Farklı ağırlıktaki bireylerde intragastrik botulinum toksin enjeksiyonu sonrası kilo kaybı

Year 2020, Volume: 3 Issue: 3, 295 - 300, 18.06.2020

Fatih Can Karaca

https://doi.org/10.32322/jhsm.496356

Abstract

Amaç: İntragastrik Botulinum toksin A enjeksiyonunun, kilo kaybını indüklediği ve asetilkolin aracılı gastrik kasılmaların inhibisyonu sonucu gastrik motiliteyi yavaşlattığı gösterilmiştir. Bu çalışmanın amacı, obez hastalarda intragastrik botulinum toksin A enjeksiyonunun endoskopik intragastrik enjeksiyonlarının kilo kaybı üzerine etkilerini gözlemlemektir.
Gereç ve Yöntem: Toplam 400 U intragastrik botulinum toksin A enjeksiyonu endoskopik olarak midenin antrum, korpus ve fundus bölgelerine enjekte edildi. Vücut kitle indeksi değerlerine göre alt gruplara ayrılan 102 hastanın takip sonuçları ve kilo verme durumları değerlendirildi. Kilo kaybı verileri, birbirini izleyen üç ay boyunca aylık takip vizitlerinde kaydedildi.
Bulgular: Üçüncü ayın sonunda tüm hastaların vücut ağırlığında azalma gözlendi ve toplam ortalama kilo kaybı oranı %4,76-19,47 arasında değişti. Ortalama toplam vücut ağırlığı kaybı yüzdeleri Sınıf II ve III obez bireylerde normal ve aşırı kilolu ve Sınıf I obez bireylere göre anlamlı olarak daha yüksekti. Gastrointestinal yan etkiler hastaların sadece beşinde (%4,9) gözlendi.
Sonuç: 400 U’luk dozla intragastrik botulinum toksini enjeksiyonu uygulaması, farklı vücut kitle indekslerindeki bireylerde kilo kaybı amacıyla kullanımı uygun bir yöntemdir.

Keywords

Botulinum toksini, botulinum toksin enjeksiyonu, obezite, kilo kaybı

Weight loss after intragastric botulinum toxin injection in different weight individuals

Abstract

Background: Intragastric injection of Botulinum toxin A has been shown to induce weight loss, slowering gastric motility as a result of inhibition of the acetylcholine-mediated gastric contractions. The aim of this study was to observe the effects of endoscopic intragastric injections of intragastric injection of botulinum toxin A in obese patients.
Material and Method: A total dose of 400 U intragastric injection of botulinum toxin A was injected endoscopically into the antrum, corpus and fundus regions of the stomach. The follow-up results of 102 patients sub-grouped according to body mass indices values and evaluated the weight loss status were evaluated. Weight loss data was collected on the monthly follow-up visits for three consecutive months.
Results: At the end of the third month, all subjects lost body weight, with a mean total weight loss ratio ranging between 4.76-19.47%. Mean total body weight loss percentages were significantly higher in Class II and III obese subjects compared to the normal- and over-weight and Class I obese individuals. Gastrointestinal adverse effects were observed in only five (4.9%) of the patients.
Conclusion: Intragastric injection of botulinum toxin A administration with a dose of 400 U is a convenient method for weight loss for the individuals of different body mass indices.

Keywords

botulinum toxin, botulinum toxin injection, obesity, weight loss

References

• 1. WHO. Obesity and overweight. Key facts. Available at: http://www.who.int/mediacentre/factsheets/fs311/en/ Date accessed: April, 2020.
• 2. OECD. Obesity Update 2017. Available at: https://www.oecd.org/els/health-systems/Obesity-Update-2017.pdf Date accessed: April, 2020.
• 3. Nyberg ST, Batty GD, Pentti J, et al. Obesity and loss of disease-free years owing to major non-communicable diseases: a multicohort study. Lancet 2018; 3: 490-7.
• 4. Hallett, M. One man’s poison—clinical applications of botulinum toxin. N Engl J Med 1999; 341: 11-20.
• 5. Lemiere S, Bruley Des Varannes S. Pharmacologic actions and therapeutic importance of botulinum toxin in digestive diseases. Gastroenterol Clin Biol 1999; 23: 229-37.
• 6. Avena, NM, Rada PV. Cholinergic modulation of food and drug satiety and withdrawal. Physiol Behav 2012; 3: 333-6.
• 7. Cullen JJ, Kelly KA. Motility disorders of the gastro-intestinal tract: gastric motor physiology and pathophysiology. Surg Clin N Am 1993: 743: 1145-60.
• 8. Gui D, De Gaetano A, Spada PL, Viggiano A, Cassetta E, Albanese A. Botulinum toxin injected in the gastric wall reduces body weight and food intake in rats. Aliment Pharmacol Ther 2000; 14: 829-34.
• 9. Coskun H, Duran Y, Dilege E, Mihmanli M, Seymen H, Demirkol MO. Effect on gastric emptying and weight reduction of botulinum toxin-A injection into the gastric antral layer: an experimental study in the obese rat model. Obes Surg 2005; 15: 1137-43.
• 10. Bang CS, Baik GH, Shin IS, et al. Effect of intragastric injection of botulinum toxin a for the treatment of obesity: a meta-analysis and meta-regression. Gastrointest Endosc 2015; 81: 1141-9.
• 11. Plecka Östlund M, Marsk R, Rasmussen F, Lagergren J, Näslund E. Morbidity and mortality before and after bariatric surgery for morbid obesity compared with the general population. Br J Surg 2011; 98: 811-6.
• 12. Topazian M, Camilleri M, De La Mora-Levy J, et al. Endoscopic ultrasound-guided gastric botulinum toxin injections in obese subjects: a pilot study. Obes Surg 2008; 18: 401-7.
• 13. Foschi D, Lazzaroni M, Sangaletti O, Corsi F, Trabucchi E, Bianchi Porro G. Effects of intramural administration of botulinum toxin a on gastric emptying and eating capacity in obese patients. Dig Liver Dis 2008; 40: 667-72.
• 14. Mittermair R, Keller C, Geibel J. Intragastric injection of botulinum toxin a for the treatment of obesity. obes Surg 2007; 17: 732-6.
• 15. Bustamante F, Brunaldi VO, Bernardo WM, et al. Obesity treatment with botulinum toxin-a is not effective: a systematic review and meta-analysis. Obes Surg 2017; 27: 2716-23.
• 16. Topazian M, Camilleri M, Enders FT, et al. Gastric antral injections of botulinum toxin delay gastric emptying but do not reduce body weight. Clin Gastroenterol Hepatol 2013; 11: 145-50.
• 17. Garcia-Compean D, Mendoza-Fuerte E, Martinez JA, Villarreal I, Maldonado H. Endoscopic injection of botulinum toxin in the gastric antrum for the treatment of obesity. results of a pilot study. Gastroenterol Clin Biol 2005; 29: 789-91.
• 18. Júnior AC, Savassi-Rocha PR, Coelho LG, et al. Botulinum A toxin injected into the gastric wall for the treatment of class III obesity: a pilot study. Obes Surg 2006; 16: 335-43.
• 19. Gui D, Mingrone G, Valenza V, et al. Effect of botulinum toxin antral injection on gastric emptying and weight reduction in obese patients: a pilot study. Aliment Pharmacol Ther 2006; 23: 675-80.
• 20. Gracis JM, Simpson DM. Botulinum toxin therapy. The Neurol 2000; 6: 98-100.
• 21. Brin MF. Botulinum toxin: chemistry, pharmacology, toxicity, and immunology. Muscle Nerve 1997; 6: 146-68.
• 22. Granstrom L, Backman L. Stomach distension in extremely obese and normal subjects. Acta Chir Scand 1985; 151: 367-70.