Dataset Information

Improvement in mood symptoms after post-bariatric surgery among people with obesity: A systematic review and meta-analysis.

ABSTRACT:

Aims

We aimed to examine if bariatric surgery was associated with a reduction in the prevalence of depressive and anxiety symptoms among people with obesity.

Materials and methods

We pooled data from 49 studies involving 11,255 people with obesity who underwent bariatric surgery. The study outcomes were the prevalence of depressive and anxiety symptoms among these patients pre- and post-surgery.

Results

There was a significant reduction in body mass index (BMI) post-operatively (pooled d+: -13.3 kg/m² [95% confidence interval [CI] 15.19, -11.47], p < 0.001). The pooled proportion of patients with anxiety symptoms reduced from 24.5% pre-operatively to 16.9% post-operatively, with an odds ratio (OR) of 0.58 (95% CI 0.51, 0.67, p < 0.001). The reduction remained significant in women aged ≥40 years and irrespective of post-operative BMI. There were significant reductions in Hospital Anxiety and Depression Score (HADS) (anxiety component) by 0.64 (pooled d+: -0.64 [95% CI -1.06, -0.22], p = 0.003) and Generalized Anxiety Disorder Assessment-7 score by 0.54 (pooled d+: -0.54 [95% CI -0.64, -0.44], p < 0.001). The pooled proportion of depressive symptoms reduced from 34.7% pre-operatively to 20.4% post-operatively, with an OR of 0.49 (95% CI 0.37, 0.65, p < 0.001). The reduction remained significant irrespective of patient's age and post-operative BMI. There were also significant reductions in HADS score (depressive component) (pooled d+: -1.34 [95% CI -1.93, -0.76], p < 0.001), Beck's Depression Inventory score (pooled d+: -1.04 [95% CI -1.46, -0.63], p < 0.001) and Patient Health Questionnaire-9 score (pooled d+: -1.11 [95% CI -1.21, -1.01], p < 0.001).

Conclusion

Bariatric surgery was associated with significant reduction in the prevalence and severity of depressive and anxiety symptoms among people with obesity.

SUBMITTER: Loh HH

PROVIDER: S-EPMC9285936 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Publications

Improvement in mood symptoms after post-bariatric surgery among people with obesity: A systematic review and meta-analysis.

Loh Huai Heng HH Francis Benedict B Lim Lee-Ling LL Lim Quan Hziung QH Yee Anne A Loh Huai Seng HS

Diabetes/metabolism research and reviews 20210504 8

<h4>Aims</h4>We aimed to examine if bariatric surgery was associated with a reduction in the prevalence of depressive and anxiety symptoms among people with obesity.<h4>Materials and methods</h4>We pooled data from 49 studies involving 11,255 people with obesity who underwent bariatric surgery. The study outcomes were the prevalence of depressive and anxiety symptoms among these patients pre- and post-surgery.<h4>Results</h4>There was a significant reduction in body mass index (BMI) post-operati ...[more]

PMID: 33891377

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Project description:BackgroundAlthough numerous studies have shown that bariatric surgery results in sustained weight loss and modifications in gut microbiota composition and cognitive function, the exact underlying mechanisms are unclear. This study aimed to investigate the effects of bariatric surgery on cognitive function through the microbiota-gut-brain axis (MGBA).MethodsDemographic data, serum samples, fecal samples, cognitive assessment scales, and resting-state functional connectivity magnetic resonance imaging (rs-fMRI) scans were obtained from 39 obese patients before and after (6 months) laparoscopic sleeve gastrectomy (LSG). PCA analysis, OPLS-DA analysis, and permutation tests were used to conduct fecal 16 S microbiota profiling, serum metabolomics, and neuroimaging analyses, and a bariatric surgery-specific rs-fMRI brain functional connectivity network was constructed. Spearman correlation analysis and Co-inertia analysis were employed to correlate significant alterations in cognitive assessment scales and resting-state functional connectivity difference networks with differential serum metabolites and 16 S microbiota data to identify key gut microbiota and serum metabolic factors.ResultsLSG significantly reduced the weight of obese patients, with reductions of up to 28%. Furthermore, cognitive assessment scale measurements revealed that LSG enhanced cognitive functions, including memory (HVLT, p = 0.000) and executive function (SCWT, p = 0.008). Also, LSG significantly altered gut microbiota composition (p = 0.001), with increased microbial abundance and diversity (p < 0.05). Moreover, serum metabolite levels were significantly altered, revealing intergroup differences in 229 metabolites mapped to 72 metabolic pathways (p < 0.05, VIP > 1). Spearman correlation analysis among cognitive assessment scales, gut microbiota species, and serum metabolites revealed correlations with 68 gut microbiota species and 138 serum metabolites (p < 0.05). Furthermore, pairwise correlations were detected between gut microbiota and serum metabolites (p < 0.05). Functional neuroimaging analysis revealed that LSG increased functional connectivity in cognitive-related frontotemporal networks (FPN, p < 0.01). Additionally, normalization of the default mode network (DMN) and salience network (SN) connectivity was observed after LSG (p < 0.001). Further canonical correlation and correlation analysis suggested that the cognitive-related brain network changes induced by LSG were associated with key gut microbiota species (Akkermansia, Blautia, Collinsella, Phascolarctobacterium, and Ruminococcus, p < 0.05) and neuroactive metabolites (Glycine, L-Serine, DL-Dopa, SM (d18:1/24:1(15Z), p < 0.05).ConclusionThese findings indicate the pathophysiological role of the microbiota-gut-brain axis in enhancing cognitive function after bariatric surgery, and the study provides a basis for clinical dietary adjustments, probiotic supplementation, and guidance for bariatric surgery, but further research is still needed.Trial registrationChinese Clinical Trial Registry, ChiCTR2100049403. Registered 02 August 2021, https://www.chictr.org.cn/ .

Project description:ObjectiveTo quantify the overall effects of bariatric surgery compared with non-surgical treatment for obesity.DesignSystematic review and meta-analysis based on a random effects model.Data sourcesSearches of Medline, Embase, and the Cochrane Library from their inception to December 2012 regardless of language or publication status.Eligibility criteriaEligible studies were randomised controlled trials with ≥ 6 months of follow-up that included individuals with a body mass index ≥ 30, compared current bariatric surgery techniques with non-surgical treatment, and reported on body weight, cardiovascular risk factors, quality of life, or adverse events.ResultsThe meta-analysis included 11 studies with 796 individuals (range of mean body mass index at baseline 30-52). Individuals allocated to bariatric surgery lost more body weight (mean difference -26 kg (95% confidence interval -31 to -21)) compared with non-surgical treatment, had a higher remission rate of type 2 diabetes (relative risk 22.1 (3.2 to 154.3) in a complete case analysis; 5.3 (1.8 to 15.8) in a conservative analysis assuming diabetes remission in all non-surgically treated individuals with missing data) and metabolic syndrome (relative risk 2.4 (1.6 to 3.6) in complete case analysis; 1.5 (0.9 to 2.3) in conservative analysis), greater improvements in quality of life and reductions in medicine use (no pooled data). Plasma triglyceride concentrations decreased more (mean difference -0.7 mmol/L (-1.0 to -0.4) and high density lipoprotein cholesterol concentrations increased more (mean difference 0.21 mmol/L (0.1 to 0.3)). Changes in blood pressure and total or low density lipoprotein cholesterol concentrations were not significantly different. There were no cardiovascular events or deaths reported after bariatric surgery. The most common adverse events after bariatric surgery were iron deficiency anaemia (15% of individuals undergoing malabsorptive bariatric surgery) and reoperations (8%).ConclusionsCompared with non-surgical treatment of obesity, bariatric surgery leads to greater body weight loss and higher remission rates of type 2 diabetes and metabolic syndrome. However, results are limited to two years of follow-up and based on a small number of studies and individuals.Systematic review registrationPROSPERO CRD42012003317 (www.crd.york.ac.uk/PROSPERO).

Dataset Information

Improvement in mood symptoms after post-bariatric surgery among people with obesity: A systematic review and meta-analysis.

Aims

Materials and methods

Results

Conclusion

Publications

Improvement in mood symptoms after post-bariatric surgery among people with obesity: A systematic review and meta-analysis.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

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Dataset Information

Improvement in mood symptoms ​after post-bariatric surgery among people with obesity: A systematic review and meta-analysis.

Aims

Materials and methods

Results

Conclusion

Publications

Improvement in mood symptoms ​after post-bariatric surgery among people with obesity: A systematic review and meta-analysis.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Improvement in mood symptoms after post-bariatric surgery among people with obesity: A systematic review and meta-analysis.

Improvement in mood symptoms after post-bariatric surgery among people with obesity: A systematic review and meta-analysis.