Gasteyger C, Suter M, Calmes J M, Gaillard R C, Giusti V
Department of Endocrinology, Diabetology and Metabolism, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Obes Surg. 2006 Mar;16(3):243-50. doi: 10.1381/096089206776116381.
Laparoscopic adjustable gastric banding (LAGB) causes significant weight loss in morbidly obese adults. However, its consequences on nutritional status still remain unclear. This study aimed to investigate the effects of LAGB on body composition, metabolic profile and nutritional status in obese, premenopausal women.
36 obese, premenopausal women (age 24-52 years; mean BMI 43.8 kg/m2) who underwent LAGB were included. Body composition was measured using dual-X-ray absorptiometry at baseline, 6, 12 and 24 months after surgery. Blood pressure, total cholesterol, HDL-cholesterol, triglycerides, glucose, uric acid, total proteins, iron, ferritin, vitamin B12, folic acid, hemoglobin and mean corpuscular volume were measured at baseline, 6, 12, 18 and 24 months after surgery.
All patients lost weight over 24 months (range 16.0-71.9 kg): there was a significant loss of fat mass (-51.4%; P<0.0001) as well as of fat-free mass (-13.1%; P<0.0001). There was a significant improvement in blood pressure, glucose, total cholesterol, HDL-cholesterol, triglycerides and urates during the first year; during the second year, a further significant decline was noted only in glucose and urates. According to ATP III criteria, 21 of our patients (58%) had a metabolic syndrome before surgery, but only 9 of them (25%) after 12 months and 1 of them (3%) after 24 months. No nutritional deficiency was noted, except for a significant decrease in serum folate (44.1%; P<0.0001 between baseline and month 24).
LAGB allows significant improvements in metabolic profile, especially during the first postoperative year, without causing major nutritional deficiencies, except for folates.
腹腔镜可调节胃束带术（LAGB）可使病态肥胖成年人显著减重。然而，其对营养状况的影响仍不明确。本研究旨在调查LAGB对肥胖绝经前女性身体成分、代谢状况和营养状况的影响。
纳入36例接受LAGB的肥胖绝经前女性（年龄24 - 52岁；平均体重指数43.8kg/m²）。在基线、术后6个月、12个月和24个月时使用双能X线吸收法测量身体成分。在基线、术后6个月、12个月、18个月和24个月时测量血压、总胆固醇、高密度脂蛋白胆固醇、甘油三酯、血糖、尿酸、总蛋白、铁、铁蛋白、维生素B12、叶酸、血红蛋白和平均红细胞体积。
所有患者在24个月内均减重（范围16.0 - 71.9kg）：脂肪量显著减少（-51.4%；P<0.0001），去脂体重也显著减少（-13.1%；P<0.0001）。第一年血压、血糖、总胆固醇、高密度脂蛋白胆固醇、甘油三酯和尿酸水平有显著改善；第二年，仅血糖和尿酸进一步显著下降。根据ATP III标准，我们的患者中有21例（58%）术前患有代谢综合征，但术后12个月时只有9例（25%），术后24个月时只有1例（3%）。除血清叶酸显著降低外（44.1%；基线与第24个月之间P<0.0001），未发现营养缺乏。
LAGB可使代谢状况显著改善，尤其是在术后第一年期间，除叶酸外不会导致严重营养缺乏。
