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Fernández Ruiz, Virginia Esperanza

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Fernández Ruiz, Virginia Esperanza
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Universidad de Murcia. Departamento de Enfermería
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Subject: Obesity ×

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    Mid-term changes in quality of life and nutritional habits following gastric bypass: a 24-month follow-up study
    (MDPI, 2026-01-16) Martínez-Sánchez, María Antonia; Ros Madrid, Inmaculada; Fernández Ruiz, Virginia Esperanza; Cano-Mármol, Rosario Paloma; Hernández-Morante, Juan José; Núñez-Sánchez, María Ángeles; Balaguer-Román, Andrés; Frutos Bernal, María Dolores; Ruiz Alcaraz, Antonio José; Queipo-Ortuño, María Isabel; Ferrer Gómez, Mercedes; Ramos-Molina, Bruno; Bioquímica y Biología Molecular B e Inmunología; Facultad de Biología
    Background/Objectives: Obesity is an increasingly concerning public health issue due to its high prevalence and its association with multiple comorbidities. A significant proportion of patients with obesity who undergo bariatric surgery could exhibit suboptimal mid-term outcomes. This study aims to comprehensively assess anthropometric, clinical, biochemical, nutritional, and quality of life parameters in patients with severe obesity undergoing bariatric surgery, with a particular focus on outcomes at 24 months post-surgery to capture mid-term effects that may not be apparent during the first year of follow-up. Methods: A prospective study was conducted in 95 patients with obesity undergoing bariatric surgery (Roux-en Y gastric bypass; RYGB) at the Virgen de la Arrixaca University Clinical Hospital (Murcia, Spain) between 2020 and 2023. Participants were followed up at 6, 12, and 24 months after RYGB. The study incorporated anthropometric assessments (BMI, body composition via bioelectrical impedance), full biochemical profiling, dietary analysis (using a validated food frequency questionnaire), and quality of life assessment (SF-36 questionnaire). Results: Our results showed significant weight loss after the intervention, accompanied by improvements in metabolic parameters, and dietary habits. Regarding quality of life, significant improvements were observed in both the physical (baseline: 39.62%; 6 months: 52.40%; 12 months: 53.12%) and mental components (baseline: 42.08; 6 months: 53.40; 12 months: 52.14%) at 6 and 12 months post-surgery. However, our prospective 24-month follow-up revealed that, despite these initial benefits, mental health significantly declined compared with the 12-month follow-up (24 months: 46.85%). In contrast, the physical component remained relatively stable at 24 months (24 months: 50.91%). However, our prospective 24-month follow-up revealed that, despite these initial benefits, there was a decline in mental health compared to the 12-month follow-up. Conclusions: While bariatric surgery is associated with improvements in anthropometric measures and some aspects of quality of life, our findings underscore the need for continued mid-term support to address emerging challenges in mental well-being.
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    Lipidomic analysis reveals alterations in hepatic FA profile associated with MASLD stage in patients with obesity
    (Oxford University Press, 2024-01-13) Núñez-Sánchez, María Ángeles; Martínez-Sánchez, María Antonia; Martínez-Montoro, José Ignacio; Balaguer-Román, Andrés; Murcia-García, Elena; Fernández Ruiz, Virginia Esperanza; Ferrer Gómez, Mercedes; Martínez Cáceres, Carlos Manuel; Sledzinski, Tomasz; Frutos Bernal, María Dolores; Hernández-Morante, Juan José; Fernández-García, José Carlos; Queipo-Ortuño, María Isabel; Ruiz Alcaraz, Antonio José; Mika, Adriana; Ramos-Molina, Bruno; Bioquímica y Biología Molecular B e Inmunología; Facultad de Biología
    Context. Metabolic dysfunction–associated steatotic liver disease (MASLD) is characterized by the intracellular lipid accumulation in hepatocytes. Excess caloric intake and high-fat diets are considered to significantly contribute to MASLD development. Objective. To evaluate the hepatic and serum fatty acid (FA) composition in patients with different stages of MASLD, and their relationship with FA dietary intake and MASLD-related risk factors. Methods. This was a case–control study in patients with obesity undergoing bariatric surgery at a university hospital between January 2020 and December 2021. Participants were distributed in 3 groups: no MASLD (n = 26), steatotic liver disease (n = 33), and metabolic dysfunction–associated steatohepatitis (n = 32). Hepatic and serum FA levels were determined by gas chromatography-mass spectrometry. Nutritional status was evaluated using validated food frequency questionnaires. The hepatic expression of genes involved in FA metabolism was analyzed by reverse transcription quantitative polymerase chain reaction. Results. The hepatic, but not serum, FA profiles were significantly altered in patients with MASLD compared with those without MASLD. No differences were observed in FA intake between the groups. Levels of C16:0, C18:1, and the C18:1/C18:0 ratio were higher, while C18:0 levels and C18:0/C16:0 ratio were lower in patients with MASLD, being significantly different between the 3 groups. Hepatic FA levels and ratios correlated with histopathological diagnosis and other MASLD-related parameters. The expression of genes involved in the FA metabolism was upregulated in patients with MASLD. Conclusion. Alterations in hepatic FA levels in MASLD patients were due to enhancement of de novo lipogenesis in the liver.
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    Open Access
    Plasma short-chain fatty acid changes after bariatric surgery in patients with severe obesity
    (Elsevier, 2023-01-31) Marıa Antonia, Martínez-Sánchez; Balaguer-Roman, Andrés; Fernández Ruiz, Virginia Esperanza; Almansa-Saura, Sonia; García-Zafra, Victoria; Ferrer Gómez, Mercedes; Frutos Bernal, María Dolores; Queipo-Ortuño, María I.; Ruiz Alcaraz, Antonio José; Nuñez-Sánchez, María A.; Ramos-Molina, Bruno; Bioquímica y Biología Molecular B e Inmunología; Facultad de Biología
    Background: Obesity has reached epidemic dimensions in recent decades. Bariatric surgery (BS) is one of the most effective interventions for weight loss and metabolic improvement in patients with obesity. Short-chain fatty acids (SCFA) are gut microbiota-derived metabolites with a key role in body weight control and insulin sensitivity. Although BS is known to induce significant changes in the gut microbiota composition, its impact on the circulating levels of certain metabolites produced by the gut microbiota such as SCFA remains poorly understood. Objective: To determine the impact of BS on the circulating SCFA levels in patients with severe obesity. Setting University hospital. Methods: An observational, prospective study was performed on 51 patients undergoing Roux-en-Y gastric bypass. Plasma samples were collected at baseline (1 day before surgery) and at 6 and 12 months after BS. Plasma SCFA levels were determined by liquid chromatography–mass spectrometry. Results: The results revealed significant changes in the circulating levels of SCFA after BS. A marked increase in propionate, butyrate, isobutyrate, and isovalerate levels and a decrease in acetate, valerate, hexanoate, and heptanoate levels were observed 12 months after BS. Furthermore, the changes in the levels of propionate, butyrate, and isobutyrate negatively correlated with changes in body mass index, while those of isobutyrate correlated negatively with changes in the homeostatic model assessment for insulin resistance index. Conclusion: These results suggest that propionate, butyrate, and isobutyrate levels could be related to weight loss and improved insulin sensitivity in patients with severe obesity after BS.
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    The role of PCSK9 in metabolic dysfunction-associated steatotic liver disease and its impact on bariatric surgery outcomes
    (2024-07-01) Nuñez-Sánchez, María Ángeles; Balaguer-Román, Andrés; Martínez-Sánchez, María Antonia; Castellano-Castillo, Daniel; Ferrer Gómez, Mercedes; Manuel Martínez, Carlos; Dolores Frutos, María; Queipo-Ortuño, María Isabel; Cardona, Fernando; Ramos-Molina, Bruno; Fernández Ruiz, Virginia Esperanza; Enfermería
    Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is closely tied to obesity. The degree ranges from steatosis (MASL) and steatohepatitis (MASH) to liver cirrhosis. PCSK9 controls cholesterol and lipid particle transport to the liver. PCSK9 might interfere with the pathophysiology of MASLD and bariatric surgery (BS) outcomes of patients with MASLD. Objectives: Evaluate the relationship between serum and hepatic PCSK9 levels with the degree of MASLD and the metabolic outcome of BS. Setting: University Hospital, Spain. Methods: A total of 110 patients with obesity undergoing BS were classified according to liver histology as controls, MAS, and MASH. PCSK9 levels in serum were measured before and 6 months after BS using enzyme-linked immunosorbent assay. PCSK9 protein and mRNA levels in liver tissue were analyzed by immunohistochemistry and reverse transcriptase-polymerase chain reaction, respectively. Results: Hepatic PCSK9 protein levels were diminished in MASL and MASH compared with patients without MASLD and showed a strong negative association with MASLD severity scores. Liver PCSK9 mRNA was higher in MASH compared with controls and MASL and showed positive associations with MASLD severity scores. There were no differences in serum PCSK9 pre or postBS between the groups. Pre- and postsurgery serum PCSK9 positively correlated with cholesterol fold-changes and body mass index (BMI), cholesterol, and low-density lipoprotein -cholesterol fold-changes, respectively. PCSK9 fold-change positively correlated with BMI changes and was the sole variable explaining BMI fold changes in a regression model. Conclusions: PCSK9 mRNA and protein in the liver might be associated with the degree of MASLD. Serum PCSK9 may be associated with cholesterol and/or BMI fold changes. Serum changes of PCSK9 after BS could explain BMI loss outcome.
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