胃旁路术后、可调胃束带术或单纯饮食后的产热变化。
Thermogenic changes after gastric bypass, adjustable gastric banding or diet alone.
机构信息
Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Surgery, University of California San Francisco, San Francisco, CA; Department of Surgery, Paracelsus Medical University, Salzburg, Austria.
Department of Medicine, University of California San Francisco, San Francisco, CA.
出版信息
Surgery. 2014 Oct;156(4):806-12. doi: 10.1016/j.surg.2014.06.070.
BACKGROUND
The mechanisms by which bariatric surgery achieves weight loss (WL) are under scrutiny. We assessed changes in resting energy expenditure (REE) after gastric bypass (RYGB) and gastric banding (AGB) to determine if changes in REE are associated with WL and type of surgery.
METHODS
Three groups of morbidly obese patients were studied: RYGB (n = 12), AGB (n = 8), and a control group that underwent caloric restriction alone (Diet, n = 10). Studies were performed at baseline and after 14 days in all groups and 6 months after RYGB and AGB. REE (kcal/day) was measured by indirect calorimetry and adjusted for body weight (Wt-REE), and lean body mass by dual-energy X-ray absorptiometry (LBM-REE).
RESULTS
At baseline, REE did not differ significantly among groups (RYGB = 2,114 ± 337, AGB = 1,837 ± 154, Diet = 2,091 ± 363 kcal/day, P = .13). After 14 days, the groups had similar percent excess WL (%EWL). Neither Wt-REE nor LBM-REE changed significantly in any group. After 6 months %EWL was 49 ± 10% after RYGB and 21 ± 11% after AGB (P < .01); RYGB patients had greater increase in the percent of weight that was LBM (RYGB = 7.9 ± 3.0 vs. AGB = 1.6 ± 1.5%, P < .01). Wt-REE increased significantly only after RYGB (+2.58 ± 1.51 kcal/kg/day, P < .01). There was a significant correlation between changes in Wt-REE and %EWL (r = 0.670, P = .003).
CONCLUSION
The increase in Wt-REE may be a factor supporting WL after RYGB.
背景
减重手术实现体重减轻（WL）的机制正在受到审查。我们评估了胃旁路术（RYGB）和胃带术（AGB）后静息能量消耗（REE）的变化，以确定 REE 的变化是否与 WL 和手术类型有关。
方法
研究了三组病态肥胖患者：RYGB（n=12）、AGB（n=8）和仅接受热量限制的对照组（饮食，n=10）。所有组均在基线和 14 天后以及 RYGB 和 AGB 后 6 个月进行研究。通过间接热量法测量 REE（千卡/天），并根据体重（Wt-REE）和双能 X 射线吸收法（LBM-REE）调整瘦体重。
结果
基线时，各组 REE 无显著差异（RYGB=2114±337，AGB=1837±154，饮食=2091±363 千卡/天，P=0.13）。14 天后，各组的超重百分比减轻（%EWL）相似。任何一组的 Wt-REE 或 LBM-REE 均无明显变化。6 个月后，RYGB 组的 EWL 为 49±10%，AGB 组为 21±11%（P<0.01）；RYGB 患者 LBM 占体重的百分比增加更多（RYGB=7.9±3.0 比 AGB=1.6±1.5%，P<0.01）。只有 RYGB 后 Wt-REE 显著增加（+2.58±1.51 千卡/公斤/天，P<0.01）。Wt-REE 的变化与 EWL 之间存在显著相关性（r=0.670，P=0.003）。
结论
RYGB 后 Wt-REE 的增加可能是支持 WL 的一个因素。
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