Effect of Conventional Medical Therapy or Laparoscopic Sleeve Gastrectomy on Urinary Albumin in Japanese Subjects with Severe Obesity: An Observational Study

Introduction: In patients with severe obesity, albuminuria can be improved by both conventional medical therapy and bariatric surgery. The purpose of this study was to compare the impact of weight loss achieved through conventional medical therapy or laparoscopic sleeve gastrectomy (LSG) on albuminu...

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Autores principales:	Yasuhiro Watanabe, Takashi Yamaguchi, Shuhei Yamaoka, Kazuki Abe, Hiroki Onda, Shoko Nakamura, Sho Tanaka, Takashi Oshiro, Masahiro Ohira, Daiji Nagayama, Naomi Shimizu, Ichiro Tatsuno, Atsuhito Saiki
Formato:	article
Lenguaje:	EN
Publicado:	Karger Publishers 2021
Materias:	obesity conventional medical therapy sleeve gastrectomy albuminuria Nutrition. Foods and food supply TX341-641 Nutritional diseases. Deficiency diseases RC620-627
Acceso en línea:	https://doaj.org/article/e1636c710d3646579fb09f72095bca4b
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spelling	oai:doaj.org-article:e1636c710d3646579fb09f72095bca4b2021-11-11T10:40:44ZEffect of Conventional Medical Therapy or Laparoscopic Sleeve Gastrectomy on Urinary Albumin in Japanese Subjects with Severe Obesity: An Observational Study1662-40251662-403310.1159/000519156https://doaj.org/article/e1636c710d3646579fb09f72095bca4b2021-10-01T00:00:00Zhttps://www.karger.com/Article/FullText/519156https://doaj.org/toc/1662-4025https://doaj.org/toc/1662-4033Introduction: In patients with severe obesity, albuminuria can be improved by both conventional medical therapy and bariatric surgery. The purpose of this study was to compare the impact of weight loss achieved through conventional medical therapy or laparoscopic sleeve gastrectomy (LSG) on albuminuria in Japanese subjects with severe obesity and identify the factors involved. Methods: We retrospectively evaluated the clinical characteristics including the urinary albumin/creatinine ratio (UACR) of 340 consecutive subjects with a body mass index ≥35 who received LSG (n = 242) or medical therapy (n = 98) between 2010 and 2018 and were followed for at least 12 months. Results: The baseline of the UACR was not different between the 2 groups. At the 12-month follow-up, total weight loss (TWL) and decreases in glycosylated hemoglobin (HbA1c) and loge UACR were greater in the LSG group than in the medical therapy group (body weight; −35.7 kg vs. −8.0 kg, p < 0.001, HbA1c; −1.4% vs. −0.7%, p < 0.001, loge UACR; −0.3 vs. 0.9, p < 0.001). The rate of complete remission of diabetes was significantly higher in the LSG group than in the medical therapy group. At 12 and 36 months (n = 111 in the medical therapy group, n = 56 in the LSG group at 36 months), loge UACR increased in the medical therapy group, while it remained unchanged or decreased in the LSG group. In subjects with microalbuminuria and macroalbuminuria, changes in the loge UACR correlated with percent total body weight loss (%TWL) in both groups at 12 months. Percent TWL contributed independently to the change in the loge UACR, irrespective of whether LSG was performed. In receiver-operating characteristic analysis, a weight loss of 7.8% predicted a decrease in the UACR (∆UACR <0 at 12 months). Conclusion: Our analysis suggests that albuminuria may increase over time if only medical therapy is continued. To improve albuminuria, weight loss may be more important than whether LSG is performed.Yasuhiro WatanabeTakashi YamaguchiShuhei YamaokaKazuki AbeHiroki OndaShoko NakamuraSho TanakaTakashi OshiroMasahiro OhiraDaiji NagayamaNaomi ShimizuIchiro TatsunoAtsuhito SaikiKarger Publishersarticleobesityconventional medical therapysleeve gastrectomyalbuminuriaNutrition. Foods and food supplyTX341-641Nutritional diseases. Deficiency diseasesRC620-627ENObesity Facts, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	obesity conventional medical therapy sleeve gastrectomy albuminuria Nutrition. Foods and food supply TX341-641 Nutritional diseases. Deficiency diseases RC620-627
spellingShingle	obesity conventional medical therapy sleeve gastrectomy albuminuria Nutrition. Foods and food supply TX341-641 Nutritional diseases. Deficiency diseases RC620-627 Yasuhiro Watanabe Takashi Yamaguchi Shuhei Yamaoka Kazuki Abe Hiroki Onda Shoko Nakamura Sho Tanaka Takashi Oshiro Masahiro Ohira Daiji Nagayama Naomi Shimizu Ichiro Tatsuno Atsuhito Saiki Effect of Conventional Medical Therapy or Laparoscopic Sleeve Gastrectomy on Urinary Albumin in Japanese Subjects with Severe Obesity: An Observational Study
description	Introduction: In patients with severe obesity, albuminuria can be improved by both conventional medical therapy and bariatric surgery. The purpose of this study was to compare the impact of weight loss achieved through conventional medical therapy or laparoscopic sleeve gastrectomy (LSG) on albuminuria in Japanese subjects with severe obesity and identify the factors involved. Methods: We retrospectively evaluated the clinical characteristics including the urinary albumin/creatinine ratio (UACR) of 340 consecutive subjects with a body mass index ≥35 who received LSG (n = 242) or medical therapy (n = 98) between 2010 and 2018 and were followed for at least 12 months. Results: The baseline of the UACR was not different between the 2 groups. At the 12-month follow-up, total weight loss (TWL) and decreases in glycosylated hemoglobin (HbA1c) and loge UACR were greater in the LSG group than in the medical therapy group (body weight; −35.7 kg vs. −8.0 kg, p < 0.001, HbA1c; −1.4% vs. −0.7%, p < 0.001, loge UACR; −0.3 vs. 0.9, p < 0.001). The rate of complete remission of diabetes was significantly higher in the LSG group than in the medical therapy group. At 12 and 36 months (n = 111 in the medical therapy group, n = 56 in the LSG group at 36 months), loge UACR increased in the medical therapy group, while it remained unchanged or decreased in the LSG group. In subjects with microalbuminuria and macroalbuminuria, changes in the loge UACR correlated with percent total body weight loss (%TWL) in both groups at 12 months. Percent TWL contributed independently to the change in the loge UACR, irrespective of whether LSG was performed. In receiver-operating characteristic analysis, a weight loss of 7.8% predicted a decrease in the UACR (∆UACR <0 at 12 months). Conclusion: Our analysis suggests that albuminuria may increase over time if only medical therapy is continued. To improve albuminuria, weight loss may be more important than whether LSG is performed.
format	article
author	Yasuhiro Watanabe Takashi Yamaguchi Shuhei Yamaoka Kazuki Abe Hiroki Onda Shoko Nakamura Sho Tanaka Takashi Oshiro Masahiro Ohira Daiji Nagayama Naomi Shimizu Ichiro Tatsuno Atsuhito Saiki
author_facet	Yasuhiro Watanabe Takashi Yamaguchi Shuhei Yamaoka Kazuki Abe Hiroki Onda Shoko Nakamura Sho Tanaka Takashi Oshiro Masahiro Ohira Daiji Nagayama Naomi Shimizu Ichiro Tatsuno Atsuhito Saiki
author_sort	Yasuhiro Watanabe
title	Effect of Conventional Medical Therapy or Laparoscopic Sleeve Gastrectomy on Urinary Albumin in Japanese Subjects with Severe Obesity: An Observational Study
title_short	Effect of Conventional Medical Therapy or Laparoscopic Sleeve Gastrectomy on Urinary Albumin in Japanese Subjects with Severe Obesity: An Observational Study
title_full	Effect of Conventional Medical Therapy or Laparoscopic Sleeve Gastrectomy on Urinary Albumin in Japanese Subjects with Severe Obesity: An Observational Study
title_fullStr	Effect of Conventional Medical Therapy or Laparoscopic Sleeve Gastrectomy on Urinary Albumin in Japanese Subjects with Severe Obesity: An Observational Study
title_full_unstemmed	Effect of Conventional Medical Therapy or Laparoscopic Sleeve Gastrectomy on Urinary Albumin in Japanese Subjects with Severe Obesity: An Observational Study
title_sort	effect of conventional medical therapy or laparoscopic sleeve gastrectomy on urinary albumin in japanese subjects with severe obesity: an observational study
publisher	Karger Publishers
publishDate	2021
url	https://doaj.org/article/e1636c710d3646579fb09f72095bca4b
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Effect of Conventional Medical Therapy or Laparoscopic Sleeve Gastrectomy on Urinary Albumin in Japanese Subjects with Severe Obesity: An Observational Study

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