Obesity, which is a worldwide epidemic, confers increased risk for multiple serious conditions including type 2 diabetes, nonalcoholic fatty liver disease, and cardiovascular diseases. Adipose tissue is considered one of the largest endocrine organs in the body as well as an active tissue for cellular reactions and metabolic homeostasis rather than an inert tissue only for energy storage. The functional pleiotropism of adipose tissue relies on its ability to synthesize and release a large number of hormones, cytokines, extracellular matrix proteins, and growth and vasoactive factors, which are collectively called adipokines known to influence a variety of physiological and pathophysiological processes. In the obese state, excessive visceral fat accumulation causes adipose tissue dysfunctionality that strongly contributes to the onset of obesity-related comorbidities. The mechanisms underlying adipose tissue dysfunction include adipocyte hypertrophy and hyperplasia, increased inflammation, impaired extracellular matrix remodeling, and fibrosis together with an altered secretion of adipokines. This review describes the relevance of specific adipokines in the obesity-associated cardiovascular disease.

Background Weight loss after bariatric surgery varies among patients. Patients who do not complete long-term follow-up are considered to loose less weight than those with regular follow-up visits. Objective To evaluate the influence of patients’ follow-up compliance on long-term excess weight loss (%EWL) and total weight loss (%TWL) after bariatric surgery, comparing results between gastric bypass (GB) and sleeve gastrectomy (SG). Methods Patients with up to 5 years of follow-up data after bariatric surgery were included in this retrospective analysis. Patients were divided in 2 groups: those in group 1 who had attended every scheduled postoperative appointment and those in group 2 who had been lost to follow-up before 1 year and were later contacted by telephone. %EWL and %TWL were compared to determine the possible relationship between type of surgery and regularity of the follow-up. Results A total of 385 patients were included. A significant difference in EWL was observed at 5 years in the SG group (78% for group 1 versus 39% for group 2; p = 0.02) and GB group (75% for group 1 versus 62% for group 2; p = 0.01). No significant differences between surgeries were found when comparing long-term EWL in group 1 patients 77% for SG versus 75% for GB. For group 2 patients, GB achieved greater EWL than SG; p = 0.005. %TWL patients in group 2 showed significant differences in all periods of study (p < 0.05). Conclusion Bariatric surgery patients who attended all scheduled follow-up appointments experienced significantly greater long-term EWL and TWL than those who did not. GB has apparent increased benefits for weight loss in long-term follow-up when compared with SG for patients who did not attend long-term follow-up. Therefore, continued long-term follow-up of bariatric patients should be encouraged to increase postoperative weight loss results.

Bariatric surgery has been recognized as the safest and most effective procedure for controlling type 2 diabetes (T2D) and obesity in carefully selected patients. The aim of the present study was to compare the effects of Sleeve Gastrectomy (SG) and Single Anastomosis Duodenoileal Bypass with SG (SADI-S) on the metabolic profile of diet-induced obese rats. A total of 35 four-week-old male Wistar rats were submitted to surgical interventions (sham operation, SG and SADI-S) after 4 months of being fed a high-fat diet. Body weight, metabolic profile and the expression of molecules involved in the control of subcutaneous white (SCWAT), brown (BAT) and beige (BeAT) adipose tissue function were analyzed. SADI-S surgery was associated with significantly decreased amounts of total fat pads (p < 0.001) as well as better control of lipid and glucose metabolism compared to the SG counterparts. An improved expression of molecules involved in fat browning in SCWAT and in the control of BAT and BeAT differentiation and function was observed following SADI-S. Together, our findings provide evidence that the enhanced metabolic improvement and their continued durability after SADI-S compared to SG rely, at least in part, on the improvement of the BeAT phenotype and function.

Acute massive gastric dilatation is a rare condition mainly seen in patients with alimentary disorders. This massive distention may cause gastric necrosis and even perforation and emphysematous gastritis. We report the case of an 18-year-old female with intense abdominal pain and signs of sepsis. Computed-tomography scan diagnosed an acute massive gastric distention within gas into the gastric wall. Despite rapid instauration of conservative treatment, the patient finally underwent surgery. It is important to discard this infrequent pathology even in young and healthy people. An early diagnosis is crucial, a rapid instauration of conservative management may be effective and avoid surgery.

Background: Evaluate and compare the results of weight loss outcomes, associated medical problems resolution, and complications in the short and long term between SADI-S and RYGB. Methods: A systematic review was conducted following PRISMA guidelines. Studies comparing SADI-S and RYGB as primary surgery were included if they reported weight loss (total weight loss (TWL), excess weight loss (EWL), or body mass index (BMI) changes), associated medical problems remission (diabetes and hypertension), and postoperative outcomes (complications, hospital stay, and operative time). A meta-analysis of mean differences (MD) was conducted to assess continuous outcomes, and a meta-analysis of odds ratios (OR) was performed to evaluate the categorical variables; a random effects model was used. Results: Eight studies, including 4259 patients (1625 SADI-S; 2634 RYGB), were analysed. Six studies with over 2 years of follow-up (mean 3.93 years (1.79)) were included for long-term outcomes, while all eight were considered for short-term outcomes. SADI-S resulted in a statistically significant higher total weight loss (MD 10.03; 95% CI 4.7–15.35; p < 0.001), excess weight loss (MD 10.15; 95% CI 5.2–15.1; p < 0.01), diabetes remission (OR 3.48; 95% CI 2.02–6.02; p < 0.001) with a similar number of long-term complications (OR = 0.19, 95% CI 0.03–1.36; p = 0.10). Short-term complications were inferior in the subgroup of patients undergoing SADI-S with < 50 kg/m² of BMI (OR 0.45, 95% CI 0.33 to 0.61; p < 0.01) as well as hospital stay (MD = –0.69; 95% CI –1.03 to –0.36, p < 0.01) and severe complications (OR = 0.44, 95% CI 0.25–0.80; p = 0.01). Conclusions: This meta-analysis suggests that SADI-S may offer advantages over RYGB in terms of weight loss, diabetes remission, and safety profile.