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[减肥手术前后肥胖患者的营养问题]

[Nutrition aspects in obese before and after bariatric surgery].

作者信息

Pedrosa Isabella Valois, Burgos Maria Goretti Pessoa de Araújo, Souza Niedja Cristina, Morais Caroline Neves de

机构信息

Especialista em Nutrição pela Universidade Federal de Pernambuco, PE, BR.

出版信息

Rev Col Bras Cir. 2009 Aug;36(4):316-22. doi: 10.1590/s0100-69912009000400008.

Abstract

OBJECTIVE

To determine the physical-nutritional profile of obese patients submitted to bariatric surgery at the HC/UFPE.

METHODS

Two-hundred-and-five patients were evaluated retrospectively during the period of 2002 through 2006. Analysis considered clinical history for diabetes type 2 (DM 2), high blood pressure (HBP) and metabolic syndrome (MS). The preoperative nutritional status was evaluated by MBI and the biochemistry (hemoglobin, hematocrit, albumin, total proteins, triglycerides (TG), cholesterol associated with the lipoprotein of high (HDLc) and low (LDLc) density and fasting glycemia (FG). During the postoperative periods (6, 12, 18, 24 months), we evaluated the nutritional status through measures of weight, weight loss, weight loss percentage (%WL), MBI and biochemistry including iron, ferritin, transferrin.

RESULTS

Seventy-one and two-tenth percent were female, age was 38.4 + or - 9.96 years, and MBI preoperative was 48.6 + or - 8.9 Kg /m2. MS diagnosis was present in 26.8%, HBP was present in 52.7% and DM 2 was detected in 11.7%. The biochemistry disclosed TG, it raised LDLc, and FG, and all other parameters were normal. The anthropometrical evolution demonstrated gradual loss, reaching at the 24 months, MBI 31.7 + or - 5.82 Kg/m2 (p< 0.001) and greater %WL, 36%. Values of TG, LDLc and FG reached normality at the 6th postoperative month: 104.4mg/dL(p=0.018), 95.5mg/dL(p=0.263) and 84.8g/dL(p=0.004) respectively; the transferrin showed reduced values at the 6th month. A larger prevalence of the symptoms occurred in 6th month: hair loss (19%), vomiting (18%), and food intolerances (12.2%).

CONCLUSION

The bariatric surgery was an efficient procedure to promote weight loss and its maintenance in two years, as well as improvement of biochemical parameters and comorbidities, with reduced clinical-nutritional symptoms and/or prevented by nutritional monitoring.

摘要

目的

确定在累西腓联邦大学医院接受减肥手术的肥胖患者的身体营养状况。

方法

对2002年至2006年期间的205例患者进行回顾性评估。分析考虑了2型糖尿病(DM 2)、高血压(HBP)和代谢综合征(MS)的临床病史。术前营养状况通过体质指数(MBI)和生化指标(血红蛋白、血细胞比容、白蛋白、总蛋白、甘油三酯(TG)、高密度脂蛋白胆固醇(HDLc)、低密度脂蛋白胆固醇(LDLc)和空腹血糖(FG))进行评估。在术后各阶段(6、12、18、24个月),通过测量体重、体重减轻、体重减轻百分比(%WL)、MBI和生化指标(包括铁、铁蛋白、转铁蛋白)来评估营养状况。

结果

71.2%为女性,年龄为38.4±9.96岁,术前MBI为48.6±8.9 Kg/m²。MS诊断率为26.8%,HBP为52.7%,DM 2为11.7%。生化指标显示TG、LDLc和FG升高,其他所有参数均正常。人体测量学变化显示体重逐渐减轻,到24个月时,MBI为31.7±5.82 Kg/m²(p<0.001),%WL更高,为36%。TG、LDLc和FG的值在术后第6个月恢复正常:分别为104.4mg/dL(p=0.018)、95.5mg/dL(p=0.263)和84.8mg/dL(p=0.004);转铁蛋白在第6个月时显示值降低。术后第6个月出现症状的患病率更高:脱发(19%)、呕吐(18%)和食物不耐受(12.2%)。

结论

减肥手术是一种有效的手术方法,可在两年内促进体重减轻并维持体重,改善生化指标和合并症,减少临床营养症状和/或通过营养监测预防这些症状。

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