Akheel Syed

Akheel Syed
Salford Royal NHS Foundation Trust · Department of Endocrinology & Diabetes

MBBS, FRCPE, PhD
Honorary Professor. Manchester Academic Health Science Centre. The University of Manchester

About

209
Publications
30,625
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3,380
Citations
Citations since 2017
111 Research Items
1945 Citations
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Publications

Publications (209)
Article
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Despite weight loss after (bariatric) surgery, many women still require screening for gestational diabetes mellitus during pregnancy. A history of bariatric surgery has important implications for the choice of test since an oral glucose tolerance test can trigger dumping syndromes, with serious adverse effects.
Article
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Bardet–Biedl syndrome (BBS) is a rare genetic condition, characterized by ciliary protein dysfunction, leading to multi‐organ damage. People with BBS can develop early‐onset severe obesity and associated problems including the metabolic syndrome, type 2 diabetes and coronary heart disease. Weight management can be challenging with the lack of effec...
Article
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Serum renin and aldosterone measurement is important for the diagnosis of this relatively common secondary cause of hypertension.
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Weight loss of 5%-10% is advised in medical weight management (MWM) programmes prior to bariatric surgery but it remains to be established whether it influences postoperative weight loss outcomes. We studied postoperative percent total weight loss (%TWL) in 168 patients categorized by preoperative referral weight loss <5% or ≥5% in a UK NHS bariatr...
Article
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Hyperthyroidism is a well‐recognised cause of significant metabolic changes with most patients experiencing weight loss in the acute illness This article is protected by copyright. All rights reserved.
Article
IntroductionThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus (coronavirus disease 2019 [COVID-19]) pandemic revealed the vulnerability of specific population groups in relation to susceptibility to acute deterioration in their health, including hospital admission and mortality. There is less data on outcomes for people with ty...
Article
Background and purpose Non-alcoholic fatty liver disease (NAFLD) has increasing worldwide prevalence, fuelled by rising obesity rates, and weight reduction is the mainstay of its management. We sought to study the effect of bariatric surgery, the most effective long-term treatment for obesity and associated metabolic disorders, on liver function in...
Article
Bariatric surgery in people with obesity can lead to long-term remission of type 2 diabetes mellitus (T2DM) and a reduction in the incidence of macrovascular complications. The impact of bariatric surgery on microvascular complications is less clear. In this narrative review, we sought to evaluate the effect of bariatric surgery on microvascular co...
Article
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Vaccine development against COVID-19 has mitigated severe disease. However, reports of rare but serious adverse events following immunization (sAEFI) in the young populations are fuelling parental anxiety and vaccine hesitancy. With a very early season of viral illnesses including COVID-19, respiratory syncytial virus (RSV), influenza, metapneumovi...
Article
Many individuals with marginally abnormal thyroid function test (TFT) results may be treated and it is unknown if the limits of the TSH and FT4 reference intervals reported alongside the laboratory results are associated with the prevalence of levothyroxine treatment. We obtained information regarding reported TFT reference intervals from UK Nation...
Article
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes coronavirus disease 2019 (COVID-19). It is associated with significant morbidity and mortality, and socio-economic disruption globally. Increasing age and ageing-associated comorbidities such as obesity, type 2 diabetes, and chronic cardiac, respiratory, kidney and liver...
Conference Paper
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Purpose: Obesity and/or bariatric surgery can be associated with micronutrient deficiencies. We studied whether there was a correlation between body mass index (BMI) and micronutrient levels pre- and post-bariatric surgery. Methods: We performed a retrospective cohort study of 745 patients who underwent bariatric surgery in a Northwest England tea...
Article
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Objective: To analyze rates of reported severe adverse events after immunization (sAEFI) attributed to SARS-CoV-2 vaccines in the United States (US) using safety surveillance data. Methods: Observational study of sAEFI reported to the vaccine adverse events reporting system (VAERS) between December 13, 2020, to December 13, 2021, and attributed to...
Article
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Background: The 2015 American Thyroid Association (ATA) guidelines recommend the following size cut-offs based on sonographic appearances for subjecting nodules to fine-needle aspiration (FNA) biopsy: low-risk 15mm, intermediate-risk and high-risk 10mm. Objective: We conducted a 'real world' study evaluating the diagnostic performance of the ATA...
Article
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Background: Obesity poses significant challenges to healthcare globally, particularly through its bi-directional relationship with co-morbid metabolic conditions such as type 2 diabetes and hypertension. There is also emerging evidence of an association between obesity and chronic kidney disease (CKD) which is less well characterized. Methods: A...
Article
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Obesity is not a new phenomenon, it’s as old as humanity itself. The Venus of Willendorf (Vienna, Austria) stands testimony to the recognition, and perhaps celebration, of (pathological) voluptuousness in the Palaeolithic era. What is new, however, is the unimaginable scale of the obesity epidemic today. The World Health Organization estimates tha...
Article
Background Emerging evidence suggests an association between impaired high-density lipoprotein (HDL) functionality and cardiovascular disease (CVD). HDL is essential for reverse cholesterol transport (RCT) and reduces inflammation and oxidative stress principally via paraoxonase-1 (PON1). RCT depends on HDL’s capacity to accept cholesterol (cholest...
Conference Paper
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Background: Bardet-Biedl syndrome (BBS) is a rare genetic condition characterised by ciliary protein dysfunction leading to multi-organ damage. Patients with BBS can suffer from hyperphagia and severe obesity from childhood and associated weight-related comorbid diseases such as type 2 diabetes and hypertension. However, the optimal weight manageme...
Article
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Introduction: Research is ongoing to increase our understanding of how much a previous diagnosis of type 2 diabetes mellitus (T2DM) affects someone's risk of becoming seriously unwell following a COVID-19 infection. In this study we set out to determine the relative likelihood of death following COVID-19 infection in people with T2DM when compared...
Article
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Introduction: Since early 2020 the whole world has been challenged by the SARS-CoV-2 virus and the associated global pandemic (Covid-19). People with diabetes are particularly at high risk of becoming seriously unwell after contracting this virus. Methods: This population-based study included people living in the Greater Manchester conurbation w...
Article
Objective: Thyroid status in the months following radioiodine (RI) treatment for Graves' disease can be unstable. Our objective was to quantify frequency of abnormal thyroid function post-RI and compare effectiveness of common management strategies. Design: Retrospective, multicentre and observational study. Patients: Adult patients with Grave...
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Background The incidence of endometrial cancer is rising in parallel with the obesity epidemic. Obesity increases endometrial cancer risk and weight loss is protective, but the underlying mechanisms are incompletely understood. We hypothesise that the immune microenvironment may influence susceptibility to malignant transformation in the endometriu...
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Alemtuzumab, a humanized monoclonal antibody used as a disease-modifying treatment in relapsing-remitting multiple sclerosis (RRMS), frequently causes autoimmunity as its principal adverse effect. We describe a typical case of a young man treated with two courses of alemtuzumab presenting 18 months later with initial hyperthyroidism due to Graves'...
Article
Purpose Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are novel drugs that have proven efficacy in improving cardiovascular outcomes. Roles for the PCSK9 molecule in metabolic pathways beyond LDL receptor processing and cholesterol homeostasis are well established. PCSK9 genetic variants associated with lower LDL-C levels correla...
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Introduction: Endometrial cancer rates are rising in parallel with the global obesity epidemic. Our aim was to assess the willingness of women at greatest risk of obesity-related endometrial cancer to engage with risk-reducing strategies and establish perceived barriers that may preclude their participation in a randomized controlled trial of prim...
Article
Background and aims The causal relationship between LDL cholesterol (LDL-C) and the pathogenesis of atherosclerosis is well established. Previous studies have shown that modifications, glycation and oxidation of LDL enhance its atherogenic potential. Glycation of LDL occurs in it is main protein component, apolipoprotein 100 (ApoB). Our aim was to...
Article
Viral myositis is commonly seen with influenza and COVID-19 infections. While it has been described with acute viral hepatitis, concomitant involvement of the peripheral nerves causing a neuromyopathy has not been reported. A 67-year-old man with acute hepatitis B infection developed a severe myalgia and lower limb weakness around 1 month into his...
Article
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Purpose Autoantibodies against apolipoprotein A-1 have been associated with cardiovascular disease, poorer CV outcomes and all-cause mortality in obese individuals. The impact of bariatric surgery (BS) on the presence of circulating anti-apoA-1 IgG antibodies is unknown. This study aimed to determine the effect of bariatric surgery on auto-antibodi...
Article
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Severe obesity is a disease associated with multiple adverse effects on health. Metabolic bariatric surgery (MBS) can have significant effects on multiple body systems and was shown to improve inflammatory markers in previous short-term follow-up studies. We evaluated associations between changes in inflammatory markers (CRP, IL6 and TNFα) and circ...
Article
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Cerebral venous sinus thrombosis (CVST) following novel coronavirus-2019 (nCoV-19) vaccination is a rare adverse effect. We report the first case of CVST associated with ChAdOx1 vaccination, with positive anti-platelet factor 4 (PF4) antibodies, from India. A 44-year-old woman developed a thunderclap headache 4 days after the first dose of the aden...
Conference Paper
https://www.easd.org/virtualmeeting/home.html#!resources/b-heat-shock-70-kda-protein-4-declines-after-bariatric-surgery-in-association-with-markers-of-inflammation-and-glycaemia-b
Preprint
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Background: We have previously shown that subjects with obesity have elevated vibration and thermal perception thresholds and central corneal nerve loss and patients with diabetic neuropathy have greater corneal nerve loss at the inferior whorl compared to the central cornea. In the current study, we assessed whether there is evidence for a dying-b...
Article
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Bariatric surgery (BS) results in metabolic pathway recalibration. We have identified potential biomarkers in plasma of people achieving type 2 diabetes mellitus (T2DM) remission after BS. Longitudinal analysis was performed on plasma from 10 individuals following Roux-en-Y gastric bypass (n = 7) or sleeve gastrectomy (n = 3). Sequential window acq...
Article
Background: Obesity is being recognised as a risk factor for COVID-19 infection and severity. However, it is unclear if obesity is associated with COVID-19 at the ecological population-level, independent of other putative risk factors. This analysis assesses the association of country-level obesity prevalence with COVID-19 case and mortality rates...
Article
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Intrauterine progestin is a treatment option for women with atypical hyperplasia or low-risk endometrial cancer who wish to preserve their fertility, or whose poor surgical fitness precludes safe hysterectomy. We hypothesized that in such women with obesity, weight loss during progestin treatment may improve oncological outcomes. We conducted a pro...
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A Correction to this paper has been published: https://doi.org/10.1007/s11695-020-04943-0
Article
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A 41-year-old woman presented to hospital with anterior neck swelling and pain, made worse with swallowing, after a week of febrile upper respiratory illness. She had an exquisitely tender goitre and fine hand tremor. Her temperature was 37.1°C, with a resting heart rate of 92-122 beats/minute and blood pressure of 116/68 mm Hg. Her thyroid-stimula...
Article
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Obesity and associated dyslipidemia may contribute to increased cardiovascular disease. Obesity has also been associated with neuropathy. We have investigated presence of peripheral nerve damage in patients with severe obesity without type 2 diabetes and the status of metabolic syndrome and lipoprotein abnormalities. 47participants with severe obes...
Article
As of April 22, 2021, around 1.5 million individuals in 3 districts of Kerala, India had been vaccinated with COVID-19 vaccines. Over 80% of these individuals (1.2 million) received the ChAdOx1-S/nCoV-19 vaccine. In this population, during this period of 4 weeks (mid-March to mid-April 2021), we observed seven cases of Guillain-Barre syndrome (GBS)...
Article
Purpose of review: Coronavirus Disease 2019 (COVID19) has caused significant global morbidity and mortality, especially in persons with underlying cardiovascular disease. There have been concerns that lipid-lowering therapy (LLT) increases angiotensin-converting enzyme 2 levels. Conversely, pleiotropic effects of statins can theoretically protect...
Article
Background and objectives: Weight loss is the mainstay of management for women with polycystic ovarian syndrome (PCOS). However, lifestyle and dietary modifications, and gastric banding have generally poor long-term efficacy. We aimed to investigate whether gastric bypass is equally efficacious in women with or without PCOS. Methods: We performe...
Article
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Introduction Subjects with obesity have metabolic risk factors for nerve fibre damage. Because bariatric surgery improves these risk factors we have assessed whether this can ameliorate nerve fibre damage. Methods Twenty-six obese subjects without diabetes (age: 46.23 ± 8.6, BMI: 48.7 ± 1.5, HbA1c: 38.0 ± 4.5) and 20 controls (age: 48.3 ± 6.2, BMI...
Article
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PurposeBariatric surgery is associated with deficiencies of vitamins and minerals, and patients are routinely advised supplements postoperatively. We studied prevalence of vitamin B12, folate and iron deficiencies and anaemia before and after bariatric surgery over 4 years of follow-up.Materials and Methods We performed a retrospective cohort analy...
Article
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Purpose: There are limited data on the impact of bariatric surgery on microvascular complications of type 2 diabetes (T2D), particularly diabetic neuropathy. We assessed microvascular complications (especially neuropathy) in obese patients with T2D before and 12 months after bariatric surgery. Materials and methods: This was a prospective observat...
Article
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Roux-en-Y gastric bypass (RYGB) is one of the most commonly performed weight-loss procedures, but how severe obesity and RYGB affect circulating HDL-associated microRNAs (miRNAs) remains unclear. Here, we aim to investigate how HDL-associated miRNAs are regulated in severe obesity and how weight loss after RYGB surgery affects HDL-miRNAs. Plasma HD...
Article
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In this mini-review, we examine the utilization of thyroid sonography as a ‘point-of-care’ tool for assessing and managing patients with (suspected) hyperthyroidism who present to the endocrine outpatients. Thyroid USS may aid the distinction between hyperthyroidism and destructive thyroiditis. Presence of intense vascularity (‘thyroid inferno’) on...
Article
Background Obesity is associated with adverse cardiovascular outcomes and this is improved following bariatric surgery. Oxidised phospholipids (OxPL) are thought to reflect the pro-inflammatory effects of lipoprotein(a) [Lp(a)], and both are independent predictors of cardiovascular disease. Objective Our study sought to determine the impact of bar...
Article
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IntroductionDay-long fasting creates considerable metabolic stress that poses challenges in people with diabetes and those who have undergone bariatric surgery. Clinical knowledge of glucose fluctuations and the risks for such patients during fasting is limited.Objectives This study examined the effect of intermittent fasting on glucose excursions,...
Article
Background & aims The emergence of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which causes Coronavirus Disease 2019 (COVID-19) has resulted in a worldwide pandemic. SARS-CoV-2 is highly contagious and its severity highly variable. The fatality rate is unpredictable but is amplified by several factors including advancing...
Conference Paper
Obesity is a major contributor to many metabolic disorders such as type 2 diabetes, hypertension, hyperlipidaemia, cardiovascular disease and sleep apnoea. In women, obesity affects fertility; and obesity in pregnancy increases the risk of complications such as miscarriage, prematurity, still birth and neonatal death, gestational diabetes, pregnanc...
Article
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Obesity is an emerging independent risk factor for susceptibility to and severity of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Previous viral pandemics have shown that obesity , particularly severe obesity (BMI > 40 kg/m2), is associated with increased risk of hospitalization, cr...
Article
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Two seemingly disparate risk factors have emerged for susceptibility and severity of covid-19: obesity and ethnicity.
Article
Purpose of review: Bariatric surgery is an effective therapy for morbid obesity that also improves weight-related metabolic parameters and reduces morbidity and mortality. The purpose of this review is to consolidate our current understanding of metabolic, macrovascular and microvascular benefits of bariatric surgery and to provide an update. Rec...
Article
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Background Bariatric surgery for severe obesity can lead to micronutrient/vitamin deficiencies. Aims To study baseline and post-surgical prevalence of vitamin D deficiency in patients undergoing bariatric surgery. Participants and Setting Patients undergoing bariatric surgery in a university teaching hospital in North West England. Methods We pe...
Conference Paper
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Section 1: Case history: A 46-year-old woman was referred to the Endocrinology clinic for evaluation of persistently elevated parathyroid hormone levels despite correction of previous vitamin D deficiency. She had a history of calcific tendinitis of the left shoulder and iris pigment dispersion syndrome. Notably, her mother had undergone two parath...
Conference Paper
Abstracts of the 11th BOMSS Annual Scientific Meeting. OBES SURG 30, 1–78 (2020). https://doi.org/10.1007/s11695-020-04433-3
Article
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We conducted a narrative review of the medical and surgical management of people with obesity and diabetes. Results of this review showed that a 5–10% loss in body weight can be achieved with a change in lifestyle, diet and behaviour and with approved pharmacological therapies in people with obesity and diabetes. New targeted therapies are now avai...
Article
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Context: Multiple factors contribute to sexual dysfunction in men with obesity. Sex hormone levels are commonly abnormal in men with obesity and this abnormality is often the focus of management in clinical practice. The role of small fibre neuropathy in obesity-related sexual dysfunction is not well established. Objective: We aimed to investiga...
Article
Kyriacou A, Kyriacou A, Makris KC, Syed AA, Perros P. Weight gain following treatment of hyperthyroidism—A forgotten tale. Clin Obes. 2019;e12328. Hyperthyroidism causes weight loss in the majority, but its effect is variable and 10% of patients gain weight. Its treatment usually leads to weight gain and some studies have reported an excess weight...
Conference Paper
Background: Endometrial cancer (EC) has strongest association with obesity of all cancers; a 1.60-fold greater risk is conferred per 5kg/m2 increase in body mass index (BMI). Similarly, surgically induced weight loss reduces risk by up to 81%. It is proposed that this association is related to changes in the microenvironment. Although the immune mi...