de Castro Cesar Marcelo, de Lima Montebelo Maria Imaculada, Rasera Irineu, de Oliveira Adalberto Vicente, Gomes Gonelli Pamela Roberta, Aparecida Cardoso Gabrielle
College of Health Sciences (FACIS), Piracicaba Methodist University (UNIMEP), Rodovia do Açúcar Km 156-Taquaral, Piracicaba, CEP 13400-911, SP, Brazil.
Obes Surg. 2008 Nov;18(11):1376-80. doi: 10.1007/s11695-008-9460-8. Epub 2008 Mar 5.
Bariatric surgery is the gold standard treatment for morbid obesity, but little is known about its effects on resting energy expenditure.
Twenty-one women underwent anthropometric and resting energy expenditure (REE) measurements before and 3 months after bariatric surgery using the Roux-en-Y gastric bypass (RYGBP) technique developed by Capella.
The patients experienced a significant reduction in body weight, body mass index, waist circumference, and waist-to-hip ratio (WHR). The cardiopulmonary variables oxygen uptake, carbon dioxide output, non-protein respiratory quotient, and heart rate all decreased, whereas oxygen pulse did not change significantly. Absolute REE showed a significant reduction 3 months postoperatively (2006.7 +/- 376.4 kcal/day to 1763.3 +/- 310.5 kcal/day), but no significant difference was found compared with REE relative to body weight (0.71 +/- 0.15 kcal kg(-1)h(-1) to 0.75 +/- 0.12 kcal kg(-1) h(-1)) or as percent of Harris-Benedict predicted REE (106.2 +/- 21.0% to 103.3 +/- 15.1%).
In this study, bariatric surgery using the RYGBP technique (Capella) led to a significant decrease of body weight that decreased resting energy expenditure proportional to this weight loss, and to an increase in the utilization of fat as an energy substrate. It can be concluded that after 3 months, the Roux-en-Y gastric bypass surgery may provide significant metabolic benefits to morbidly obese women.
减肥手术是治疗病态肥胖的金标准疗法，但关于其对静息能量消耗的影响却知之甚少。
21名女性在接受由卡佩拉研发的Roux-en-Y胃旁路术（RYGBP）减肥手术前及术后3个月接受了人体测量和静息能量消耗（REE）测量。
患者的体重、体重指数、腰围和腰臀比（WHR）均显著降低。心肺变量摄氧量、二氧化碳排出量、非蛋白呼吸商和心率均下降，而氧脉搏无显著变化。绝对REE在术后3个月显著降低（从2006.7±376.4千卡/天降至1763.3±310.5千卡/天），但与相对于体重的REE（从0.71±0.15千卡·千克⁻¹·小时⁻¹降至0.75±0.12千卡·千克⁻¹·小时⁻¹）或占哈里斯-本尼迪克特预测REE的百分比（从106.2±21.0%降至103.3±15.1%）相比，无显著差异。
在本研究中，采用RYGBP技术（卡佩拉）的减肥手术导致体重显著下降，静息能量消耗随体重减轻成比例降低，且脂肪作为能量底物的利用率增加。可以得出结论，3个月后，Roux-en-Y胃旁路手术可能为病态肥胖女性带来显著的代谢益处。
