Seroprevalence of Helicobacter pylori in morbidly obese patients
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mellitus, the prevalence of these findings has not been correlated with liver histopathology. Methods: Routine core liver biopsy was simultaneously per- formed on 143 (13 (9%) males and 130 (91%) females) patients at the time of Roux-en-Y gastric bypass at UC Davis. Mean BMI was 46.9 5.8 kg/m 2 , and mean age was 43.5 8.9 years. Twenty-two patients (15.4%) of the 143 were diabetic. Routine LFTs were obtained on all patients preoperatively. Liver specimens were histologically evaluated for the presence of NASH. Results: Of the 143 patients, 56 (39.1%) were positive for NASH as confirmed by liver biopsy. Only 4 patients (2.7%) overall had elevated LFTs. All patients with elevated LFTs exhibited NASH on liver biopsy. In contrast, only 4 (7.1%) of the 56 patients, with biopsy-proven NASH, had elevated LFTs preoperatively. Seven (31.8%) of the 22 diabetic patients had NASH on liver biopsy, and only 7 (12.5%) of the 56 patients with NASH were diabetic. Conclusions: While abnormalities in LFTs may be associated with NASH, our findings indicate that NASH is more prevalent, in the morbidly obese, than can be deduced by changes in LFTs alone. Additionally, the presence of diabetes mellitus seems to be only loosely associated with NASH. PII: S1550-7289(05)00222-4 P35. RISK ANALYSIS IN BARIATRIC SURGERY: IMPACT OF DISEASE BURDEN Peter N. Benotti, M.D. 1 , Hector Rodriguez, M.D.#, Nino Carnevale, M.D. 1 , Eduardo Liriano, M.D. 2 , Department of Surgery 1 and Anesthesia#, Valley Hospital, Ridgewood NJ; De- partment of Surgery 2 , Englewood Hospital, Englewood, NJ. Purpose: Outcome data has identified age, body mass index (BMI) and male gender as risk factors in bariatric Surgery. In the general population, increasing BMI, and obesity disease burden have been shown to adversely affect life expectancy. At the present time, there is little information which relates obesity disease burden to surgical risk. Methods: Our 9 year experience with 1009 patients undergoing primary (n 858) and revision (n 151) gastric operations for morbid obesity demonstrated a mortality rate of 0.5%, a morbidity rate of 20% and a major complication rate of 6.8%. Surgical risk factors included BMI 55 and age 55. A preoperative patient database (n 1210) was queried in order to investigate the relationship between BMI and comorbidity prevalence. In addi- tion, patients in the database are separated according to age, BMI, and gender in order to determine which patient groups had the highest prevalence of comorbid conditions. Results: Comorbidity prevalence: N % BMI>55 BMI<55 P Musculoskeletal/joint: 564 48 50% 47% ns Hypertension 519 44 51% 42% .01 Sleep Apnea 426 36 52% 31% .0001 Diabetes 246 21 22% 20% ns Respiratory 191 16 17% 18% ns Venous Stasis 39 3 7% 2% .001 Fluid Retention 16 1 4% .6% .001 Conclusions: Disease burden appears to be associated with surgi- cal risk as severe comorbid illnesses are more prevalent in patients with BMI 55, and comorbidity penetration is higher in higher risk patient groups (men, BMI 55, and age 55). PII: S1550-7289(05)00223-6 P36. SEROPREVALENCE OF HELICOBACTER PYLORI IN MORBIDLY OBESE PATIENTS Wei-Jei Lee, M.D., Ph.D., Weu Wang, M.D., Ching-Mei Lin, N.S., Tai-Chi Chen, M.D., Po-Li Wei, M.D., De- partment of Surgery and Nursing, En-Chu-Kong Hospital, and National Taiwan University, Taipei, Taiwan. Purpose: Helicobacter pylori is a major pathogen of stomach. Recent exciting findings linked H. pylori infection to ghrelin, then to obesity. The aim of the present study is to determine the prevalence of H. pylori infection in morbidly obese patients and analyze its clinical significance. Methods: The preoperative seropositivity of H. pylori was deter- mined in 293 patients who had undergone bariatric surgery for morbid obesity during the past 5 years. A normal control group comprising normal volunteers matched in sex and age was in- cluded. All the clinical data were prospectively collected and stored in a personal computer system. Results: The overall seroprevalence of H. pylori in morbidly obese patients was lower than that of normal control (41.6% vs. 58.8%; p0.01). Differences in the estimated risk of the presence of H. pylori were more pronounced in younger age group. Morbidly obese patients positive for H. pylori were associated with younger age, central obesity and abnormal liver function but not with sex, body mass index, blood pressure, blood lipid and glucose level. The perioperative parameters and weight reduction after bariatric surgery were similar between morbidly obese patients who were positive or negative for H. pylori. Conclusions: H. pylori is not a outcome predictor for bariatric surgery. A lack of H. pylori infection, especially during childhood, might enhance the risk of the development of morbid obesity. PII: S1550-7289(05)00224-8 P37. PREVIOUSLY UNDIAGNOSED MEDICAL CONDITIONS IN PATIENTS UNDERGOING BARIATRIC RISK ASSESSMENT Richard Gorman, M.D., James Ku, M.D., Penn State Surgical Weight Loss Penn State College of Medicine, S. Hershey Medi- cal Center, Hershey, PA. COMORBIDITY PENETRATION AGE<55 BMI<55 WOMEN TOTAL MEN BMI>55 AGE>55 0.0 0.5 1.0 1.5 2.0 2.5 3.0 **** **** ****P<.0001 VS TOTAL ** **P<.05 VS TOTAL ***P<.001 VS TOTAL ** 1032 922 909 1210 301 288 146 *** N: COMORBID CONDITIONS 258 Abstracts: Plenary Session/Surgery for Obesity and Related Diseases / 1 (2005) 222–283
Transcript of Seroprevalence of Helicobacter pylori in morbidly obese patients
mellitus, the prevalence of these findings has not been correlatedwith liver histopathology.Methods: Routine core liver biopsy was simultaneously per-formed on 143 (13 (9%) males and 130 (91%) females) patientsat the time of Roux-en-Y gastric bypass at UC Davis. MeanBMI was 46.9 � 5.8 kg/m2, and mean age was 43.5 � 8.9years. Twenty-two patients (15.4%) of the 143 were diabetic.Routine LFTs were obtained on all patients preoperatively.Liver specimens were histologically evaluated for the presenceof NASH.Results: Of the 143 patients, 56 (39.1%) were positive forNASH as confirmed by liver biopsy. Only 4 patients (2.7%)overall had elevated LFTs. All patients with elevated LFTsexhibited NASH on liver biopsy. In contrast, only 4 (7.1%) ofthe 56 patients, with biopsy-proven NASH, had elevated LFTspreoperatively. Seven (31.8%) of the 22 diabetic patients hadNASH on liver biopsy, and only 7 (12.5%) of the 56 patientswith NASH were diabetic.Conclusions: While abnormalities in LFTs may be associated withNASH, our findings indicate that NASH is more prevalent, in themorbidly obese, than can be deduced by changes in LFTs alone.Additionally, the presence of diabetes mellitus seems to be onlyloosely associated with NASH.
PII: S1550-7289(05)00222-4
P35.
RISK ANALYSIS IN BARIATRIC SURGERY: IMPACTOF DISEASE BURDENPeter N. Benotti, M.D.1, Hector Rodriguez, M.D.#,Nino Carnevale, M.D.1, Eduardo Liriano, M.D.2, Department ofSurgery1 and Anesthesia#, Valley Hospital, Ridgewood NJ; De-partment of Surgery2, Englewood Hospital, Englewood, NJ.
Purpose: Outcome data has identified age, body mass index (BMI)and male gender as risk factors in bariatric Surgery. In the generalpopulation, increasing BMI, and obesity disease burden have beenshown to adversely affect life expectancy. At the present time,there is little information which relates obesity disease burden tosurgical risk.Methods: Our 9 year experience with 1009 patients undergoingprimary (n � 858) and revision (n � 151) gastric operations formorbid obesity demonstrated a mortality rate of 0.5%, a morbidityrate of 20% and a major complication rate of 6.8%. Surgical riskfactors included BMI �55 and age �55. A preoperative patientdatabase (n � 1210) was queried in order to investigate therelationship between BMI and comorbidity prevalence. In addi-tion, patients in the database are separated according to age, BMI,and gender in order to determine which patient groups had thehighest prevalence of comorbid conditions.Results:
Comorbidityprevalence:
N % BMI>55 BMI<55 P
Musculoskeletal/joint: 564 48 50% 47% nsHypertension 519 44 51% 42% �.01Sleep Apnea 426 36 52% 31% �.0001Diabetes 246 21 22% 20% nsRespiratory 191 16 17% 18% nsVenous Stasis 39 3 7% 2% �.001Fluid Retention 16 1 4% .6% �.001
Conclusions: Disease burden appears to be associated with surgi-cal risk as severe comorbid illnesses are more prevalent in patientswith BMI �55, and comorbidity penetration is higher in higherrisk patient groups (men, BMI �55, and age �55).
PII: S1550-7289(05)00223-6
P36.
SEROPREVALENCE OF HELICOBACTER PYLORI INMORBIDLY OBESE PATIENTSWei-Jei Lee, M.D., Ph.D., Weu Wang, M.D.,Ching-Mei Lin, N.S., Tai-Chi Chen, M.D., Po-Li Wei, M.D., De-partment of Surgery and Nursing, En-Chu-Kong Hospital, andNational Taiwan University, Taipei, Taiwan.
Purpose: Helicobacter pylori is a major pathogen of stomach.Recent exciting findings linked H. pylori infection to ghrelin, thento obesity. The aim of the present study is to determine theprevalence of H. pylori infection in morbidly obese patients andanalyze its clinical significance.Methods: The preoperative seropositivity of H. pylori was deter-mined in 293 patients who had undergone bariatric surgery formorbid obesity during the past 5 years. A normal control groupcomprising normal volunteers matched in sex and age was in-cluded. All the clinical data were prospectively collected andstored in a personal computer system.Results: The overall seroprevalence of H. pylori in morbidly obesepatients was lower than that of normal control (41.6% vs. 58.8%;p�0.01). Differences in the estimated risk of the presence of H.pylori were more pronounced in younger age group. Morbidlyobese patients positive for H. pylori were associated with youngerage, central obesity and abnormal liver function but not with sex,body mass index, blood pressure, blood lipid and glucose level.The perioperative parameters and weight reduction after bariatricsurgery were similar between morbidly obese patients who werepositive or negative for H. pylori.Conclusions: H. pylori is not a outcome predictor for bariatricsurgery. A lack of H. pylori infection, especially during childhood,might enhance the risk of the development of morbid obesity.
PII: S1550-7289(05)00224-8
P37.
PREVIOUSLY UNDIAGNOSED MEDICAL CONDITIONSIN PATIENTS UNDERGOING BARIATRIC RISKASSESSMENTRichard Gorman, M.D., James Ku, M.D., Penn State SurgicalWeight Loss Penn State College of Medicine, S. Hershey Medi-cal Center, Hershey, PA.
COMORBIDITY PENETRATION
AGE<55 BMI<55 WOMEN TOTAL MEN BMI>55 AGE>550.0
0.5
1.0
1.5
2.0
2.5
3.0
****
****
****P<.0001 VS TOTAL
**
**P<.05 VS TOTAL ***P<.001 VS TOTAL
**
1032 922 909 1210 301 288 146
***
N:
COM
ORBID
CONDIT
IONS
258 Abstracts: Plenary Session/Surgery for Obesity and Related Diseases / 1 (2005) 222–283
