human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background / Objectives . Embolization of the left gastric artery ( LGA ) , which preferentially supplies the gastric fundus , has been shown to produce weight loss in animal models . However , weight loss after LGA embolization in humans has not been previously established . The aim of this study was to evaluate postprocedural weight loss in patients following LGA embolization .  Subjects/ Methods . A retrospective analysis of the medical records of patients who underwent LGA embolization for upper gastrointestinal ( GI ) bleeding was performed . Postprocedural weight loss in this group was compared to a control group of patients who had undergone embolization of other arteries for upper GI bleeding . Results . The experimental group ( N = 19 ) lost an average of 7.3 % of their initial body weight within three months of LGA embolization , which was significantly greater than the 2 % weight loss observed in the control group ( N = 28 ) ( P = 0.006 ) . No significant differences were seen between the groups in preprocedural body mass index ( BMI ) , age , postprocedural care in the intensive care unit , history of malignancy , serum creatinine , or left ventricular ejection fraction . Conclusions . The current data suggest that body weight in humans may be modulated via LGA embolization . Continued research is warranted with prospect i ve studies to further investigate this phenomenon Overweight patients with uncomplicated essential hypertension were followed up biweekly for six months : 24 not receiving antihypertensive-drug therapy ( Group I ) and 83 on  regular but inadequate ( despite drug manipulation ) antihypertensive-drug therapy ( Group II ) . All patients in Group I and 57 r and omly selected patients from group II ( IIa ) participated in a weight-reduction program . The remaining 26 from Group II ( IIb ) did not receive a dietary program .  Salt intake was in the normal range in all three groups . All patients on the dietary program lost at least 3 kg ( mean , 10.5 kg ) , and all but two showed a meaningful reduction in blood pressure ; 75 per cent of Group I and 61 per cent of Group IIa returned to normal blood pressure . The weight and blood-pressure reductions were highly significant ( P less than 0.001 ) , were present in both sexes and all ages , and were directly associated . In Group IIb , no significant change in blood pressure or weight occurred ( P greater than 0.30 ) Objectives To investigate plasma total ghrelin and obestatin levels and the ghrelin/obestatin ratio prospect ively , in hypertensive obese patients . Methods Height , weight , and waist and hip circumferences were measured in hypertensive and normotensive obese patients and matched healthy controls ; the body mass index and waist to hip ratio were calculated . Fasting glucose and insulin levels were measured and the homeostasis model assessment of insulin resistance ( HOMA-IR ) was determined . Fasting ghrelin and obestatin concentrations were measured by radioimmunoassay and the ghrelin/obestatin ratio was calculated . Results A total of 38 hypertensive obese patients , 40 normotensive obese patients and 38 controls were enrolled . Hypertensive obese patients had lower plasma levels of ghrelin and obestatin than normotensive obese patients or controls . In addition , normotensive obese patients had lower plasma ghrelin and obestatin levels than controls . In hypertensive obese patients , ghrelin and obestatin levels were negatively associated with systolic and diastolic blood pressure , fasting insulin and HOMA-IR . In normotensive obese patients , ghrelin , obestatin and the ghrelin/obestatin ratio were negatively associated with fasting insulin and HOMA-IR . In both patient groups , fasting obestatin and ghrelin concentrations were significantly and positively correlated with each other . Conclusion Changes in the levels of ghrelin and obestatin may play a role in the pathophysiology of obesity and hypertension BACKGROUND Type 2 diabetes affects approximately 8 percent of adults in the United States . Some risk factors -- elevated plasma glucose concentrations in the fasting state and after an oral glucose load , overweight , and a sedentary lifestyle -- are potentially reversible . We hypothesized that modifying these factors with a lifestyle-intervention program or the administration of metformin would prevent or delay the development of diabetes . METHODS We r and omly assigned 3234 nondiabetic persons with elevated fasting and post-load plasma glucose concentrations to placebo , metformin ( 850 mg twice daily ) , or a lifestyle-modification program  with the goals of at least a 7 percent weight loss and at least 150 minutes of physical activity per week . The mean age of the participants was 51 years , and the mean body-mass index ( the weight in kilograms divided by the square of the height in meters ) was 34.0 ; 68 percent were women , and 45 percent were members of minority groups . RESULTS The average follow-up was 2.8 years . The incidence of diabetes was 11.0 , 7.8 , and 4.8 cases per 100 person-years in the placebo , metformin , and lifestyle groups , respectively . The lifestyle intervention reduced the incidence by 58 percent ( 95 percent confidence interval , 48 to 66 percent ) and metformin by 31 percent ( 95 percent confidence interval , 17 to 43 percent ) , as compared with placebo ; the lifestyle intervention was significantly more effective than metformin . To prevent one case of diabetes during a period of three years , 6.9 persons would have to participate in the lifestyle-intervention program , and 13.9 would have to receive metformin . CONCLUSIONS Lifestyle changes and treatment with metformin both reduced the incidence of diabetes in persons at high risk . The lifestyle intervention was more effective than metformin BACKGROUND Weight loss is associated with short-term amelioration and prevention of metabolic and cardiovascular risk , but whether these benefits persist over time is unknown . METHODS The prospect i ve , controlled Swedish Obese Subjects Study involved obese subjects who underwent gastric surgery and contemporaneously matched , conventionally treated obese control subjects . We now report follow-up data for subjects ( mean age , 48 years ; mean body-mass index , 41 ) who had been enrolled for at least 2 years ( 4047 subjects ) or 10 years ( 1703 subjects ) before the analysis ( January 1 , 2004 ) . The follow-up rate for laboratory examinations was 86.6 percent at 2 years and 74.5 percent at 10 years . RESULTS After two years , the weight had increased by 0.1 percent in the control group and had decreased by 23.4 percent in the surgery group ( P<0.001 ) . After 10 years , the weight had increased by 1.6 percent and decreased by 16.1 percent , respectively ( P<0.001 ) . Energy intake was lower and the proportion of physically active subjects higher in the surgery group than in the control group throughout the observation period . Two- and 10-year rates of recovery from diabetes , hypertriglyceridemia , low levels of high-density lipoprotein cholesterol , hypertension , and hyperuricemia were more favorable in the surgery group than in the control group , whereas recovery from hypercholesterolemia did not differ between the groups . The surgery group had lower 2- and 10-year incidence rates of diabetes , hypertriglyceridemia , and hyperuricemia than the control group ; differences between the groups in the incidence of hypercholesterolemia and hypertension were undetectable . CONCLUSIONS As compared with conventional therapy , bariatric surgery appears to be a viable option for the treatment of severe obesity , result ing in long-term weight loss , improved lifestyle , and , except for hypercholesterolemia , amelioration in risk factors that were elevated at baseline Objective To compare two bariatric surgical principles with regard to effects on blood pressure and salt intake . Background In most patients bariatric surgery induces a sustained weight loss and a reduced cardiovascular risk profile but the long-term effect on blood pressure is uncertain . Methods Cohort study with data from the prospect i ve , controlled Swedish Obese Subjects ( SOS ) study involving 480 primary health care centres and 25 surgical departments in Sweden . Obese patients treated with non-surgical methods ( Controls , n = 1636 and n = 1132 at 2 y and 10 y follow up , respectively ) were compared to patients treated with gastric bypass ( GBP , n = 245 and n = 277 , respectively ) or purely restrictive procedures ( vertical b and ed gastroplasty or gastric b and ing ;  VBG/B , n = 1534 and n = 1064 , respectively ) . Results At long-term follow-up ( median 10 y ) GBP was associated with lowered systolic ( mean : −5.1 mm Hg ) and diastolic pressure ( −5.6 mmHg ) differing significantly from both VBG/B ( −1.5 and −2.1 mmHg , respectively ; p<0.001 ) and Controls ( + 1.2 and −3.8 mmHg , respectively ; p<0.01 ) . Diurnal urinary output was + 100 ml ( P<0.05 ) and + 170 ml ( P<0.001 ) higher in GBP subjects than in weight-loss matched VBG/B subjects at the 2 y and 10 y follow-ups , respectively . Urinary output was linearly associated with blood pressure only after GBP and these patients consumed approximately 1 g salt per day more at the follow-ups than did VBG/B ( P<0.01 ) . Conclusions The purely restrictive techniques VBG/B exerted a transient blood pressure lowering effect , whereas gastric bypass was associated with a sustained blood pressure reduction and an increased diuresis . The daily salt consumption was higher after gastric bypass than after restrictive bariatric surgery OBJECTIVES To determine relationship of intra-abdominal pressure to central obesity and the comorbidity of obesity . DESIGN Non-r and omized , prospect i ve . SETTING University hospital , operating room . SUBJECTS Eighty-four anaesthetized consecutive patients prior to gastric bypass for morbid obesity and five non-obese patients before colectomy for ulcerative colitis . MAIN OUTCOME MEASURES Weight , body mass index ( BMI ) , co-morbid history , sagittal abdominal diameter , waist : hip ( W : H ) ratio and urinary bladder pressure , as an estimate of intra-abdominal pressure . RESULTS Urinary bladder pressure was greater in the obese than the non-obese ( 18 + /- 0.7 vs. 7 + /- 1.6 cm H2O , P < 0.001 ) , correlated with sagittal abdominal diameter ( r = + 0.67 , P < 0.001 ) and was greater ( P < 0.05 ) in patients with , than those without , morbidity probably ( hypoventilation , gastroesophageal reflux , venous stasis , stress incontinence , incisional hernia ) or possibly ( hypertension , diabetes ) due to increased abdominal pressure . W : H ratio correlated with urinary bladder pressure in men ( r = + 0.6 , P < 0.05 ) but not women ( r = -0.3 ) . CONCLUSIONS Increased sagittal abdominal diameter was associated with increased intraabdominal pressure which contributed to obesity-related comorbidity . W : H ratio was not a reliable indicator of intra-abdominal pressure for women who often have both peripheral and central obesity . Further studies are needed to evaluate the relationship between intra-abdominal pressure and Type II diabetes and hypertension Background  Laparoscopic Roux-en-Y gastric bypass ( LRYGB )  is the most common bariatric technique . Laparoscopic sleeve gastrectomy ( LSG ) is a restrictive procedure ; the metabolic and endocrine effects of which remain unknown . We compared the effects of both procedures on glucose metabolism and fasting and meal-stimulated gut hormone levels . Methods Seven patients were r and omised to LRYGB and eight to LSG .  All patients were evaluated before and at 3 and 12 months postoperatively . Plasma levels of glucose , insulin , ghrelin , leptin , peptide YY ( PYY ) , GLP-1 and pancreatic polypeptide were measured before and after 10 and 60 min of a st and ard test meal ingestion . Results Age , body mass index and preoperative hormone levels were similar in both groups . A significant reduction of plasma glucose and insulin levels was observed after surgery . Moreover , a normalisation of homeostatic model assessment for insulin resistance value was also seen after both procedures . The fasting and postpr and ial leptin levels were significantly lower in the LRYGB group . LSG was followed by a significant reduction in fasting ghrelin levels . In the LRYGB group , GLP-1 levels increased significantly after the test meal . Conclusions LRYGB and LSG markedly improved glucose homeostasis . Only LSG decreased fasting and postpr and ial ghrelin levels , whereas GLP-1 and PYY levels increased similarly after both procedures Purpose This study examines the effect of Roux-en-Y gastric bypass ( RYGB ) and laparoscopic adjustable gastric b and ing ( LAGB ) on renal function for at least 5 years post-operatively in a tertiary referral center for bariatric surgery . Material s and Methods This prospect i ve cohort study of patients undergoing RYGB and LAGB  measured  renal function , blood pressure , and diabetes status pre-operatively and then 1 and 
    Output:
    
agent
Evidence suggests significant improvement in obesity-hypertension in patients who undergo surgical weight-reduction procedures .
Malabsorptive techniques such as the Roux-en-Y gastric bypass or surgical resection techniques such as laparoscopic sleeve gastrectomy appear to offer superior results in regards to hypertension control over restrictive techniques such as Gastric B and ing .
Though long-term control of hypertension following surgery remains a concern , available follow-up post-operative data of up to 10 years suggests a sustained , if lessened , effect on hypertension control over time
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background / Objectives . Embolization of the left gastric artery ( LGA ) , which preferentially supplies the gastric fundus , has been shown to produce weight loss in animal models . However , weight loss after LGA embolization in humans has not been previously established . The aim of this study was to evaluate postprocedural weight loss in patients following LGA embolization .  Subjects/ Methods . A retrospective analysis of the medical records of patients who underwent LGA embolization for upper gastrointestinal ( GI ) bleeding was performed . Postprocedural weight loss in this group was compared to a control group of patients who had undergone embolization of other arteries for upper GI bleeding . Results . The experimental group ( N = 19 ) lost an average of 7.3 % of their initial body weight within three months of LGA embolization , which was significantly greater than the 2 % weight loss observed in the control group ( N = 28 ) ( P = 0.006 ) . No significant differences were seen between the groups in preprocedural body mass index ( BMI ) , age , postprocedural care in the intensive care unit , history of malignancy , serum creatinine , or left ventricular ejection fraction . Conclusions . The current data suggest that body weight in humans may be modulated via LGA embolization . Continued research is warranted with prospect i ve studies to further investigate this phenomenon Overweight patients with uncomplicated essential hypertension were followed up biweekly for six months : 24 not receiving antihypertensive-drug therapy ( Group I ) and 83 on  regular but inadequate ( despite drug manipulation ) antihypertensive-drug therapy ( Group II ) . All patients in Group I and 57 r and omly selected patients from group II ( IIa ) participated in a weight-reduction program . The remaining 26 from Group II ( IIb ) did not receive a dietary program .  Salt intake was in the normal range in all three groups . All patients on the dietary program lost at least 3 kg ( mean , 10.5 kg ) , and all but two showed a meaningful reduction in blood pressure ; 75 per cent of Group I and 61 per cent of Group IIa returned to normal blood pressure . The weight and blood-pressure reductions were highly significant ( P less than 0.001 ) , were present in both sexes and all ages , and were directly associated . In Group IIb , no significant change in blood pressure or weight occurred ( P greater than 0.30 ) Objectives To investigate plasma total ghrelin and obestatin levels and the ghrelin/obestatin ratio prospect ively , in hypertensive obese patients . Methods Height , weight , and waist and hip circumferences were measured in hypertensive and normotensive obese patients and matched healthy controls ; the body mass index and waist to hip ratio were calculated . Fasting glucose and insulin levels were measured and the homeostasis model assessment of insulin resistance ( HOMA-IR ) was determined . Fasting ghrelin and obestatin concentrations were measured by radioimmunoassay and the ghrelin/obestatin ratio was calculated . Results A total of 38 hypertensive obese patients , 40 normotensive obese patients and 38 controls were enrolled . Hypertensive obese patients had lower plasma levels of ghrelin and obestatin than normotensive obese patients or controls . In addition , normotensive obese patients had lower plasma ghrelin and obestatin levels than controls . In hypertensive obese patients , ghrelin and obestatin levels were negatively associated with systolic and diastolic blood pressure , fasting insulin and HOMA-IR . In normotensive obese patients , ghrelin , obestatin and the ghrelin/obestatin ratio were negatively associated with fasting insulin and HOMA-IR . In both patient groups , fasting obestatin and ghrelin concentrations were significantly and positively correlated with each other . Conclusion Changes in the levels of ghrelin and obestatin may play a role in the pathophysiology of obesity and hypertension BACKGROUND Type 2 diabetes affects approximately 8 percent of adults in the United States . Some risk factors -- elevated plasma glucose concentrations in the fasting state and after an oral glucose load , overweight , and a sedentary lifestyle -- are potentially reversible . We hypothesized that modifying these factors with a lifestyle-intervention program or the administration of metformin would prevent or delay the development of diabetes . METHODS We r and omly assigned 3234 nondiabetic persons with elevated fasting and post-load plasma glucose concentrations to placebo , metformin ( 850 mg twice daily ) , or a lifestyle-modification program  with the goals of at least a 7 percent weight loss and at least 150 minutes of physical activity per week . The mean age of the participants was 51 years , and the mean body-mass index ( the weight in kilograms divided by the square of the height in meters ) was 34.0 ; 68 percent were women , and 45 percent were members of minority groups . RESULTS The average follow-up was 2.8 years . The incidence of diabetes was 11.0 , 7.8 , and 4.8 cases per 100 person-years in the placebo , metformin , and lifestyle groups , respectively . The lifestyle intervention reduced the incidence by 58 percent ( 95 percent confidence interval , 48 to 66 percent ) and metformin by 31 percent ( 95 percent confidence interval , 17 to 43 percent ) , as compared with placebo ; the lifestyle intervention was significantly more effective than metformin . To prevent one case of diabetes during a period of three years , 6.9 persons would have to participate in the lifestyle-intervention program , and 13.9 would have to receive metformin . CONCLUSIONS Lifestyle changes and treatment with metformin both reduced the incidence of diabetes in persons at high risk . The lifestyle intervention was more effective than metformin BACKGROUND Weight loss is associated with short-term amelioration and prevention of metabolic and cardiovascular risk , but whether these benefits persist over time is unknown . METHODS The prospect i ve , controlled Swedish Obese Subjects Study involved obese subjects who underwent gastric surgery and contemporaneously matched , conventionally treated obese control subjects . We now report follow-up data for subjects ( mean age , 48 years ; mean body-mass index , 41 ) who had been enrolled for at least 2 years ( 4047 subjects ) or 10 years ( 1703 subjects ) before the analysis ( January 1 , 2004 ) . The follow-up rate for laboratory examinations was 86.6 percent at 2 years and 74.5 percent at 10 years . RESULTS After two years , the weight had increased by 0.1 percent in the control group and had decreased by 23.4 percent in the surgery group ( P<0.001 ) . After 10 years , the weight had increased by 1.6 percent and decreased by 16.1 percent , respectively ( P<0.001 ) . Energy intake was lower and the proportion of physically active subjects higher in the surgery group than in the control group throughout the observation period . Two- and 10-year rates of recovery from diabetes , hypertriglyceridemia , low levels of high-density lipoprotein cholesterol , hypertension , and hyperuricemia were more favorable in the surgery group than in the control group , whereas recovery from hypercholesterolemia did not differ between the groups . The surgery group had lower 2- and 10-year incidence rates of diabetes , hypertriglyceridemia , and hyperuricemia than the control group ; differences between the groups in the incidence of hypercholesterolemia and hypertension were undetectable . CONCLUSIONS As compared with conventional therapy , bariatric surgery appears to be a viable option for the treatment of severe obesity , result ing in long-term weight loss , improved lifestyle , and , except for hypercholesterolemia , amelioration in risk factors that were elevated at baseline Objective To compare two bariatric surgical principles with regard to effects on blood pressure and salt intake . Background In most patients bariatric surgery induces a sustained weight loss and a reduced cardiovascular risk profile but the long-term effect on blood pressure is uncertain . Methods Cohort study with data from the prospect i ve , controlled Swedish Obese Subjects ( SOS ) study involving 480 primary health care centres and 25 surgical departments in Sweden . Obese patients treated with non-surgical methods ( Controls , n = 1636 and n = 1132 at 2 y and 10 y follow up , respectively ) were compared to patients treated with gastric bypass ( GBP , n = 245 and n = 277 , respectively ) or purely restrictive procedures ( vertical b and ed gastroplasty or gastric b and ing ;  VBG/B , n = 1534 and n = 1064 , respectively ) . Results At long-term follow-up ( median 10 y ) GBP was associated with lowered systolic ( mean : −5.1 mm Hg ) and diastolic pressure ( −5.6 mmHg ) differing significantly from both VBG/B ( −1.5 and −2.1 mmHg , respectively ; p<0.001 ) and Controls ( + 1.2 and −3.8 mmHg , respectively ; p<0.01 ) . Diurnal urinary output was + 100 ml ( P<0.05 ) and + 170 ml ( P<0.001 ) higher in GBP subjects than in weight-loss matched VBG/B subjects at the 2 y and 10 y follow-ups , respectively . Urinary output was linearly associated with blood pressure only after GBP and these patients consumed approximately 1 g salt per day more at the follow-ups than did VBG/B ( P<0.01 ) . Conclusions The purely restrictive techniques VBG/B exerted a transient blood pressure lowering effect , whereas gastric bypass was associated with a sustained blood pressure reduction and an increased diuresis . The daily salt consumption was higher after gastric bypass than after restrictive bariatric surgery OBJECTIVES To determine relationship of intra-abdominal pressure to central obesity and the comorbidity of obesity . DESIGN Non-r and omized , prospect i ve . SETTING University hospital , operating room . SUBJECTS Eighty-four anaesthetized consecutive patients prior to gastric bypass for morbid obesity and five non-obese patients before colectomy for ulcerative colitis . MAIN OUTCOME MEASURES Weight , body mass index ( BMI ) , co-morbid history , sagittal abdominal diameter , waist : hip ( W : H ) ratio and urinary bladder pressure , as an estimate of intra-abdominal pressure . RESULTS Urinary bladder pressure was greater in the obese than the non-obese ( 18 + /- 0.7 vs. 7 + /- 1.6 cm H2O , P < 0.001 ) , correlated with sagittal abdominal diameter ( r = + 0.67 , P < 0.001 ) and was greater ( P < 0.05 ) in patients with , than those without , morbidity probably ( hypoventilation , gastroesophageal reflux , venous stasis , stress incontinence , incisional hernia ) or possibly ( hypertension , diabetes ) due to increased abdominal pressure . W : H ratio correlated with urinary bladder pressure in men ( r = + 0.6 , P < 0.05 ) but not women ( r = -0.3 ) . CONCLUSIONS Increased sagittal abdominal diameter was associated with increased intraabdominal pressure which contributed to obesity-related comorbidity . W : H ratio was not a reliable indicator of intra-abdominal pressure for women who often have both peripheral and central obesity . Further studies are needed to evaluate the relationship between intra-abdominal pressure and Type II diabetes and hypertension Background  Laparoscopic Roux-en-Y gastric bypass ( LRYGB )  is the most common bariatric technique . Laparoscopic sleeve gastrectomy ( LSG ) is a restrictive procedure ; the metabolic and endocrine effects of which remain unknown . We compared the effects of both procedures on glucose metabolism and fasting and meal-stimulated gut hormone levels . Methods Seven patients were r and omised to LRYGB and eight to LSG .  All patients were evaluated before and at 3 and 12 months postoperatively . Plasma levels of glucose , insulin , ghrelin , leptin , peptide YY ( PYY ) , GLP-1 and pancreatic polypeptide were measured before and after 10 and 60 min of a st and ard test meal ingestion . Results Age , body mass index and preoperative hormone levels were similar in both groups . A significant reduction of plasma glucose and insulin levels was observed after surgery . Moreover , a normalisation of homeostatic model assessment for insulin resistance value was also seen after both procedures . The fasting and postpr and ial leptin levels were significantly lower in the LRYGB group . LSG was followed by a significant reduction in fasting ghrelin levels . In the LRYGB group , GLP-1 levels increased significantly after the test meal . Conclusions LRYGB and LSG markedly improved glucose homeostasis . Only LSG decreased fasting and postpr and ial ghrelin levels , whereas GLP-1 and PYY levels increased similarly after both procedures Purpose This study examines the effect of Roux-en-Y gastric bypass ( RYGB ) and laparoscopic adjustable gastric b and ing ( LAGB ) on renal function for at least 5 years post-operatively in a tertiary referral center for bariatric surgery . Material s and Methods This prospect i ve cohort study of patients undergoing RYGB and LAGB  measured  renal function , blood pressure , and diabetes status pre-operatively and then 1 and 
    Output:
    