Susan C Modesitt1, Peter T Hallowell2, Jill K Slack-Davis3, Ryan D Michalek4, Kristen A Atkins5, Sarah L Kelley6, Sanja Arapovic1, Margaret A Shupnik7, Kyle Hoehn8. 1. Gynecologic Oncology Division, University of Virginia School of Medicine, Charlottesville, VA, United States. 2. Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA, United States. 3. Department of Microbiology, Immunology and Cancer Biology, University of Virginia School of Medicine, Charlottesville, VA, United States. 4. Metabolon, Inc., Durham, NC, United States. 5. Department of Pathology, University of Virginia School of Medicine, Charlottesville, VA, United States. 6. College of Arts and Sciences, University of Virginia, Charlottesville, VA, United States. 7. Endocrinology Division, University of Virginia School of Medicine, Charlottesville, VA, United States. 8. Department of Pharmacology, University of Virginia School of Medicine, Charlottesville, VA, United States; School of BABS, University of New South Wales, Sydney, Australia.
Abstract
OBJECTIVES: The study objectives were to determine baseline endometrial histology in morbidly obese women undergoing bariatric surgery and to assess the surgical intervention's impact on serum metabolic parameters, quality of life (QOL), and weight. METHODS: Women undergoing bariatric surgery were enrolled. Demographic and clinicopathologic data, serum, and endometrium (if no prior hysterectomy) were collected preoperatively and serum collected postoperatively. Serum global biochemical data were assessed pre/postoperatively. Welch's two sample t-tests and paired t-tests were used to identify significant differences. RESULTS: Mean age of the 71 women enrolled was 44.2 years, mean body mass index (BMI) was 50.9 kg/m(2), and mean weight loss was 45.7 kg. Endometrial biopsy results: proliferative (13/30; 43%), insufficient (8/30; 27%), secretory (6/30; 20%) and hyperplasia (3/30; 10%-1 complex atypical, 2 simple). QOL data showed significant improvement in physical component scores (PCS means 33.9 vs. 47.2 before/after surgery; p<0.001). Twenty women underwent metabolic analysis which demonstrated significantly improved glucose homeostasis, improved insulin responsiveness, and free fatty acid levels. Significant perturbations in tryptophan, phenylalanine and heme metabolism suggested decreased inflammation and alterations in the intestinal microbiome. Most steroid hormones were not significantly impacted with the exception of decreased DHEAS and 4-androsten metabolites. CONCLUSIONS: Bariatric surgery is accompanied by an improved physical quality of life as well as beneficial changes in glucose homeostasis, insulin responsiveness, and inflammation to a greater extent than the hormonal milieu. The potential cancer protective effects of bariatric surgery may be due to other mechanisms other than simply hormonal changes.
OBJECTIVES: The study objectives were to determine baseline endometrial histology in morbidly obesewomen undergoing bariatric surgery and to assess the surgical intervention's impact on serum metabolic parameters, quality of life (QOL), and weight. METHODS:Women undergoing bariatric surgery were enrolled. Demographic and clinicopathologic data, serum, and endometrium (if no prior hysterectomy) were collected preoperatively and serum collected postoperatively. Serum global biochemical data were assessed pre/postoperatively. Welch's two sample t-tests and paired t-tests were used to identify significant differences. RESULTS: Mean age of the 71 women enrolled was 44.2 years, mean body mass index (BMI) was 50.9 kg/m(2), and mean weight loss was 45.7 kg. Endometrial biopsy results: proliferative (13/30; 43%), insufficient (8/30; 27%), secretory (6/30; 20%) and hyperplasia (3/30; 10%-1 complex atypical, 2 simple). QOL data showed significant improvement in physical component scores (PCS means 33.9 vs. 47.2 before/after surgery; p<0.001). Twenty women underwent metabolic analysis which demonstrated significantly improved glucose homeostasis, improved insulin responsiveness, and free fatty acid levels. Significant perturbations in tryptophan, phenylalanine and heme metabolism suggested decreased inflammation and alterations in the intestinal microbiome. Most steroid hormones were not significantly impacted with the exception of decreased DHEAS and 4-androsten metabolites. CONCLUSIONS: Bariatric surgery is accompanied by an improved physical quality of life as well as beneficial changes in glucose homeostasis, insulin responsiveness, and inflammation to a greater extent than the hormonal milieu. The potential cancer protective effects of bariatric surgery may be due to other mechanisms other than simply hormonal changes.
Authors: Taryn E Hassinger; J Hunter Mehaffey; Robert B Hawkins; Bruce D Schirmer; Peter T Hallowell; Anneke T Schroen; Shayna L Showalter Journal: Obes Surg Date: 2019-03 Impact factor: 4.129
Authors: Melinda S Yates; Adriana M Coletta; Qian Zhang; Rosemarie E Schmandt; Meena Medepalli; Denise Nebgen; Beth Soletsky; Andrea Milbourne; Erma Levy; Bryan Fellman; Diana Urbauer; Ying Yuan; Russell R Broaddus; Karen Basen-Engquist; Karen Lu Journal: Cancer Prev Res (Phila) Date: 2018-05-01
Authors: Joseph A Dottino; Qian Zhang; David S Loose; Bryan Fellman; Brenda D Melendez; Mikayla S Borthwick; Laurie J McKenzie; Ying Yuan; Richard K Yang; Russell R Broaddus; Karen H Lu; Pamela T Soliman; Melinda S Yates Journal: Am J Obstet Gynecol Date: 2020-08-21 Impact factor: 8.661