IMPACT OF ROUX-EN-Y GASTRIC BYPASS SURGERY (RYGB) ON METABOLIC SYNDROME COMPONENTS AND ON THE USE OF ASSOCIATED DRUGS IN OBESE PATIENTS

ABSTRACT BACKGROUND The prevalence of obesity and metabolic syndrome is increasing worldwide and both behavior modification and drug therapy have low adherence. Gastric bypass has shown effective results in both reducing weight and improving comorbidities. OBJECTIVE To evaluate the impact of Roux-en-Y Gastric Bypass Surgery (RYGB) on both metabolic syndrome components and the use of associated drugs in obese patients. METHODS Historical cohort of patients subjected to Roux-en-Y Gastric Bypass Surgery (RYGB) between January 2007 and March 2014 in a private clinic. The sample consisted of 273 obese class II and III individuals, 86.4% of whom were female, with age ≥20 years, followed up for 2 months after surgery. Sociodemographic, anthropometric, biochemical, clinical, and drug-use data were collected from patients’ medical records. RESULTS Significant differences were found in weight, body mass index and waist circumference, after 60 postoperative days. Components for metabolic syndrome diagnosis (hypertension P=0.001; hyperglycemia P<0.001; hypertriglyceridemia P=0.006) were reduced after 60 days of postoperative, with the exception HDL-c (P=0.083). There was a significant reduction in the use of antihypertensive (P<0.001), hypoglycemic (P=0.013), lipid lowering (P<0.001), and antiobesity (P=0.010) drugs and increased use of gastroprotective drugs, vitamins, and minerals (P<0.001) after 60 postoperative days. CONCLUSION Patients subjected to Roux-en-Y Gastric Bypass Surgery exhibited both weight loss and significant improvement not only in metabolic syndrome components (except for HDL-c) but in the use of drugs associated with obesity and metabolic syndrome

Cigarette smoke exposure severely reduces peripheral insulin sensitivity without changing GLUT4 expression in oxidative muscle of Wistar rats

OBJETIVO: Avaliar o efeito da exposição à fumaça de cigarro e do treinamento de corrida em esteira rolante sobre a expressão do transportador de glicose GLUT4 no músculo oxidativo solear de ratos. MATERIAIS E MÉTODOS: Ratos Wistar foram divididos em: (C) controle, (E) exercitado, (SS) fumante sedentário e (ES) fumante exercitado. Foram realizados testes de tolerância à insulina, Western Blotting e RT-PCR para avaliação da expressão de GLUT4. RESULTADOS: O grupo SS apresentou menor sensibilidade à insulina, com redução de proteína GLUT4 na membrana plasmática (MP), sem alteração na fração microssomal, e conteúdo de RNAm aumentado. O treinamento reverteu esse quadro. Nenhuma intervenção alterou o conteúdo total de GLUT4 no músculo oxidativo. CONCLUSÃO: Esses resultados sugerem que o fumo estimula a transcrição de GLUT4 sem alterar o conteúdo total de proteína, porém prejudica a capacidade de translocação para a MP. Já o treinamento em esteira parece, mesmo sob influência do cigarro, reduzir seus efeitos deletérios.OBJECTIVE: To evaluate the effect of exposure to cigarette smoke and running training on a treadmill on the expression of glucose transporter GLUT4 in oxidative soleus muscle of rats. MATERIALS and METHODS: Wistar rats were divided into: (C) control, (E) exercise control, (SS), sedentary smoker, and (ES) exercise smoker. Insulin Tolerance Test, Western blotting, and RT-PCR were performed for the evaluation of GLUT4 levels. RESULTS: The SS group presented lower insulin sensitivity with reduced GLUT4 protein in the plasma membrane (PM), no changes in the microsomal fraction, but increased mRNA content. Training reversed this condition. No intervention altered total GLUT4 content of the oxidative muscle. CONCLUSION: These results suggest that passive smoking stimulates GLUT4 transcription without changing total protein content, but impairs the ability of GLUT4 translocation to the PM. on the other hand, training seems to reduce the deleterious effects, even under the influence of cigarette smoking.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Estadual Paulista (Unesp) School of Science and Technology Department of Physical TherapyUniversidade de São Paulo (USP) Institute of Biomedical Sciences Department of Physiology and BiophysicsUniversidade Estadual Paulista (Unesp) School of Science and Technology Department of Physical TherapyFAPESP: 04/10130-0FAPESP: 08/01955-6FAPESP: 08/10886-8FAPESP: 08/09328-