Cardiovascular Diseases, Obese Patients, Production Rates of These TRL Before and After the Bariatric Surgery
Conditions
Keywords
obese patients, TRL, the bariatric surgery
Brief summary
Morbidly obesity (body mass index 40 kg/m²), the most serious, is more and more frequent. Cardiovascular diseases are the first cause of morbidity and mortality. An excess of TRL particles is one of the characteristics, represents a major cardiovascular risk factor. The overproduction of the intestinal TRL (which apoprotein B48 is the specific tracer) is recently recognized of insulin-resistance and the atherogenous role of these intestinal TRL has been shown. In front of this important overmortality, the bariatric surgery quickly developed. Three main procedures are performed: 2 based exclusively on the gastric restriction (the adjustable gastric banding and the sleeve gastrectomy) and one associating a malabsorption (the gastric bypass).
Detailed description
It is a monocentric, prospective, comparative study. After identification of the eligible subjects, the kinetics (production and clearance rates) of the intestinal TRL will be performed in the hospital, using a stable isotope method (5,5,5-D3-L-Leucine), in 3 groups of obese patients (12 patients per surgery procedure), before and 6 months after the surgery
Interventions
PROCEDURESurgical and medical procedures
this study want to compare the differential effect of the 3 bariatric surgery procedures on the production rates of the intestinal TRL: the adjustable gastric banding the sleeve gastrectomy the gastric bypass
Sponsors
Assistance Publique Hopitaux De Marseille
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Men or women from 18 to 65 years old * Subject having a BMI included between 35 and 40 kg / m2 associated to at least a comorbidity susceptible to be improved after the surgery * Subject in failure of a medical treatment, led by an expert in nutrition, associating a dietary coverage and a physical activity adapted for at least 6 months * Subject without contraindication for 3 studied surgical techniques * Subject without cardiovascular events 6 months ago * subject is informed and is consented * Subject having a biologic balance dating less than 3 months
Exclusion criteria
* subject with contraindication for 3 studied surgical techniques * women pregnant * subject did not consent and is not informed
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| to compare the differential effect of the 3 bariatric surgery procedures on the production rates of the intestinal TRL | 36 months | the 3 bariatric surgery procedures are: the adjustable gastric banding the sleeve gastrectomy the gastric bypass (associating a malabsorption). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| to compare the production rates of these TRL before and after the bariatric surgery | 36 months | TRL particles is one of the characteristics, represents a major cardiovascular risk factor. The overproduction of the intestinal TRL (which apoprotein B48 is the specific tracer) is a constituent recently recognized of insulin-resistance and the atherogenous role of these intestinal TRL has been shown |
Countries
France
Outcome results
None listed