Weight regain or inadequate weight loss following Roux‐en‐Y gastric bypass poses a significant clinical challenge. Our objective was to evaluate various revisional techniques for addressing weight regain and insufficient weight loss after Roux‐en‐Y gastric bypass through a systematic review and meta‐analysis. We performed a literature search (in PubMed and Embase) on revisional interventions in collaboration with a medical information specialist. Measured outcomes included body mass index at intervention, total weight loss during follow‐up, and complications. Random effects models were used to determine pooled effect size and corresponding 95% confidence intervals. Thirty‐nine studies were included: four studies reported on argon plasma coagulation, four studies on transoral outlet reduction, nine studies on transoral outlet reduction + argon plasma coagulation, four studies on pouch/gastrojejunal anastomosis revision, five on laparoscopic gastric banding, two studies on laparoscopic gastric banding + pouch resizing, 10 on distalization‐RYGB, and one on duodenal switch. All techniques resulted in short‐term clinically relevant weight loss. Endoscopic procedures had a short follow‐up and resulted in modest and temporary weight loss. Surgical revision techniques were successful for weight loss in longer term follow‐up, at the expense of high complication rates.
Keywords	bariatric surgery ; body mass index ; coagulation ; meta-analysis ; obesity ; systematic review ; weight loss
Language	English
Dates of publication	2023-10
Publishing place	John Wiley & Sons, Ltd
Document type	Article ; Online
Note	REVIEW
ZDB-ID	2147980-X
ISSN	1467-789X ; 1467-7881
ISSN (online)	1467-789X
ISSN	1467-7881
DOI	10.1111/obr.13607
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Pancreatitis following bariatric surgery.

Baran, Kiran Chandni / de Brauw, Maurits

BMC surgery

2019 Volume 19, Issue 1, Page(s) 77

Abstract: Background: The laparoscopic Roux-en-Y gastric bypass (LRYGBP) is the second most performed bariatric surgical procedure. With the increasing number of patients undergoing bariatric surgery, the number of complications is also growing. Early diagnosis ... ...

Abstract	Background: The laparoscopic Roux-en-Y gastric bypass (LRYGBP) is the second most performed bariatric surgical procedure. With the increasing number of patients undergoing bariatric surgery, the number of complications is also growing. Early diagnosis and treatment of the complications is crucial. Case presentation: A very unusual complication was met after an uneventful laparoscopic gastric bypass (LGBP) procedure due to an obstructing blood clot in the biliairy limb resulting in an acute pancreatitis and gastric distention, accompanied by an obstructing blood clot in the distal ileum causing small bowel obstruction. A review of the occurrence of these complications and the diagnosis and treatment is presented. Conclusion: Post-bariatric acute pancreatitis is uncommon, but could be fatal. Blood clots should be considered as possible causes of small bowel obstruction, ileus or pancreatitis.
MeSH term(s)	Adult ; Female ; Gastric Bypass/adverse effects ; Humans ; Ileal Diseases/diagnostic imaging ; Ileal Diseases/etiology ; Ileal Diseases/therapy ; Intestinal Obstruction/diagnostic imaging ; Intestinal Obstruction/etiology ; Intestinal Obstruction/therapy ; Laparoscopy/adverse effects ; Obesity, Morbid/surgery ; Pancreatitis/diagnostic imaging ; Pancreatitis/etiology ; Pancreatitis/therapy ; Postoperative Complications/diagnostic imaging ; Postoperative Complications/etiology ; Postoperative Complications/therapy ; Tomography, X-Ray Computed
Language	English
Publishing date	2019-07-05
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2050442-1
ISSN	1471-2482 ; 1471-2482
ISSN (online)	1471-2482
ISSN	1471-2482
DOI	10.1186/s12893-019-0532-6
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Article ; Online: Variation in HbA1c in Patients with Obesity and type 2 Diabetes Mellitus 12 months after Laparoscopic One-Anastomosis Gastric Bypass and Laparoscopic Roux-en-Y Gastric Bypass: a Retrospective Matched Cohort Study.

van Rijswijk, Anne-Sophie / Meijnikman, Abraham S / Mikdad, Sarah / Hutten, Barbara A / van der Peet, Donald L / van de Laar, Arnold W / Gerdes, Victor E A / de Brauw, Maurits

Obesity surgery

2024 Volume 34, Issue 3, Page(s) 940–946

Abstract: Background: Glycemic control is an important goal of bariatric surgery in patients with type 2 diabetes mellitus (T2DM) and obesity. The laparoscopic one-anastomosis gastric bypass (OAGB) has potential metabolic benefits over the laparoscopic Roux-en-Y ... ...

Abstract	Background: Glycemic control is an important goal of bariatric surgery in patients with type 2 diabetes mellitus (T2DM) and obesity. The laparoscopic one-anastomosis gastric bypass (OAGB) has potential metabolic benefits over the laparoscopic Roux-en-Y gastric bypass (RYGB). Aim of this study is to examine whether RYGB or OAGB grants better glycemic control 12 months post-surgery. Methods: For this retrospective cohort study, patients with T2DM and obesity, who underwent primary OAGB between 2008 and 2017 were reviewed. For each OAGB patient, three primary RYGB patients were matched for age, gender and body mass index (BMI). Glycemic control was expressed by the glycated hemoglobin (HbA1c), which was measured pre- and 12 months post-operatively. Weight loss was reported in percentage total weight loss (%TWL). Results: A total of 152 patients, of whom 38 had OAGB and 114 RYGB, were included. Mean (standard deviation (SD)) HbA1c was 7.49 (1.51)% in the OAGB group and 7.56(1.23)% in the RYGB group at baseline. Twelve months after surgery the mean (SD) HbA1c dropped to 5.73 (0.71)% after OAGB and 6.09 (0.76)% after RYGB (adjusted p = 0.011). The mean (SD) BMI was reduced from 42.5(6.3) kg/m Conclusion: This study indicates that OAGB leads to lower HbA1c one year after surgery compared to RYGB, without a difference in weight loss. Prospective (randomized) studies are needed to ascertain the most optimal metabolic treatment for patients with obesity and T2DM.
MeSH term(s)	Humans ; Gastric Bypass/adverse effects ; Obesity, Morbid/surgery ; Glycated Hemoglobin ; Retrospective Studies ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/surgery ; Prospective Studies ; Cohort Studies ; Obesity/surgery ; Obesity/etiology ; Laparoscopy ; Weight Loss
Chemical Substances	Glycated Hemoglobin
Language	English
Publishing date	2024-02-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-024-07067-x
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Article ; Online: Treatment Options for Weight Regain or Insufficient Weight Loss After Sleeve Gastrectomy: a Systematic Review and Meta-analysis.

Franken, Rutger J / Sluiter, Nina R / Franken, Josephine / de Vries, Ralph / Souverein, Dennis / Gerdes, Vitor E A / de Brauw, Maurits

Obesity surgery

2022 Volume 32, Issue 6, Page(s) 2035–2046

Abstract: Weight failure after sleeve gastrectomy (SG) is frequently observed. Consensus on the most effective treatment is lacking. The aim of this meta-analysis was to assess revisional strategies for weight regain (WR) or insufficient weight loss (IWL) ... ...

Abstract	Weight failure after sleeve gastrectomy (SG) is frequently observed. Consensus on the most effective treatment is lacking. The aim of this meta-analysis was to assess revisional strategies for weight regain (WR) or insufficient weight loss (IWL) following SG. The included studies reported on endoscopic gastroplasty (ESG), re-sleeve gastrectomy (re-SG), Roux-en-Y gastric bypass (RYGB), one-anastomosis gastric bypass (OAGB), single-anastomosis duodeno-ileal bypass (SADI), and duodenal switch (DS). All techniques resulted in clinically relevant weight loss. Although our data suggest that revisional OAGB was the most effective procedure, the lack of direct comparisons precludes strong conclusions. All procedures were feasible but differed regarding complication rates. Choice of procedure is depending on patient's characteristics and surgeons' expertise.
MeSH term(s)	Gastrectomy/adverse effects ; Gastrectomy/methods ; Gastric Bypass/methods ; Humans ; Obesity, Morbid/surgery ; Reoperation ; Retrospective Studies ; Weight Gain ; Weight Loss
Language	English
Publishing date	2022-04-02
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Review ; Systematic Review
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-022-06020-0
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Article ; Online: Identifying Gut Microbiota associated with Gastrointestinal Symptoms upon Roux-en-Y Gastric Bypass.

Wijdeveld, Madelief / van Olst, Nienke / van der Vossen, Eduard W J / de Brauw, Maurits / Acherman, Yair I Z / de Goffau, Marcus C / Gerdes, Victor E A / Nieuwdorp, Max

Obesity surgery

2023 Volume 33, Issue 6, Page(s) 1635–1645

Abstract: Purpose: Roux-en-Y gastric bypasses (RYGB) are frequently accompanied by long-term gastrointestinal (GI) symptoms. Direct mechanistic insight into the causation of these symptoms is lacking, but changes in the intestinal microbiome have been proposed to ...

Abstract	Purpose: Roux-en-Y gastric bypasses (RYGB) are frequently accompanied by long-term gastrointestinal (GI) symptoms. Direct mechanistic insight into the causation of these symptoms is lacking, but changes in the intestinal microbiome have been proposed to play a role. With this study, we aimed to investigate whether a microbial predisposition exists before RYGB which is associated with GI symptoms during follow-up and to evaluate which microbial groups are involved. Materials and methods: In total, 67 RYGB patients were included. Shotgun metagenomic sequencing was performed on fecal samples obtained just before and 1 year after surgery. To assess GI symptoms, patients filled out Gastrointestinal Quality of Life Index (GIQLI) questionnaires and were divided into groups based on their total GIQLI score and change in score (postsurgery versus baseline). Extremely randomized tree predictor models were used to identify the most distinctive microbial species associated with postoperative GI symptoms. Results: Beta diversity differed significantly between baseline and 1-year post-surgery samples, with the post-surgery microbiome resembling a more dysbiotic profile. The most predictive species regarding total GIQLI (AUC 0.77) or delta GIQLI score (AUC 0.83) were identified. Many of these species are known butyrate producers or species known to support them and/or species with anti-inflammatory properties, including Coprococcus eutactus, Faecalibacterium prausnitzii, and Ruminococcus callidus. Conclusion: Beneficial commensal gut microbiota related to a high GI score were associated to adequate intestinal fermentative capacity, suggesting these species might have protective properties against postoperative GI malfunctioning.
MeSH term(s)	Humans ; Gastric Bypass/adverse effects ; Gastrointestinal Microbiome ; Obesity, Morbid/surgery ; Quality of Life ; Microbiota
Language	English
Publishing date	2023-04-24
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/s11695-023-06610-6
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Article ; Online: Pancreatic exocrine insufficiency after bariatric surgery.

Guman, Maimoena S S / van Olst, Nienke / Yaman, Zehra G / Voermans, Rogier P / de Brauw, Maurits L / Nieuwdorp, Max / Gerdes, Victor E A

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

2021 Volume 18, Issue 4, Page(s) 445–452

Abstract: Background: Chronic abdominal complaints after bariatric surgery may be explained by pancreatic exocrine insufficiency (PEI).: Objectives: We aimed to evaluate the clinical value of the Pancreatic Exocrine Insufficiency Questionnaire (PEI-Q) as a ... ...

Abstract	Background: Chronic abdominal complaints after bariatric surgery may be explained by pancreatic exocrine insufficiency (PEI). Objectives: We aimed to evaluate the clinical value of the Pancreatic Exocrine Insufficiency Questionnaire (PEI-Q) as a screening tool to identify patients with a high probability of having PEI. Setting: Outpatient clinic for bariatric surgery. Methods: Patients scheduled for a screening or follow-up appointment were asked to complete the PEI-Q and the Gastrointestinal Quality of Life Index questionnaire (GIQLI). Postoperative patients with a high PEI-Q score (0,6) were offered a fecalelastase (FE) test (abnormal if <200 μg/g). Results: Between June 2020 and February 2021, a total of 1600 of 1629 PEI-Qs were completed, 1073 (67%) of which after surgery. The postoperative group consisted mostly of females (81.9%), aged 49.0 ± 10.6 years, with a total weight loss of 30.3% ± 8.8%. Among them, 63.4% had abnormal PEI-Q scores compared with 34.9% before surgery (P < .01). In contrast, the median GIQLI score increased (119 [interquartile range (IQR), 107-129.25] versus 110 [IQR, 95-121.75]) before surgery (P < .01). Additionally, 310 FE tests were performed, of which only 11.9% was suggestive of PEI. No correlation was found between the PEI-Q scores and FE levels (c-index .55). Conclusion: The PEI-Q in its current version is not able to distinguish complaints of PEI and bariatric surgery itself and therefore cannot be used as a screening tool for PEI. The specificity of the FE test seems to be reduced after surgery. Future research should include a more direct pancreatic function test, which may provide more insight into PEI after bariatric surgery.
MeSH term(s)	Adult ; Bariatric Surgery/adverse effects ; Exocrine Pancreatic Insufficiency/diagnosis ; Exocrine Pancreatic Insufficiency/etiology ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Surveys and Questionnaires ; Weight Loss
Language	English
Publishing date	2021-12-22
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.2021.12.017
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Article ; Online: Weight Loss Results and Compliance with Follow-up after Bariatric Surgery.

Reiber, Beata M M / Leemeyer, Anna-Marie R / Bremer, Marjolein J M / de Brauw, Maurits / Bruin, Sjoerd C

Obesity surgery

2021 Volume 31, Issue 8, Page(s) 3606–3614

Abstract: Purpose: The importance of follow-up (FU) for midterm weight loss (WL) after bariatric surgery is controversial. Compliance to this FU remains challenging. Several risk factors for loss to FU (LtFU) have been mentioned. The aim was therefore to evaluate ...

Abstract	Purpose: The importance of follow-up (FU) for midterm weight loss (WL) after bariatric surgery is controversial. Compliance to this FU remains challenging. Several risk factors for loss to FU (LtFU) have been mentioned. The aim was therefore to evaluate the association between WL and LtFU 3 to 5 years postoperatively and to identify risk factors for LtFU. Materials and methods: A single-center cross-sectional study in the Netherlands. Between June and October 2018, patients scheduled for a 3-, 4-, or 5-year FU appointment were included into two groups: compliant (to their scheduled appointment and overall maximally 1 missed appointment) and non-compliant (missed the scheduled appointment and at least 1 overall). Baseline, surgical, and FU characteristics were collected and a questionnaire concerning socio-economic factors. Results: In total, 217 patients in the compliant group and 181 in the non-compliant group were included with a median body mass index at baseline of 42.0 and 42.9 respectively. Eighty-eight percent underwent a laparoscopic Roux-en-Y gastric bypass. The median percentage total weight loss for the compliant and non-compliant groups was 30.7% versus 28.9% at 3, 29.3% versus 30.2% at 4, and 29.6% versus 29.9% at 5 years respectively, all p>0.05. Age, persistent comorbidities and vitamin deficiencies, a yearly salary <20,000 euro, no health insurance coverage, and not understanding the importance of FU were risk factors for LtFU. Conclusion: Three to 5 years postoperatively, there is no association between LtFU and WL. The compliant group demonstrated more comorbidities and vitamin deficiencies. Younger age, not understanding the importance of FU, and financial challenges were risk factors for LtFU.
MeSH term(s)	Bariatric Surgery ; Body Mass Index ; Cross-Sectional Studies ; Follow-Up Studies ; Gastrectomy ; Gastric Bypass ; Humans ; Laparoscopy ; Netherlands/epidemiology ; Obesity, Morbid/surgery ; Retrospective Studies ; Treatment Outcome ; Weight Loss
Language	English
Publishing date	2021-05-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-021-05450-6
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