Introduction: Obesity is a major health problem that affects an individual's overall health. Bariatric metabolic surgery is most important and has permanent impact on weight loss in comparison with conservative therapy. The downside is that it often leads to a row nutritional deficiencies requiring long-term supplementation. Object: The aim of the thesis is to map the intake of nutrients in the diet of bariatric patients six months and one year after the procedure. The research is primarily focused on the intake of vitamin D and calcium in diet, vitamin D, parathyroid hormone and calcium levels are also evaluated. Marginally, laboratory values are assessed prior to surgery as deficiencies are known to occur before surgery. Methodology: The research sample consists of 30 respondents who are six months (M6) and one year (Y1) from the procedure. Micronutrients are evaluated from three-day dining records recorded by respondents for at least one week. The research laboratory data was used from the medical information system of the hospital information system. The evaluation parameters for vitamin D-25 (OH)D (limit level was established to > 30 ng/ml). To assess the parathyroid hormone concentration, a minimum limit is set to 1.58 pmol/l, calcium 2.00-2.75 (mmol/l). We were wondering if the profile of...

Obesity is a frequent metabolic disease that causes many other health and socioeconomic complications. Obesity arises due to excessive energy intake and decrease in energy expenditure, which is a conseqence of contemporary lifestyle. Moreover, obesity has a strong genetic component. Common obesity is polygenic, multifactorial disease, in which individual genes interact with each other and with environmental factors. Genome-wide association studies, conducted between 2006-09, led to the discovery of dozens of gene loci that predispose individuals to obesity. The strongest signals were registered for polymorphisms in FTO (fat mass and obesity-associated) and near a gene MC4R (melanocortin 4 receptor). However, the contributions of these variations on the phenotype of obesity are very small, therefore, it is necessary to validate the results of such robust studies. It is very important to uncover the effects of genetic variants for understanding the molecular mechanisms of energy metabolism. The studies presented in this thesis refer about the impact of polymorphisms in selected genes on anthropometric and metabolic parameters of the patients of the Institute of Endocrinology and of healthy volunteers who underwent functional tests. Our cohort includes a representative sample of Czech children (COPAT...

This thesis focuse on bariatric-metabolic surgery and its impact on serum concentrations of various metabolic parameters. The thesis is divided into two parts - theoretical and practical. Basic facts about bariatric-metabolic surgery such as its history, indications, contraindications, surgical methods and their results, nutrition after surgery and the frequency of micronutrient's deficits are described in the theoretical part. Furthermore, information about calcium-phosphate metabolism and metabolites such as calcium, phosphorus, magnesium, vitamin D, vitamin K, parathyroid hormone and osteomarkers is also included. The influence of nutrition and nutritional status on the quality of bone tissue is also mentioned. Last section of the theoretical part is focused on the important vitamins and minerals. The practical part discusses measurements of selected metabolites in serum before and half a year after the surgery. Results of questionnaires which were given to respondents are also included. Questionnaires were focused on lifestyle, nutrition, physical activities and whether the patients take some supplements of micronutrients and protein concentrates. The goal of this work is to evaluate the effect of the surgery on serum concentrations of metabolic parameters and their effect on the health and...

The bariatric surgery is regarded as the most effective treatment method of dangerous forms of obesity. Since the bariatric surgery is closely related to nutrition, it is thus necessary to emphasize the importance of good nutritional knowledge of patients that have undergone this type of surgery. The aim of this thesis was to examine the nutritional knowledge of patients that are at least one year after the surgery, or reoperation. To get relevant data, patients were examined using an anonymous questionnaire. The survey indicates that the patients have insufficient knowledge regarding the recommended protein intake. Furthermore, the examination exhibited, surprisingly, that men have statistically worse knowledge than women do as well as that the majority of patients does not know what the dumping syndrome is. The survey confirmed that the patients operated more than two and a half years ago have worse nutritional knowledge than the ones operated within such a period of time. Moreover, the examination did not identify problems regarding the correct food preparation, post- operational diet, and inappropriate eatables. In addition, it was discovered that about fifty percent of all the examined patients have sufficient knowledge of the post-bariatric surgery eating habits. Since the importance of...

Title: The Effect of Exercise Intervention on Physical Fitness and Quality of Life in Patients after Bariatric Surgery Objectives: The aim of this thesis is to evaluate the effect of a three-month physical intervention on the physical fitness and quality of life in patients after bariatric surgery. Compare the measured values from six-minute walk test (6MWT) and the questionnaire survey of quality of life between the group undergoing exercise program and the group of non-exercise patients. Methods: The diploma thesis was constructed as a quasi-experiment. A six-minute walk test, a visual analogue pain scale, a Borg scale and a standardized IWQOL-Lite questionnaire were used to asses physical fitness and quality of life. The study involved 28 patients (8 undergoing an exercise program, 20 non-excercisers). The groups were measured before the planned bariatric surgery and about 3-4 months after the surgery. For the analysis of final values, the Microsoft Excel and its add-in Realstatistics was used. Results: In patients undergoing the exercise program, the VAS on average decreased of 2,04 cm, 6MWT improved on average of 42,75 m, and quality of life of 34 points. In non-exercise patients there was an average decrease in VAS of 0,08 cm, an increase in 6MWT of 41,45 m and an increase in quality of life...

Introduction: Obesity and type 2 diabetes mellitus (hereinafter referred to as DM2T) are called the greatest epidemic of the 21st century. Its occurrence is on the rise not only in the Czech Republic but all around the world. Overweight and obesity are the key factors in developing DM2T, they are affecting the occurrence of the disease in men in 64 % and 77 % in women. Based on the observations, nearly 60 % of the population in the Czech Republic are considered obese or overweight. Bariatric/Metabolic surgery is one of the most effective treatments of the DM2T. Objectives: The objective of this thesis is to describe and analyze the effect of each bariatric surgery on the patients of 3rd Internal Clinic of Endocrinology and Metabolism, General University Hospital and 1st Medical Faculty, Charles University in Prague within the first two years post-surgery. The same time period is observed to monitor the DM2T compensation depending on the type of bariatric surgery. Methodology: 128 patients were observed (including 52 patients diagnosed with DM2T), that underwent the bariatric surgery. The data were gathered from the medical records in the hospital's information system Medea. These data were further analyzed, processed and assessed in Microsoft Excel and also together with the agency STEM/MARK a.s....

Title: Influence of physical intervention on the musculoskeletal system in patients before and after planned bariatric surgery. Objectives: The main objective of this study was to evaluate the effect of three months physical intervention on the development of static postural stability, musculoskeletal pain, health-related quality of life and physical fitness of obese individuals before and after bariatric surgery. Methods: This is a monocentric prospective non-randomized study. The study included 25 patients of both sexes aged 40 to 57 years (BMI 36-49 kg/m2 ). The patients were divided into an intervention and a control group. The intervention group (INT, n = 7; age 48.9 ± 5.6 years; BMI 40.6 ± 5.5 kg/m2 ) underwent a 3-month resistance aerobic exercise program with a frequency of exercises 3 times a week. The control group (KON, n = 18; age 46.8 ± 12.7 years, BMI 44.2 ± 6.4 kg/m2 ) was not subjected to the exercise program. The level of static postural stability, perceived musculoskeletal pain, health-related quality of life and the level of physical fitness in the periods before and 3, 6 and 12 months after bariatric surgery were assessed. Results: The study showed that resistance aerobic physical intervention improves musculoskeletal pain and health-related quality of life in obese patients...

The diploma thesis deals the problematics of weight reduction with the using of bariatric- metabolic surgery and focuses on the changing risk components of the metabolic syndrome during one year long observation of 45 probands who have undergone Partial Jejuno-Ileal Diversion, Laparoscopic Sleeve Gastrectomy or Laparoscopic Gastric Plication. The main aim of the diploma thesis is to evaluate the changing risk components of the metabolic syndrome during weight reduction after undergoing bariatric surgery. The thesis shows that in the studied sample of bariatric patients it is an effective method of weight reduction (in PJID the success rate was 48 % EWL, in LGCP 51 % EWL and the most successful was LSG with 76 % EWL) with metabolic effect such as for example observed positive changes in risk components of the metabolic syndrome - reduction of morning glucose levels, increase of HDL cholesterol and decrease of triacylglycerols in the blood, decrease of waist circumferences and decrease of blood pressure or elimination of metabolic syndrome. Up to 68.9 % of the monitored probands showed signs of metabolic syndrome when evaluating the initial measurement before bariatric surgery, the remaining 22.2 % of the probands showed the signs after the year's observation. As part of the risk assessment for the...