PHARMACOKINETICS AND PHARMACOLOGICAL EFFECTS OF ALCOHOL AFTER BARIATRIC SURGERY

减肥手术后酒精的药代动力学和药理作用

• 批准号: 8301433
• 负责人: MARTA YANINA PEPINO DE GRUEV
• 金额: $ 25.87万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-10 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8301433
• 关键词: Affect; Alcohol abuse; Alcohol consumption; Alcoholic Beverages; Alcoholism; Alcohols; American; Anatomy; Bariatrics; Beverages; Blood alcohol level measurement; Blood specimen; Body Water; Body Weight; Body Weight decreased; Breath Tests; Clinical Practice Guideline; Consumption; Control Groups; Counseling; Data; Deuterium; Development; Dose; Drug Kinetics; Drug abuse; Epidemic; Equipment and supply inventories; Ethanol Metabolism; Family history of; Foundations; Gas Chromatography; Gastric Bypass; Goals; Gold; Health; Health Benefit; Intestines; Kinetics; Laparoscopy; Limb structure; Longitudinal Studies; Measures; Methods; Moods; Obesity; Operative Surgical Procedures; Participant; Patients; Pharmaceutical Preparations; Pharmacodynamics; Physiological; Placebo Control; Placebos; Postoperative Period; Prevention; Procedures; Process; Quality of life; Questionnaires; Randomized; Research; Risk; Route; Sampling; Stomach; Techniques; Testing; Time; United States; Upper digestive tract structure; Weight; Woman; addiction; alcohol effect; alcohol misuse; alcohol response; alcohol use disorder; bariatric surgery; drinking; evidence base; falls; improved; non-alcoholic; obesity treatment; prevent; response; sensor; standard of care

DESCRIPTION (provided by applicant): Today, millions of Americans have had bariatric surgery, and given the magnitude of the obesity epidemic, it is anticipated that this number will continue to rise. Despite the numerous health benefits of these procedures, there is a growing concern with the development of alcohol problems after gastric bypass surgery. We believe that changes in alcohol pharmacokinetics and subjective responses to alcohol that occur as a result of the anatomical and physiological changes caused by upper gastrointestinal tract diversion might be an important mechanism responsible for the association between gastric bypass surgery and postoperative alcohol abuse. The current proposal will be the first study that will investigate the effects of gastric bypass surgery on subjective responses to alcohol and alcohol pharmacokinetic using validated methods and controlling for the important confounding effect of changes in body weight. Patients who will undergo gastric bypass surgery and a group of patients undergoing banding gastric surgery will be evaluated 3 times before and 3 times 9 m after surgery following identical procedures. Unlike after gastric bypass, the anatomy of the intestine/stomach is intact after gastric banding. Thus, gastric banding subjects will allow controlling for changes in alcohol metabolism and mood effects that could be caused by weight loss. Breath and blood samples will be taken before and at various times after a dose of alcohol (0.8 or 1.4 g/l of total body water) or non-alcoholic placebo control are consumed. Blood alcohol concentrations (BAC) will be determined by the gold standard technique of headspace gas chromatography and these concentrations will be compared with the BAC estimated from breath samples. Subjective ratings of alcohol effects will be measured by validated questionnaires extensively used in the field. The results from our study will lay the foundation for understanding the effect of gastric bypass and gastric banding procedures on alcohol kinetics and pharmacodynamics, which can help tailor counseling in patients undergoing these procedures and prevent alcohol misuse after surgery. PUBLIC HEALTH RELEVANCE: Although gastric bypass surgery provides one of the most successful long-term treatments for obesity and is associated with numerous health benefits, there is an increasing concern about the development of alcohol problems after this procedure. The results from our study will lay the foundation for understanding how gastric bypass surgery affects the way alcohol is processed by the body and the effects that alcohol has on patients after surgery. This evidence-base data will support patient counseling and may help in the prevention of alcohol misuse after gastric bypass surgery.

描述（由申请人提供）：今天，数以百万计的美国人进行了减肥手术，并且鉴于肥胖症流行的大小，预计这一数字将继续增加。尽管这些程序对健康有很多好处，但胃搭桥手术后的酒精问题的发展越来越关注。我们认为，由于上胃肠道转移引起的解剖学和生理变化而导致的酒精药代动力学和对酒精的主观反应的变化可能是负责胃旁路手术与术后酒精滥用之间关联的重要机制。当前的提案将是第一项研究，该研究将研究胃搭桥手术对酒精和酒精药代动力学对主观反应的影响，并控制体重变化的重要混杂作用。将在手术前3次接受胃搭桥手术和一组接受胃手术的患者进行3次评估，然后在手术后9 m进行3次评估。与胃旁路后不同，胃结束后肠道/胃的解剖结构完好无损。因此，胃束缚受试者将允许控制酒精代谢的变化以及可能由体重减轻引起的情绪影响。消耗酒精剂量（0.8或1.4 g/l的全身水）或非酒精安慰剂控制后的不同时间和血液样本。血液酒精浓度（BAC）将由顶空气相色谱的黄金标准技术确定，这些浓度将与呼吸样品估计的BAC进行比较。酒精效应的主观评分将通过在现场广泛使用的经过验证的问卷来衡量。我们研究的结果将为理解奠定基础 胃搭桥和胃束带程序对酒精动力学和药效学的影响，这可以帮助量身定制接受这些程序的患者咨询，并在手术后防止滥用酒精。 公共卫生相关性：尽管胃旁路手术提供了肥胖症最成功的长期治疗方法之一，并且与众多健康益处有关，但人们对此后酒精问题的发展越来越担心。我们研究的结果将为了解胃旁路手术如何影响人体的酒精处理方式以及酒精对手术后患者的影响奠定基础。该证据基本数据将支持患者咨询，并可能有助于预防胃搭桥手术后的酒精滥用。