Chronobiological related factors and weight loss evolution in severe obese patients undergoing bariatric surgery
Currently, the most effective treatment for severe obesity resulting in a large and marked weight loss is bariatric surgery (BS) (Courcoulas, AP et al. 2013).However, several studies have shown that weight loss outcomes after bariatric surgery can vary widely among patients and a sizable portion of...
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| Format: | doctoral thesis |
| Status: | Published version |
| Publication Date: | 2016 |
| Country: | España |
| Institution: | CBUC, CESCA |
| Repository: | TDR. Tesis Doctorales en Red |
| OAI Identifier: | oai:www.tdx.cat:10803/403987 |
| Online Access: | http://hdl.handle.net/10803/403987 |
| Access Level: | Open access |
| Keyword: | Cronobiologia Cronobiología Chronobiology Aprimament Adelgazamiento Weight loss Cirurgia de l'obesitat Cirugía de la obesidad Obesity surgery Hàbits alimentaris Hábitos alimenticios Food habits Ciències de la Salut 663/664 |
| Summary: | Currently, the most effective treatment for severe obesity resulting in a large and marked weight loss is bariatric surgery (BS) (Courcoulas, AP et al. 2013).However, several studies have shown that weight loss outcomes after bariatric surgery can vary widely among patients and a sizable portion of them present a relative poor weight loss response (Christou, NV et al. 2006;Courcoulas, AP et al. 2013). The reasons why patients do not achieve success in terms of weight loss after a bariatric surgery are still largely unknown. Recent evidence has shown an association between weight loss- resistance in obesity and factors related with chronobiology such as the individual chronotype; a set of polymorphisms of the CLOCK; and external synchronizing factors such as the timing of food intake(Garaulet, M et al. 2010; Garaulet, M et al. 2011;Garaulet, M et al. 2012; Garaulet, M et al. 2013 López-Guimerà,G et al 2014).Chronobiology is a relatively new area of research that studies the biological rhythms, which are found throughout the living organism(Levandovski, R. et al 2013). Despite the increasing body of literature on this field, there is no evidence that chronobiology related factors may influence the weight loss outcome in subjects undergoing bariatric surgery. The following work aims to elucidate the role of chronobiological related factors in obesity and weight loss evolution in patients that underwent the two currently more common bariatric surgery techniques: Roux-en-Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG). In order to test our hypothesis we have evaluated data from a severely obese cohort of patients that went through bariatric surgery at Hospital Clinic from 2009-2011. We evaluated weight loss evolution after RYGB and SG, and a set of internal and external chronobiology related factors such as CLOCK 3111T/C SNP, individual chronotype and the time of food intake. Our results suggest that the high inter-individual variability of the weight loss response to RYGB and SG at mid-term following could be depicted by distinct patterns of weight loss. Interesting poor weight loss can be illustrated by two different patterns: 1) primary poor weight loss characterized by poor weight loss response throughout follow up 2) secondarily poor weight loss pattern characterized by significant weight loss but subsequent weight. Also we shown that evening chronotype is associated with initial obesity and to weight loss evolution in severe obese patients after BS. In addition, we found that carriers of the risk allele C in CLOCK 3111T/C with more evening type showed a higher body weight compared with more morning type subjects. Moreover, we have found that the percentage of late lunch eaters was significantly higher in the primarily poor weight loss responders. Interestingly these differences in weight loss evolution could not being explained in differences in energy intake, dietary composition, circadian preference and sleep duration. Our results imply that genetic and circadian assessment could provide tailored weight loss recommendations even in subjects that undergo bariatric surgery. Moreover, the timing of food intake also is important for weight regulation and eating at the right time, and may be a relevant factor to considerer in weight loss therapies including bariatric surgery. |
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