Alcohol sensitivity in women after undergoing bariatric surgery: a cross-sectional study.
Alcohol
Bariatric surgery
Ethanol
Laparoscopic adjustable gastric banding surgery
Metabolic surgery
Pharmacokinetics
Roux-en-Y gastric bypass
Sleeve gastrectomy
Subjective response
Journal
Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
ISSN: 1878-7533
Titre abrégé: Surg Obes Relat Dis
Pays: United States
ID NLM: 101233161
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
30
08
2019
revised:
07
01
2020
accepted:
12
01
2020
pubmed:
23
2
2020
medline:
28
4
2021
entrez:
21
2
2020
Statut:
ppublish
Résumé
Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), the most common bariatric surgeries performed worldwide, increase the risk to develop an alcohol use disorder. This might be due, in part, to surgery-related changes in alcohol pharmacokinetics. Another risk factor, unexplored within this population, is having a reduced subjective response to alcohol's sedative effects. To assess whether the alcohol sensitivity questionnaire (ASQ), a simple self-report measure, could pinpoint reduced alcohol sensitivity in the bariatric population. University medical centers in Missouri and Illinois. Women who had RYGB (n = 16), SG (n = 28), or laparoscopic adjustable gastric banding surgery (n = 11) within the last 5 years completed the ASQ for both pre- and postsurgical timeframes, and 45 of them participated in oral alcohol challenge testing postsurgery. Blood alcohol concentration (BAC) and subjective stimulation and sedation were measured before and for 3.5 hours after drinking. In line with faster and higher peak BACs after RYGB and SG than laparoscopic adjustable gastric banding surgery (P < .001), postsurgery ASQ scores were more reduced from presurgery scores after RYGB/SG than after laparoscopic adjustable gastric banding surgery (-2.3 ± .3 versus -1.2 ± .2; P < .05). However, despite the dramatic changes in BAC observed when ingesting alcohol after RYGB/SG surgeries, which resulted in peak BAC that were approximately 50% above the legal driving limit, a third of these women felt almost no alcohol-related sedative effects. Although RYGB/SG dramatically increased sensitivity to alcohol in all participants, meaningful interindividual differences remained. The ASQ might help identify patients at increased risk to develop an alcohol use disorder after surgery.
Sections du résumé
BACKGROUND
BACKGROUND
Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), the most common bariatric surgeries performed worldwide, increase the risk to develop an alcohol use disorder. This might be due, in part, to surgery-related changes in alcohol pharmacokinetics. Another risk factor, unexplored within this population, is having a reduced subjective response to alcohol's sedative effects.
OBJECTIVES
OBJECTIVE
To assess whether the alcohol sensitivity questionnaire (ASQ), a simple self-report measure, could pinpoint reduced alcohol sensitivity in the bariatric population.
SETTING
METHODS
University medical centers in Missouri and Illinois.
METHODS
METHODS
Women who had RYGB (n = 16), SG (n = 28), or laparoscopic adjustable gastric banding surgery (n = 11) within the last 5 years completed the ASQ for both pre- and postsurgical timeframes, and 45 of them participated in oral alcohol challenge testing postsurgery. Blood alcohol concentration (BAC) and subjective stimulation and sedation were measured before and for 3.5 hours after drinking.
RESULTS
RESULTS
In line with faster and higher peak BACs after RYGB and SG than laparoscopic adjustable gastric banding surgery (P < .001), postsurgery ASQ scores were more reduced from presurgery scores after RYGB/SG than after laparoscopic adjustable gastric banding surgery (-2.3 ± .3 versus -1.2 ± .2; P < .05). However, despite the dramatic changes in BAC observed when ingesting alcohol after RYGB/SG surgeries, which resulted in peak BAC that were approximately 50% above the legal driving limit, a third of these women felt almost no alcohol-related sedative effects.
CONCLUSIONS
CONCLUSIONS
Although RYGB/SG dramatically increased sensitivity to alcohol in all participants, meaningful interindividual differences remained. The ASQ might help identify patients at increased risk to develop an alcohol use disorder after surgery.
Identifiants
pubmed: 32075778
pii: S1550-7289(20)30030-7
doi: 10.1016/j.soard.2020.01.014
pmc: PMC7141947
mid: NIHMS1551625
pii:
doi:
Substances chimiques
Blood Alcohol Content
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
536-544Subventions
Organisme : NIDDK NIH HHS
ID : P30 DK056341
Pays : United States
Organisme : NIAAA NIH HHS
ID : R01 AA024103
Pays : United States
Organisme : NIAAA NIH HHS
ID : R21 AA020018
Pays : United States
Informations de copyright
Copyright © 2020 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Références
Alcohol Clin Exp Res. 2002 Aug;26(8):1205-14
pubmed: 12198395
J Am Coll Surg. 2012 Oct;215(4):475-9
pubmed: 22770864
Arch Gen Psychiatry. 2011 Apr;68(4):389-99
pubmed: 21464363
Obesity (Silver Spring). 2013 Dec;21(12):2444-51
pubmed: 23520203
J Stud Alcohol Drugs. 2016 Jan;77(1):25-37
pubmed: 26751352
Am J Psychiatry. 1994 Feb;151(2):184-9
pubmed: 8296886
Br J Clin Pharmacol. 2002 Dec;54(6):587-91
pubmed: 12492605
Psychopharmacologia. 1963 May 15;4:155-66
pubmed: 14054658
Psychol Addict Behav. 2010 Sep;24(3):508-515
pubmed: 20853936
Alcohol Clin Exp Res. 2002 Jun;26(6):827-35
pubmed: 12068251
JAMA Surg. 2013 Feb;148(2):145-50
pubmed: 23560285
Surg Obes Relat Dis. 2013 May-Jun;9(3):470-3
pubmed: 23507629
JAMA Surg. 2013 Apr;148(4):374-7
pubmed: 23716012
Psychol Bull. 1990 Nov;108(3):383-402
pubmed: 2270234
Alcohol Clin Exp Res. 2018 May;42(5):822-835
pubmed: 29623680
Psychopharmacology (Berl). 2005 May;179(2):430-6
pubmed: 15565433
Alcohol Clin Exp Res. 1993 Feb;17(1):140-6
pubmed: 8452195
Psychopharmacology (Berl). 2001 Apr;154(4):420-8
pubmed: 11349397
Surg Endosc. 2019 Aug;33(8):2521-2530
pubmed: 30350107
Biol Psychiatry. 2014 May 15;75(10):798-806
pubmed: 24094754
Alcohol Clin Exp Res. 2009 May;33(5):916-24
pubmed: 19320625
JAMA. 2012 Jun 20;307(23):2516-25
pubmed: 22710289
Alcohol Clin Exp Res. 2015 Nov;39(11):2215-23
pubmed: 26503068
Alcohol Clin Exp Res. 2016 Apr;40(4):880-8
pubmed: 27012527
Alcohol Clin Exp Res. 2007 Jun;31(6):909-18
pubmed: 17433009
Obes Surg. 2018 Dec;28(12):3783-3794
pubmed: 30121858
Surg Obes Relat Dis. 2018 Mar;14(3):277-283
pubmed: 29305304
JAMA Surg. 2015 Nov;150(11):1096-8
pubmed: 26244751
Surg Obes Relat Dis. 2017 Aug;13(8):1392-1402
pubmed: 28528115
J Stud Alcohol. 1994 Mar;55(2):149-58
pubmed: 8189735