Albert Goday Arno1,2,3,4, Magí Farré5,6,7, Jose Rodríguez-Morató4,5, Jose M Ramon8, Clara Pérez-Mañá5,6, Esther Papaseit5,6,7, Ester Civit5, Klaus Langohr5,9, Marcel Lí Carbó5,10, David Benaiges Boix1,2,3, Olga Castañer Nino3,4, Juana Antonia Flores Le Roux1,2,3, Manuel Pera8, Luis Grande8, Rafael de la Torre11,12,13. 1. Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain. 2. Department of Medicine, Autonomous University of Barcelona, Cerdanyola, Barcelona, Spain. 3. Cardiovascular Risk and Nutrition Research Group, IMIM, Hospital del Mar Medical Research Institute, Dr. Aiguader 88, 08003, Barcelona, Spain. 4. Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto Salud Carlos III, 28029, Madrid, Spain. 5. Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program, IMIM, Hospital del Mar Medical Research Institute, Doctor Aiguader, 88, Office 217, 08003, Barcelona, Spain. 6. Department of Pharmacology, Therapeutics and Toxicology, Autonomous University of Barcelona, Cerdanyola, Badalona, Spain. 7. IGTP, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. 8. Section of Gastrointestinal Surgery, Hospital del Mar, Barcelona, Spain. 9. Department of Statistics and Operations Research, Polytechnic University of Catalonia, Barcelona, Spain. 10. Department of Experimental and Health Sciences, CEXS-UPF, Universitat Pompeu Fabra, Dr. Aiguader 80, 08003, Barcelona, Spain. 11. Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto Salud Carlos III, 28029, Madrid, Spain. rtorre@imim.es. 12. Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program, IMIM, Hospital del Mar Medical Research Institute, Doctor Aiguader, 88, Office 217, 08003, Barcelona, Spain. rtorre@imim.es. 13. Department of Experimental and Health Sciences, CEXS-UPF, Universitat Pompeu Fabra, Dr. Aiguader 80, 08003, Barcelona, Spain. rtorre@imim.es.
Abstract
PURPOSE: The purpose of the study was to study the impact of the two most common bariatric surgery techniques on paracetamol pharmacokinetics (a marker of gastric emptying) and caffeine metabolism (a marker of liver function). MATERIALS AND METHODS: In the present prospective study, we studied 24 morbid obese patients before, at 4 weeks, and 6 months after having undergone sleeve gastrectomy (n = 10) or Roux-en-Y gastric bypass (n = 14). For comparative purposes, 28 healthy controls (14 normal weights and 14 overweights) were also included in the study. RESULTS: Paracetamol pharmacokinetics was altered in the obese participants leading to lower bioavailability. Bariatric surgery resulted in faster absorption and normalized pharmacokinetic parameters, prompting an increase in paracetamol bioavailability. No differences were found between surgical procedures. In the case of caffeine, the ratio paraxanthine/caffeine did not differ between morbid obese and healthy individuals. This ratio remained unmodified after surgery, indicating that the liver function (assessed by cytochrome P450 1A2 activity) was unaffected by obesity or bariatric surgery. CONCLUSIONS: Paracetamol pharmacokinetics and caffeine plasma levels are altered in severely obese patients. The two studied bariatric surgical techniques normalize paracetamol oral bioavailability without impairing the liver function (measured by cytochrome P450 1A2 activity).
PURPOSE: The purpose of the study was to study the impact of the two most common bariatric surgery techniques on paracetamol pharmacokinetics (a marker of gastric emptying) and caffeine metabolism (a marker of liver function). MATERIALS AND METHODS: In the present prospective study, we studied 24 morbid obesepatients before, at 4 weeks, and 6 months after having undergone sleeve gastrectomy (n = 10) or Roux-en-Y gastric bypass (n = 14). For comparative purposes, 28 healthy controls (14 normal weights and 14 overweights) were also included in the study. RESULTS:Paracetamol pharmacokinetics was altered in the obeseparticipants leading to lower bioavailability. Bariatric surgery resulted in faster absorption and normalized pharmacokinetic parameters, prompting an increase in paracetamol bioavailability. No differences were found between surgical procedures. In the case of caffeine, the ratio paraxanthine/caffeine did not differ between morbid obese and healthy individuals. This ratio remained unmodified after surgery, indicating that the liver function (assessed by cytochrome P450 1A2 activity) was unaffected by obesity or bariatric surgery. CONCLUSIONS:Paracetamol pharmacokinetics and caffeine plasma levels are altered in severely obesepatients. The two studied bariatric surgical techniques normalize paracetamol oral bioavailability without impairing the liver function (measured by cytochrome P450 1A2 activity).
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