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Biomedical subjects

Nicola Scopinaro

Publications and source records attributed to Nicola Scopinaro.

11 recordsLinked to original sources
PubMed2003

Recovery of insulin sensitivity in obese patients at short term after biliopancreatic diversion.

OBJECTIVE: To gain insight into the specific mechanisms by which biliopancreatic diversion (BPD) can improve insulin action. MATERIALS AND METHODS: Nondiabetic severely obese patients (n=20) undergoing BPD were included. Waist-to-hip ratio and serum concentration of glucose, insulin, and leptin were determined before, at 4-day, and at 2 months after the operation. Insulin sensitivity was calculated according to the homeostatic model assessment (HOMA IR). RESULTS: A marked increase of insulin sensitivity was observed by the fourth day after the operation; at the second postoperative month, when body weight was still in the obese range and the food intake was substantially similar to the preoperative one, a further improvement of insulin action towards normality was found. Moreover, before BPD HOMA IR data were independently correlated both to BMI and waist-to-hip ratio values, whereas at 2 months after the operation data were in positive correlation only with the BMI. DISCUSSION: In obese patients, BPD seems to achieve recovery of insulin sensitivity by specific mechanisms independent of weight loss: the main causes of this sharp improvement might be both the intramyocellular fat depletion and the interruption of enteroinsular axis.

Adult↗
PubMed2003

A new approach to the fashioning of the gastroenteroanastomosis in laparoscopic standard biliopancreatic diversion.

A retrocolic submesocolic approach was used for creating the gastroenteroanastomosis in 42 consecutive patients who underwent laparoscopic biliopancreatic diversion for obesity. The surgical technique is described in detail. The laparoscopic gastroenteroanastomosis was successfully performed on all the operated patients, with no intraoperative complications requiring conversion to open surgery and no immediate or late postoperative morbidity related to the anastomosis.

Adult↗
PubMed2003

Leptin and insulin action in severely obese women.

BACKGROUND: The authors investigated the interrelationships between the components of the metabolic syndrome in severe obesity. METHODS: In non-diabetic, severely obese women, the degree of obesity (BMI), the insulin sensitivity (from the Homeostatic Model of Assessment, HOMA), the serum leptin concentration and the presence of dyslipidemia and arterial hypertension were evaluated. RESULTS: In insulin-resistant patients, an overall impaired metabolic status and a greater cardiovascular risk were observed, while serum leptin concentration was higher than in the insulin-sensitive ones. Leptin levels and HOMA data correlated independent of BMI findings, while the presence of dyslipidemia and hypertension was unrelated to the other metabolic syndrome factors. CONCLUSION: In severely obese women, although other factors independently intervene, serum leptin has a role in developing the metabolic syndrome.

Female↗
PubMed2002

Relationships of serum leptin to clinical and anthropometric findings in obese patients.

BACKGROUND: The authors evaluated the relationship between leptin and the clinical, anthropometric and metabolic variables connected to the metabolic syndrome in obese individuals. METHODS: A large group of patients with different degrees of obesity was investigated: body mass index (BMI) values, serum leptin, fasting glucose and insulin, triglycerides and HDL-cholesterol concentrations, insulin resistance index and blood pressure were measured. RESULTS: On multiple regression analysis, serum leptin levels appeared to be positively correlated to the BMI and to the serum HDL-cholesterol concentration. Principal component factor analysis revealed three factors, explaining 61.3% of the total variance of the sample. General features of these factors were: factor 1--BMI values and serum leptin and fasting glucose concentration; factor 2--systolic and diastolic blood pressure and serum triglycerides and HDL-cholesterol concentration; factor 3--fasting serum insulin concentration and insulin resistance index. CONCLUSIONS: In obese subjects multiple factors underlie the metabolic syndrome and therefore more than one mechanism may account for the clustering characteristics. In obese patients leptin loads only one factor, and therefore leptin does not appear to be a key feature in the metabolic syndrome. On the contrary, multiple correlation and factor analysis data give rise to the hypothesis that in obese patients, leptin may play a protective role against cardiovascular risk.

Adolescent↗
PubMed2002

Laparoscopic standard biliopancreatic diversion: technique and preliminary results.

BACKGROUND: A technique for standard laparoscopic BPD was developed. METHODS: Standard laparoscopic BPD was performed in 26 morbidly obese patients with mean BMI 43. Details of the technique, using 6 trocars, and instrumentation are described. Intestinal limb lengths were measured fully stretched, and the gastric remnant volume was also measured. Both enteroenteral and gastrointestinal anastomoses were fashioned with a side-to-side technique using the endoGIA, the conjoined defect being closed with a manual running seromuscular suture. RESULTS: 6 and 12 month weight loss results were similar to those obtained in open BPD. CONCLUSION: Laparoscopic standard BPD is a feasible alternative to the open operative procedure, the major advantage being the likely near total avoidance of wound hernia.

Adult↗
PubMed2002

Radiology of patients with vertical banded gastroplasty.

BACKGROUND: The authors evaluated the usefulness of routine traditional radiology in the management of patients submitted to VBG. METHODS: Radiological findings in 65 subjects who had undergone VBG were evaluated. Post-surgical clinical and radiological examinations were performed 3 days, 1, 4 and 12 months after surgery. Upper GI symptoms, gastroesophageal imaging and 80% solid meal pouch emptying time were recorded. RESULTS: The routine postoperative study, in the absence of clinical symptoms, showed no unsuspected complication in any patient, both in the early and in the late postoperative period. There was no significant correlation at 4 and 12 months between emptying time and duration of satiation, emptying time and percent excess weight loss (%EWL), and duration of satiation and %EWL. CONCLUSIONS: Traditional radiological studies can be safely omitted from both the immediate postoperative period and from the long-term follow-up in asymptomatic VBG patients. The studies were not helpful in understanding functional changes leading to weight loss after VBG.

Adult↗
PubMed2002

Laparoscopic standard biliopancreatic diversion: technique and preliminary results.

BACKGROUND: A technique for standard laparoscopic BPD was developed. METHODS: Standard laparoscopic BPD was performed in 26 morbidly obese patients with mean BMI 43. Details of the technique, using 6 trocars, and instrumentation are described. Intestinal limb lengths were measured fully stretched, and the gastric remnant volume was also measured. Both enteroenteral and gastrointestinal anastomoses were fashioned with a side-to-side technique using the endoGIA, the conjoined defect being closed with a manual running seromuscular suture. RESULTS: 6 and 12 month weight loss results were similar to those obtained in open BPD. CONCLUSION: Laparoscopic standard BPD is a feasible alternative to the open operative procedure, the major advantage being the likely near total avoidance of wound hernia.

Adult↗
PubMed2000

Laparoscopic BPD.

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Journal Article↗
PubMedDate not supplied

Night eating in obesity: a descriptive study.

OBJECTIVE: We investigated the frequency of night eating (NE) among obese patients, its biological correlates, and its relationships with binge eating disorder (BED). METHODS: The eating behaviors of 166 patients enrolled in a weight-loss program were evaluated by a clinical interview specifically designed to detect BED and NE and by the Three Factor Eating Questionnaire. In all cases body weight and resting energy expenditure were measured. RESULTS: Among all obese subjects, NE was observed in 18 cases (15.7%) and BED in 54 cases (32.5%). NE was more frequent among BED than among non-BED patients; however, in the BED patients the Three Factor Eating Questionnaire Disinhibition and Hunger scores were higher than those in non-BED and NE individuals. Further, between NE and non-NE subjects with similar body weights, fully comparable resting energy expenditure was observed, indirectly indicating the lack of difference in overall daily food intake. CONCLUSIONS: Although these behaviors may well overlap, the data of this study uphold the concept that NE and BED have different underlying behavioral constructs.

Adipose Tissue↗