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Country of origin and bariatric surgery in Sweden during 2001-2010.

ABSTRACT: The prevalence of obesity, as well as use of bariatric surgery, has increased worldwide. The aim of the present study was to investigate the potential differences in the use of bariatric surgery among Swedes and immigrants in Sweden and whether the hypothesized differences remain after adjustment for socioeconomic factors.A closed cohort of all individuals aged 20-64 years was followed during 2001-2010. Further analyses were performed in 2 periods separately (2001-2005 and 2006-2010). Age-standardized cumulative incidence rates (CR) of bariatric surgery were compared between Swedes and immigrants considering individual variables. Cox proportional hazards models were used in univariate and multivariate models for males and females.A total of 12,791 Swedes and 2060 immigrants underwent bariatric surgery. The lowest rates of bariatric surgery were found in immigrant men. The largest difference in CR between Swedes and immigrants was observed among low-income individuals (3.4 and 2.3 per 1000 individuals, respectively). Adjusted hazard ratios (HRs) were lower for all immigrants compared with Swedes in the second period. The highest HRs were observed among immigrants from Chile and Lebanon and the lowest among immigrants from Bosnia. Except for Nordic countries, immigrants from all other European countries had a lower HR compared with Swedes.Men in general and some immigrant groups had a lower HR of bariatric surgery. Moreover, the difference between Swedes and immigrants was more pronounced in individuals with low socioeconomic status (income). It is unclear if underlying barriers to receive bariatric surgery are due to patients' preferences/lack of knowledge or healthcare structures. Future studies are needed to examine potential causes behind these differences.

SUBMITTER: Memarian E

PROVIDER: S-EPMC4804704 | biostudies-literature | 2015 Nov-Dec

REPOSITORIES: biostudies-literature

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Country of origin and bariatric surgery in Sweden during 2001-2010.

Memarian Ensieh E Sundquist Kristina K Calling Susanna S Sundquist Jan J Li Xinjun X

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery 20150328 6

<h4>Background</h4>The prevalence of obesity, as well as use of bariatric surgery, has increased worldwide. The aim of the present study was to investigate the potential differences in the use of bariatric surgery among Swedes and immigrants in Sweden and whether the hypothesized differences remain after adjustment for socioeconomic factors.<h4>Methods</h4>A closed cohort of all individuals aged 20-64 years was followed during 2001-2010. Further analyses were performed in 2 periods separately (2 ...[more]

PMID: 25979207

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Project description:Background:Bariatric surgery is a widely adopted treatment for obesity and its secondary complications. In the past decade, microvesicles (MVs) and CD36 have increasingly been considered as possible biomarkers for obesity, the metabolic syndrome (MetSy), type 2 diabetes mellitus (T2DM). Thus, the purpose of this study was to investigate how weight loss resulting from bariatric surgery affects levels of specific MV phenotypes and their expression of CD36 scavenger receptor. Additionally, we hypothesised that subjects with MetSy had higher baseline concentrations of investigated MV phenotypes. Methods:Twenty individuals undergoing Roux-en-Y gastric bypass surgery were evaluated before and 3 months after surgery. MVs were characterised by flow cytometry at both time points and defined as lactadherin-binding particles within a 100-1000 nm size gate. MVs of monocyte (CD14) and endothelial (CD62E) origin were defined by cell-specific markers, and their expression of CD36 was investigated. Results:Following bariatric surgery, subjects incurred an average BMI reduction (delta) of -?8.4?±?1.4 (p?<?0.0001). Significant reductions were observed for the total MVs (-?66.55%, p?=?0.0017) and MVs of monocyte (-?36.11%, p?=?0.0056) and endothelial (-?40.10%, p?=?0.0007) origins. Although the bulk of CD36-bearing MVs were unaltered, significant reductions were observed for CD36-bearing MVs of monocyte (-?60.04%, p?=?0.0192) and endothelial (-?54.93%, p?=?0.04) origin. No differences in levels of MVs were identified between subjects who presented with MetSy at baseline (n?=?13) and those that did not (n?=?7). Conclusion:Bariatric surgery resulted in significantly altered levels of CD36-bearing MVs of monocyte and endothelial origin. This likely reflects improvements in ectopic fat distribution, plasma lipid profile, low-grade inflammation, and oxidative stress following weight loss. Conversely, however, the presence of MetSy at baseline had no impact on MV phenotypes.

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Country of origin and bariatric surgery in Sweden during 2001-2010.

Publications

Country of origin and bariatric surgery in Sweden during 2001-2010.

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