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Background: The study of the effects of bariatic surgery on quality of life in patients of different socioeconomic levels (SEL) is worthwhile. Aim: To study quality of life (QoL), eating behaviour, depressive symptoms and sexuality in patients subjected to a gastric bypass (GBP) more than 1 year before. Material and methods: The sample was composed of 33 GPB patients (19 high SEL and 14 low SEL), and 27 non-operated women (18 high SEL and 9 low SEL) of similar weight and age, as controls. Assessment included medical history, anthropometry, radiological densitometry. Eating behaviour was assessed using the three factor eating questionnaire, quality of life using SF-36 and the Bariatric Analysis of Reporting Outcome System (BAROS) depressive symptoms were assessed using the Beck scale version II and sexual behaviour using the female sexual function index (FSFI). Results: QoL was lower in operated patients from low SEL, especially when compared to high SEL control women. Operated patients had a predominantly restrictive pattern of eating behavior. Eating behavior disorders were detected in 5 of 33 operated patients versus 4 of 27 controls (p =ns). Sexual function was absent or dysfunctional in 22 operated versus 8 controls (p =0,02). No significant differences were observed for depressive symptoms, between operated patients and controls. Conclusions: In the long term, QoL of bariatric patients, especially those from low SEL, is inferior to control women and Chilean general population. Operated patients have restrictive eating patterns and lower sexual satisfaction indexes. Frequency of depressive symptoms was high both in bariatric and control women (Rev Med Chile 2009; 137: 625-33). (Key words: Bariatric surgery; Quality of life; Socioeconomic factors)

Background: Roux-en-Y gastric bypass (RYGBP) has had a positive impact on co-morbidities associated with obesity. However, in the long-term it can induce micronutrient deficiencies. Aim: To perform a complete nutritional assessment in a group of women previously operated of RYGBP, from different socioeconomic levéis (SEL). Patients and Methods: Thirty three women (19 high SEL and 14 low SEL), were assessed by dietary recalls, anthropometric measurements, muscle strength, bone mineral density, routine clinical laboratory, serum levéis of vitamin B12, 250H-vitamin D, Mate, calcium, ferritine, ceruloplasmin and indicators ofbone turnover (parathohormone, osteocalcin and urinary pyridinolines). Their valúes were compared to those of 30 control women (18 high SEL and 12 low SEL). Results: Low SEL operated women consumed fewer vitamin and mineral supplements compared with their high SEL pairs. No cases of vitamin B12, folie acid or copper deficiencies were detected. Frequency of iron deficieney was similar in patients and controls. Vitamin D insufficieney was higher amongpatients than in controls (p =0,04 7), regardless SEL. Patients had also a higher frequency of high serum PTH and osteocalcin and urinary pyridinoline levéis. However, no differences in bone mineral density were observed between operated women and controls. Conclusions: Vitamin and mineral deficiencies were lower than expected among operated women. However, problems associated with vitamin D deficieney were highly prevalent among patients operated of RYGBP, irrespective SEL. These alterations were only detectable through speciñe markers at this stage, because they did not transíate into lower bone mineral density (BMD) of surgicalpatients, probably due to the higher pre-operative BMD of these morbidobese patients.

The contribution of high serum levels of cholesterol to atherogenesis has been widely recognized, but the mechanisms are not completely clear. Numerous publications have emphasized that oxidized, but not native low-density lipoproteins, are the particles incorporated into the arterial wall. A group of receptors generically called "scavenger" (SR), actively bind these modified lipoproteins and incorporate them into monocytes-macrophages, in the arterial intima. SR are not down regulated by intracellular concentrations of cholesterol, thus accumulating huge amounts of lipids, transforming monocyte-macrophages into foam cells, predominant cell type of the fatty streak. The simultaneous cytokine production and migration of other cellular types progressively transform this initial lesion into the organized atherosclerotic plaque. In this setting SR, which are up-regulated by oxidized LDL, play a central promoting role. Its presence has been demonstrated in arterial plaques both in human and animal models, and its blockade protects animals from development or progression of atherosclerosis. In humans, elevated antibody titers to oxidized LDL in patients with coronary stenosis, and increased SR activity, in pro-atherogenic conditions such as haemodialysis, indicate that this model may operate as well, but the evidences are still not solid enough to definitively conclude that the oxidized-LDL-SR hypothesis is a finished puzzle.