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The association between bariatric surgery (BS) and the prevention of type 2 diabetes (T2D) and its complications in patients with obesity has been rarely addressed in large, nationwide database studies.To estimate the preventive effect of BS against T2D and its vascular complications in patients with obesity without co-morbidity at baseline.All French public and private hospitals.Data were extracted from the French National Health Service database between 2008 and 2016. All patients with obesity aged 18- to 60-years old, free of T2D and major co-morbidities, and with at least 1 year of follow-up were analyzed. Patients who had undergone gastric bypass (GB), sleeve gastrectomy (SG), or adjustable gastric banding (AGB) were included in the BS group, and patients with obesity with no history of BS were considered as controls.Of 328,509 patients with obesity, 102,627 had BS. Between 2009 and 2016, 9.7% (31,946/328,509) of patients had a diagnosis of T2D associated with morbid obesity, 13.2% of the control group versus 2.0% of the BS group (P.001). BS was associated with favorable 8-year T2D event-free survival estimates of 92.3% in the BS group against 58.2% in the control group. The hazard ratio for the diagnosis of T2D was .18 (95% confidence interval, .17-.19) for the BS group versus controls, after adjustment on age, sex, body mass index, and baseline differences. A significant difference was found between the type of bariatric procedure (P.001) with more T2D after AGB (4.5%) than after GB (1.2%) or SG (0.9%). T2D complications were more common in controls (P.001) with multiple T2D complications occurring in 1% of patients in the control group and .1% in the BS group (P0.001). GB and SG were more effective than AGB.This nationwide study shows that BS reduces the new onset of T2D in patients with obesity by 82%. SG and GB give comparable results and both are more effective than AGB.

The epidemic of obesity parallels that of chronic kidney disease (CKD). Obesity worsens the course of CKD, mainly defined by an abnormal glomerular filtration rate (GFR). Patients with severe obesity stages (II and III with body mass index \textgreater35 kg/m(2)) are eligible for bariatric surgery (BS), which is the most efficient method of achieving durable weight loss. BS may reverse glomerular hyperfiltration and albuminuria, improve adipocytokine profile, and relieve diabetes and hypertension. Obesity remission after BS might prevent the progression of renal failure in populations with morbid obesity. However, evidence for the beneficial effect of BS on renal function is scant. This lack of knowledge is mainly due to methodologic reasons, which are addressed in this review. The reversibility of hyperfiltration due to the presence of functional renal reserve hampers the interpretation of changes in true GFR after BS. This true GFR is only obtained with the renal clearance of an exogenous filtration marker. Estimation of GFR is generally provided by prediction equations, namely by modification of diet in renal diseases or by chronic kidney disease epidemiology collaborative group. These equations are not accurate because the serum levels of both creatinine and cystatin C depend on extrarenal factors, which are modified by BS. Comparing the slopes of measured GFR according to various durations of exposure with morbid obesity would be critical in providing reliable data. Herein, we review the current knowledge on the effects of BS on kidney function; we specify the methodologic issues and particularities of the dietary management of CKD patients to propose reliable directions for future clinical research. (C) 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

In buffaloes in healthy condition during dry-period (DP), levels of haptoglobin which has been identified as the parameter most sensitive to stress in the buffalo, were found to be up to 8 times higher than the mean value (1). The aim of the study was to evaluate by means of a retrospective analysis the state of innate immunity of pluriparous buffaloes during the DP between healthy buffaloes vs buffaloes with health disorders in the first week after delivery. The study was conducted on 15 buffaloes in healthy clinical status whit a partum-conception period of 52.40 ± 8.80 days, milk yield of 2433.50 ± 231.60 kg in 291.80 ± 3.46 days. Weekly blood samples were taken starting from the 14th day after the beginning of the DP to 7 days after parturition. The samples were centrifuged and the serum was stocked at -80°C until analytical tests were carried out. Samples were tested for: hemolytic complement (2), lysozyme (3), bactericidal activity (4), haptoglobin, uric acid, amylase, bilirubine, ALP, CK-NAC total, cholesterol, creatinine, γGT, glucose, AST, ALT, ALP, LDH, Mg, P, triglycerides and urea. By retrospectively analyses data recovered were compared between animal with (Group NH, n=6) and without (Group H, n=9) healthy disorders in the first week after parturition. Statistical analysis were performed by Student's t-test. No differences ware observed between two groups in, milk yield, length of dry period, metabolic parameters and hemolytic complement, lysozyme, bactericidal activity values. Haptoglobin value showed a higher value in group NH starting to 21 days before calving to 7 days after parturition (fig.1) Analysis of data suggests that during dry period, haptoglobin could be used as predictive index for healthy disorders risk. Further studies are required to improve the understanding of the timing of these indexes and their correlation with different healthy postpartum disorders.