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Bariatric surgery and long-term cardiovascular events.

https://arctichealth.org/en/permalink/ahliterature128246
Source
JAMA. 2012 Jan 4;307(1):56-65
Publication Type
Article
Date
Jan-4-2012
Author
Lars Sjöström
Markku Peltonen
Peter Jacobson
C David Sjöström
Kristjan Karason
Hans Wedel
Sofie Ahlin
Åsa Anveden
Calle Bengtsson
Gerd Bergmark
Claude Bouchard
Björn Carlsson
Sven Dahlgren
Jan Karlsson
Anna-Karin Lindroos
Hans Lönroth
Kristina Narbro
Ingmar Näslund
Torsten Olbers
Per-Arne Svensson
Lena M S Carlsson
Author Affiliation
Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. lars.v.sjostrom@medfak.gu.se
Source
JAMA. 2012 Jan 4;307(1):56-65
Date
Jan-4-2012
Language
English
Publication Type
Article
Keywords
Adult
Bariatric Surgery
Cardiovascular Diseases - mortality - prevention & control
Case-Control Studies
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Myocardial Infarction - mortality - prevention & control
Obesity - surgery
Prospective Studies
Stroke - mortality - prevention & control
Sweden - epidemiology
Weight Loss
Abstract
Obesity is a risk factor for cardiovascular events. Weight loss might protect against cardiovascular events, but solid evidence is lacking.
To study the association between bariatric surgery, weight loss, and cardiovascular events.
The Swedish Obese Subjects (SOS) study is an ongoing, nonrandomized, prospective, controlled study conducted at 25 public surgical departments and 480 primary health care centers in Sweden of 2010 obese participants who underwent bariatric surgery and 2037 contemporaneously matched obese controls who received usual care. Patients were recruited between September 1, 1987, and January 31, 2001. Date of analysis was December 31, 2009, with median follow-up of 14.7 years (range, 0-20 years). Inclusion criteria were age 37 to 60 years and a body mass index of at least 34 in men and at least 38 in women. Exclusion criteria were identical in surgery and control patients. Surgery patients underwent gastric bypass (13.2%), banding (18.7%), or vertical banded gastroplasty (68.1%), and controls received usual care in the Swedish primary health care system. Physical and biochemical examinations and database cross-checks were undertaken at preplanned intervals.
The primary end point of the SOS study (total mortality) was published in 2007. Myocardial infarction and stroke were predefined secondary end points, considered separately and combined.
Bariatric surgery was associated with a reduced number of cardiovascular deaths (28 events among 2010 patients in the surgery group vs 49 events among 2037 patients in the control group; adjusted hazard ratio [HR], 0.47; 95% CI, 0.29-0.76; P = .002). The number of total first time (fatal or nonfatal) cardiovascular events (myocardial infarction or stroke, whichever came first) was lower in the surgery group (199 events among 2010 patients) than in the control group (234 events among 2037 patients; adjusted HR, 0.67; 95% CI, 0.54-0.83; P
Notes
Comment In: Nat Rev Endocrinol. 2012 Mar;8(3):13022271190
Comment In: JAMA. 2012 Apr 18;307(15):1577; author reply 1577-822511678
Comment In: Nat Rev Cardiol. 2012 Mar;9(3):12622271018
Comment In: Praxis (Bern 1994). 2012 May 9;101(10):673-522565560
Comment In: JAMA. 2012 Jan 4;307(1):88-922215170
PubMed ID
22215166 View in PubMed
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Bariatric surgery and reduction in morbidity and mortality: experiences from the SOS study.

https://arctichealth.org/en/permalink/ahliterature95300
Source
Int J Obes (Lond). 2008 Dec;32 Suppl 7:S93-7
Publication Type
Article
Date
Dec-2008
Author
Sjöström L.
Author Affiliation
Department of Body Composition and Metabolism, Sahlgrenska University Hospital, Göteborg, Sweden. lars.sjostrom@medfak.gu.se
Source
Int J Obes (Lond). 2008 Dec;32 Suppl 7:S93-7
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Bariatric Surgery - mortality
Cardiovascular Diseases - mortality
Cause of Death
Cross-Sectional Studies
Humans
Incidence
Morbidity
Neoplasms - epidemiology
Obesity - complications - mortality - surgery
Prospective Studies
Risk factors
Sweden - epidemiology
Weight Loss
Abstract
Obesity is associated with increased morbidity and mortality. Intentional weight loss results in improvement of cardiovascular risk factors, but most observational studies suggest that weight reduction is associated with increased overall and cardiovascular mortality. No prospective intervention studies on mortality have earlier been reported in obese subjects. The prospective, controlled Swedish Obese Subjects Study enrolled obese subjects who either underwent bariatric surgery (n=2010) or were allocated to a contemporaneously matched, conventionally treated obese control group (n=2037). This review sums up effects on morbidity and mortality over an average of 10 years. The mean weight change of the control group was less than +/-2% over up to 15 years of weight recording. Maximum weight losses in the surgical subgroups were observed after 1-2 years. After 10 years, the weight losses from baseline were stabilized at 25, 16 and 14%, respectively. Bariatric surgery improved all traditional cardiovascular risk states except hypercholesterolemia over 10 years. There were 129 deaths in the control group compared with 101 in the surgery group. The unadjusted overall mortality was reduced by 23.7% (P=0.0419) in the surgery group (relative to controls), whereas the gender-, age- and risk factor-adjusted mortality reduction was 30.7% (P=0.0102). The most common causes of death were myocardial infarction (controls n=25, surgery n=13) and cancer (47/29). Bariatric surgery for severe obesity is associated with long-term weight loss, improved risk factors and decreased overall mortality.
PubMed ID
19136998 View in PubMed
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Bariatric surgery reduces mortality in Swedish men.

https://arctichealth.org/en/permalink/ahliterature97613
Source
Br J Surg. 2010 Jun;97(6):877-83
Publication Type
Article
Date
Jun-2010
Author
R. Marsk
E. Näslund
J. Freedman
P. Tynelius
F. Rasmussen
Author Affiliation
Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, SE-182 88 Stockholm, Sweden. Richard.Marsk@ds.se
Source
Br J Surg. 2010 Jun;97(6):877-83
Date
Jun-2010
Language
English
Publication Type
Article
Keywords
Adult
Bariatric Surgery - mortality
Body mass index
Humans
Male
Middle Aged
Morbidity
Obesity, Morbid - mortality - surgery
Postoperative Complications - mortality
Risk factors
Sweden - epidemiology
Weight Loss
Abstract
BACKGROUND: Mortality is lower in obese patients who have undergone surgery for obesity than in those who have not. The majority of patients in these studies have been women. Perioperative mortality is known to be higher among men, and this may counterbalance the survival advantage seen after surgery. This cohort study compared mortality among operated obese patients, non-operated obese patients and a general control cohort of men. METHODS: The study was based on record linkage between Swedish registries. An operated obese, a non-operated obese and a general control cohort were created. The two non-operated cohorts were assigned pseudosurgery dates. Data regarding preoperative and postoperative morbidity were collected, as well as mortality data. RESULTS: Hazard ratios were calculated for mortality between the cohorts adjusting for preoperative morbidity and age. Comparison of all-cause mortality for the obese surgical and non-surgical cohorts gave an adjusted mortality risk of 0.7 (95 per cent confidence interval (c.i.) 0.5 to 1.0) (P = 0.039); the adjusted mortality risk was 1.5 (95 per cent c.i. 1.1 to 2.0) (P = 0.011) when the obese surgical cohort was compared with the general control cohort. CONCLUSION: Bariatric surgery reduces overall mortality in obese men.
PubMed ID
20309894 View in PubMed
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Bariatric surgery, weight reduction, and cancer prevention.

https://arctichealth.org/en/permalink/ahliterature88578
Source
Lancet Oncol. 2009 Jul;10(7):640-1
Publication Type
Article
Date
Jul-2009
Author
Renehan Andrew G
Source
Lancet Oncol. 2009 Jul;10(7):640-1
Date
Jul-2009
Language
English
Publication Type
Article
Keywords
Bariatric Surgery
Energy intake
Humans
Neoplasms - epidemiology - prevention & control
Sweden - epidemiology
Weight Loss
Notes
Comment On: Lancet Oncol. 2009 Jul;10(7):653-6219556163
PubMed ID
19556164 View in PubMed
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Body mass index and weight change in men with prostate cancer: progression and mortality.

https://arctichealth.org/en/permalink/ahliterature261103
Source
Cancer Causes Control. 2014 Aug;25(8):933-43
Publication Type
Article
Date
Aug-2014
Author
Stephanie E Bonn
Fredrik Wiklund
Arvid Sjölander
Robert Szulkin
Pär Stattin
Erik Holmberg
Henrik Grönberg
Katarina Bälter
Source
Cancer Causes Control. 2014 Aug;25(8):933-43
Date
Aug-2014
Language
English
Publication Type
Article
Keywords
Aged
Body mass index
Disease Progression
Humans
Life Style
Male
Middle Aged
Obesity - epidemiology
Proportional Hazards Models
Prostatic Neoplasms - epidemiology - mortality - pathology
Sweden - epidemiology
Weight Gain
Weight Loss
Abstract
Body mass index (BMI) is a modifiable lifestyle factor that has been associated with an increased risk of fatal prostate cancer and biochemical recurrence. The main purpose of the present study was to investigate the association between the exposure BMI at the time of a prostate cancer diagnosis and weight change after diagnosis, and the outcomes of prostate cancer progression and mortality in a large cohort study.
Data from 4,376 men diagnosed with clinically localized prostate cancer between 1997 and 2002 were analyzed. BMI and weight change were self-reported in 2007. Hazard ratios (HRs) with 95 % confidence intervals (CIs) were estimated in complete-case analysis (n = 3,214) using Cox proportional hazards models.
Progression was experienced among 639 (14.6 %) of the study participants, and in total, 450 (10.3 %) deaths of any cause and 134 (3.1 %) prostate cancer-specific deaths were recorded during follow-up. Obese men had a 47 % increased rate of overall mortality compared to normal weight men (HR 1.47, 95 % CI 1.03-2.10). No statistically significant associations were found for BMI and prostate cancer progression or prostate cancer-specific mortality. A weight loss >5 % after diagnosis almost doubled the rate of overall mortality compared to maintaining a stable weight (HR 1.94, 95 % CI 1.41-2.66), while a weight gain >5 % was associated with an almost doubled increased rate of prostate cancer-specific mortality (HR 1.93, 95 % CI 1.18-3.16).
Being obese was associated with an increased rate of overall mortality, and gaining weight after a prostate cancer diagnosis was associated with an increased rate of prostate cancer-specific mortality.
PubMed ID
24810654 View in PubMed
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Body size and hip fracture risk. Swedish Hip Fracture Study Group.

https://arctichealth.org/en/permalink/ahliterature197012
Source
Epidemiology. 2000 Mar;11(2):214-9
Publication Type
Article
Date
Mar-2000
Author
B Y Farahmand
K. Michaëlsson
J A Baron
P G Persson
S. Ljunghall
Author Affiliation
Division of Epidemiology, Karolinska Hospital, Stockholm County Council, Sweden.
Source
Epidemiology. 2000 Mar;11(2):214-9
Date
Mar-2000
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Aged, 80 and over
Body constitution
Body mass index
Case-Control Studies
Female
Hip Fractures - epidemiology - etiology
Humans
Middle Aged
Postmenopause
Questionnaires
Risk factors
Sweden - epidemiology
Weight Gain
Weight Loss
Abstract
The objective of this population-based case-control study was to determine the independent association between height, weight at different ages and adult weight change on hip fracture risk, and the joint effects of these factors. The study base comprised postmenopausal women 50-81 years of age who resided in six counties in Sweden during the period October 1993 to February 1995. The study included 1,327 cases with an incident hip fracture and 3,262 randomly selected controls. We obtained information on body measures and other factors possibly related to hip fracture through mailed questionnaires and telephone interviews. Height and weight change were dominant risk factors. Tall women (> or = 169 cm) had an odds ratio of 3.16 (95% confidence interval = 2.47-4.05) compared with women shorter than 159 cm. Weight gain during adult life was strongly protective: compared with those with moderate weight change (-3 to 3 kg), those with substantial weight gain (> or =12 kg) had a markedly decreased risk of hip fracture (odds ratio = 0.35; 95% confidence interval = 0.27-0.45), whereas weight loss was associated with an increased risk. Weight change retained important effects among all subjects, even after controlling for current weight and weight at age 18. In contrast, among women who gained weight, the separate effects of current weight and weight at age 18 were small or absent. Among women who lost weight, both current weight and weight at age 18 had effects that remained after controlling for weight change. Adult weight change and height are dominant body size risk factors for hip fracture. Weight loss vs weight changes demarcates different patterns of hip fracture risk.
PubMed ID
11021622 View in PubMed
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Changes in BMI and psychosocial functioning in partners of women who undergo gastric bypass surgery for obesity.

https://arctichealth.org/en/permalink/ahliterature267081
Source
Obes Surg. 2015 Feb;25(2):319-24
Publication Type
Article
Date
Feb-2015
Author
Mikaela Willmer
Daniel Berglind
Anders Thorell
Magnus Sundbom
Joanna Uddén
Mustafa Raoof
Jakob Hedberg
Per Tynelius
Ata Ghaderi
Erik Näslund
Finn Rasmussen
Source
Obes Surg. 2015 Feb;25(2):319-24
Date
Feb-2015
Language
English
Publication Type
Article
Keywords
Adult
Anxiety - epidemiology
Body Image - psychology
Body mass index
Depression - epidemiology
Female
Follow-Up Studies
Gastric Bypass - psychology
Humans
Male
Middle Aged
Obesity, Morbid - epidemiology - psychology - surgery
Overweight - epidemiology
Questionnaires
Sleep - physiology
Spouses - psychology - statistics & numerical data
Sweden - epidemiology
Weight Loss - physiology
Abstract
There is very little research exploring the effects of Roux-en-Y gastric bypass surgery (RYGB) on the patient's partner. The aim of the present study was to investigate longitudinally whether male partners of female RYGB patients were affected in terms of BMI, sleep quality, body dissatisfaction, depression, and anxiety.
Thirty-seven women, with partners who were willing to participate, were recruited from RYGB waiting lists at five Swedish hospitals. Data collection took place during two home visits, 3 months before and 9 months after RYGB surgery. Anthropometrical data were documented, and both women and men completed the Hospital Anxiety and Depression Scale (HADS) and the Karolinska Sleep Questionnaire (KSQ). The men also completed the Male Body Dissatisfaction Scale (MBDS).
The men's BMI changes between the two time points that were analysed using general estimating equation (GEE) regression. Their BMI decreased significantly (ß?=?-0.9, p?=?0.004). The change was more pronounced in the 26 men who had a baseline BMI of =25 (ß?=?-1.4, p?
PubMed ID
25148886 View in PubMed
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Changes in eating behaviour and meal pattern following Roux-en-Y gastric bypass.

https://arctichealth.org/en/permalink/ahliterature129266
Source
Int J Obes (Lond). 2012 Mar;36(3):348-55
Publication Type
Article
Date
Mar-2012
Author
A. Laurenius
I. Larsson
M. Bueter
K J Melanson
I. Bosaeus
H Bertéus Forslund
H. Lönroth
L. Fändriks
T. Olbers
Author Affiliation
Department of Gastrosurgical Research and Education, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. anna.laurenius@vgregion.se
Source
Int J Obes (Lond). 2012 Mar;36(3):348-55
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adult
Body mass index
Cohort Studies
Dumping Syndrome - epidemiology - prevention & control
Feeding Behavior - psychology
Female
Follow-Up Studies
Gastric Bypass - methods - psychology - statistics & numerical data
Humans
Longitudinal Studies
Male
Obesity, Morbid - epidemiology - psychology - surgery
Postoperative Period
Questionnaires
Sweden - epidemiology
Weight Loss
Abstract
Little is known about eating behaviour and meal pattern subsequent to Roux-en-Y gastric bypass (RYGB), knowledge important for the nutritional care process. The objective of the study was to obtain basic information of how meal size, eating rate, meal frequency and eating behaviour change upon the RYGB surgery.
Voluntary chosen meal size and eating rate were measured in a longitudinal, within subject, cohort study of 43 patients, 31 women and 12 men, age 42.6 (s.d. 9.7) years, body mass index (BMI) 44.5 (4.9) kg m(-2). Thirty-one non-obese subjects, 37.8 (13.6) years, BMI 23.7 (2.7) kg m(-2) served as a reference group. All subjects completed a meal pattern questionnaire and the Three-Factor Eating Questionnaire (TFEQ-R21).
Six weeks postoperatively meal size was 42% of the preoperative meal size, (P
PubMed ID
22124454 View in PubMed
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Coeliac disease characteristics, compliance to a gluten free diet and risk of lymphoma by subtype.

https://arctichealth.org/en/permalink/ahliterature131755
Source
Dig Liver Dis. 2011 Nov;43(11):862-8
Publication Type
Article
Date
Nov-2011
Author
Ola Olén
Johan Askling
Jonas F Ludvigsson
Hans Hildebrand
Anders Ekbom
Karin Ekström Smedby
Author Affiliation
Sachs' Children's Hospital, Stockholm South General Hospital, Sweden. ola.olen@ki.se
Source
Dig Liver Dis. 2011 Nov;43(11):862-8
Date
Nov-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Case-Control Studies
Celiac Disease - complications - diagnosis - diet therapy
Diet, Gluten-Free
Female
Humans
Logistic Models
Lymphoma - epidemiology - etiology
Lymphoma, B-Cell - epidemiology - etiology
Lymphoma, T-Cell - epidemiology - etiology
Male
Middle Aged
Odds Ratio
Patient compliance
Prospective Studies
Risk factors
Sweden - epidemiology
Weight Loss
Young Adult
Abstract
Coeliac disease is associated with an increased risk of malignant lymphomas. We investigated the importance of coeliac disease characteristics and diet compliance for risk of lymphoma.
In a nested case-control design, we identified 59 patients with lymphoma and 137 matched controls from a population-based cohort of 11,650 inpatients with coeliac disease. We assessed coeliac disease characteristics at diagnosis and dietary compliance collected prospectively from medical records during follow-up.
Poor compliance was not significantly associated with risk of lymphoma overall (odds ratio 1.83, 95% confidence interval 0.78-4.31) nor of lymphoma subtypes. Risk estimates differed by subtype; risk of T-cell lymphoma (odds ratio 1.01, confidence interval 0.32-3.15) or intestinal lymphoma (odds ratio 0.66, confidence interval 0.17-2.56) was unelevated, whereas there was an indication of a risk increase of B-cell lymphoma (odds ratio 4.74, confidence interval 0.89-25.3) or extraintestinal lymphoma (odds ratio 3.00, confidence interval 0.73-12.3) following poor compliance. History of weight loss (odds ratio 2.89, confidence interval 1.00-8.29) at coeliac disease diagnosis was associated with an increased risk of lymphoma when excluding tumours occurring with short latency (
PubMed ID
21880561 View in PubMed
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Coeliac disease: incidence and prevalence in Wellington 1985-92.

https://arctichealth.org/en/permalink/ahliterature35793
Source
N Z Med J. 1994 May 25;107(978):195-7
Publication Type
Article
Date
May-25-1994
Author
R. Ussher
M L Yeong
N. Stace
Author Affiliation
Wellington Medical School.
Source
N Z Med J. 1994 May 25;107(978):195-7
Date
May-25-1994
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Anemia - etiology
Biopsy
Celiac Disease - complications - diagnosis - diet therapy - epidemiology - etiology - pathology
Child
Child, Preschool
Comparative Study
Diarrhea - etiology
Female
Gluten - diagnostic use
Humans
Incidence
Male
Middle Aged
New Zealand - epidemiology
Population Surveillance
Prevalence
Research Support, Non-U.S. Gov't
Retrospective Studies
Scotland - epidemiology
Sex Distribution
Sweden - epidemiology
Weight Loss
Abstract
AIM. A retrospective study was carried out in the greater Wellington area. The objectives of this study were to identify an incidence rate, presenting symptoms and clinical features of coeliac disease. METHODS. Histology archives from the Wellington hospital department of pathology over the last eight years (1985-92) were retrieved and analysed. Abnormal duodenal and jejunal histological sections were reviewed. One hundred and seventy seven biopsy specimens from 127 patients were identified for further study from a total of 367 abnormal duodenal and jejunal biopsy specimens. Diagnosis of coeliac disease was based on information from hospital notes, biopsy request forms, and histology reports. Diagnostic criteria used for coeliac disease were evidence of malabsorption, abnormal histology consistent with coeliac disease and clinical improvement following a gluten free diet. RESULTS. Thirty eight patients were diagnosed with coeliac disease 1985-92 in a population of 267,252. Of these 38 only four were children (0-12 years). Overall incidence was 1.8 per 100,000. The estimated overall prevalence was 70 per 100,000, with 14 per 100,000 for children. The live birth rate was 0.1 per 1000. There was a female predominance of 3:1. Patients presented with a diverse range of problems, most commonly diarrhoea, anaemia, weight loss and steatorrhoea. Three out of the 6 patients who had a single problem had anaemia. CONCLUSIONS. The study has demonstrated an overall incidence and prevalence of coeliac disease in the Wellington region similar to overseas figures. However only 11% of the total were children, which is a very low proportion compared to the 50% reported in Sweden and 25% in Edinburgh. Patients presented with a wide range of clinical features. The threshold for small bowel biopsy should be relatively low in any patient considered to have clinical features of malabsorption.
PubMed ID
8196863 View in PubMed
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60 records – page 1 of 6.