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女性群体接受胃旁路术后内脏脂肪及身体成分变化:双能X线吸收法两年随访研究

Visceral fat and body composition changes in a female population after RYGBP: a two-year follow-up by DXA.

作者信息

Bazzocchi Alberto, Ponti Federico, Cariani Stefano, Diano Danila, Leuratti Luca, Albisinni Ugo, Marchesini Giulio, Battista Giuseppe

机构信息

Diagnostic and Interventional Radiology, The "Rizzoli" Institute, Via G. C. Pupilli 1, 40136, Bologna, Italy.

出版信息

Obes Surg. 2015 Mar;25(3):443-51. doi: 10.1007/s11695-014-1422-8.

Abstract

BACKGROUND

Our aim was to monitor the impact of Roux-en-Y gastric bypass (RYGBP) on body composition over a 24-month period by dual-energy X-ray absorptiometry (DXA).

METHODS

Forty-one women (40.6 ± 10.0 years old; 42.6 ± 6.6 kg/m(2)) entering a bariatric surgery programme were submitted to whole-body DXA (Lunar iDXA) before treatment and after 3, 6, 12 and 24 months. Fat mass (FM), non-bone lean mass (LM), bone mineral content (BMC) and density (BMD) were measured at whole body and regionally. Android visceral adipose tissue (VAT) was estimated by a recently validated software.

RESULTS

Twenty-nine patients (44.3 ± 11.8 years old; BMI, 45.4 ± 8.9 kg/m(2)) concluded the study. Following surgery, the progressive decrease of BMI was associated with reduced whole-body and regional FM. LM showed a moderate decrease at 3 months and stabilized thereafter. A progressive decrease of total FM/LM and android FM/LM ratios were observed in the 3- to 6-month (-19.1 ± 8.4 % and -26.5 ± 10.9 %, respectively; p < 0.0001) and 6- to 12-month periods (-23.5 ± 16.8 % and -29.4 ± 23.9 %, respectively; p < 0.0001). VAT was the parameter showing the largest decrease (-65.6 ± 17.5 % at 12 months; p < 0.0001). Two years after the surgery, a slight but significant decrease of total and regional LM was observed, without any significant change in BMI.

CONCLUSIONS

Body composition significantly changes after RYGBP with a metabolically healthier redistribution of total and regional FM and a positive balance of FM/LM variation. DXA should be considered as a valid supplementary tool for the clinical assessment and follow-up in patients undergoing bariatric surgery.

摘要

背景

我们的目的是通过双能X线吸收法(DXA)监测Roux-en-Y胃旁路术(RYGBP)在24个月期间对身体成分的影响。

方法

41名进入减肥手术项目的女性(40.6±10.0岁;42.6±6.6kg/m²)在治疗前以及治疗后3、6、12和24个月接受全身DXA(Lunar iDXA)检查。测量全身和局部的脂肪量(FM)、非骨瘦体重(LM)、骨矿物质含量(BMC)和骨密度(BMD)。通过最近验证的软件估算腹部内脏脂肪组织(VAT)。

结果

29名患者(44.3±11.8岁;BMI,45.4±8.9kg/m²)完成了研究。手术后,BMI的逐渐下降与全身和局部FM的减少相关。LM在3个月时出现中度下降,此后稳定。在3至6个月(分别为-19.1±8.4%和-26.5±10.9%;p<0.0001)以及6至12个月期间(分别为-23.5±16.8%和-29.4±23.9%;p<0.0001)观察到总FM/LM和腹部FM/LM比值逐渐下降。VAT是下降幅度最大的参数(12个月时为-65.6±17.5%;p<0.0001)。手术后两年,观察到总LM和局部LM略有但显著下降,BMI无任何显著变化。

结论

RYGBP术后身体成分发生显著变化,总FM和局部FM代谢更健康地重新分布,FM/LM变化呈正平衡。DXA应被视为减肥手术患者临床评估和随访的有效辅助工具。

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