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袖状胃切除术后的饮食摄入及胃饥饿素和瘦素的变化

Dietary intake and ghrelin and leptin changes after sleeve gastrectomy.

作者信息

Bužga Marek, Zavadilová Vladislava, Holéczy Pavol, Švagera Zdeněk, Švorc Pavol, Foltys Aleš, Zonča Pavel

机构信息

Department of Physiology and Pathophysiology, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.

Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2014 Dec;9(4):554-61. doi: 10.5114/wiitm.2014.45437. Epub 2014 Sep 23.

Abstract

INTRODUCTION

Surgical intervention in obesity is today the most effective treatment method in high level obesity management. Bariatric interventions not only ensure body weight reduction, but may influence dietary habits.

AIM

To assess changes in adipose hormones and dietary habits in obese patients after sleeve gastrectomy.

MATERIAL AND METHODS

The study set comprised 37 subjects (29 females and 8 males) 24 to 68 years old with body mass index 43.0 ±4.9 kg/m(2). Pre-operative examination included baseline measurements of body composition. Dietary habits and intake frequency were monitored by a questionnaire method. Follow-up examinations were carried out in a scope identical to the pre-operative examination, 6 and 12 months after surgery, respectively.

RESULTS

The average patient weight loss 12 months after surgery was 31.7 kg. Excess weight loss was 55.2 ±20.6%. Patients reported reduced appetite (p < 0.001), increasingly regular food intake (p < 0.001), intake of more meal portions per day (p = 0.003) and a decrease in consuming the largest portions during the afternoon and evening (p = 0.030). Plasma levels of fasting glucose, leptin and ghrelin significantly decreased (p = 0.006; p = 0.0.043); in contrast, the level of adiponectin significantly increased (p < 0.001).

CONCLUSIONS

Sleeve gastrectomy and follow-up nutritional therapy resulted in a significant body weight reduction within 1 year after surgery. An improvement of certain dietary habits in patients was registered. At 12 months after surgery, there were no statistically significant differences in decreases in ghrelin and leptin concentrations between patients without changed appetite and those reporting decreased appetite.

摘要

引言

如今,手术干预肥胖症是管理重度肥胖最有效的治疗方法。减肥手术不仅能确保体重减轻,还可能影响饮食习惯。

目的

评估肥胖患者接受袖状胃切除术后脂肪激素和饮食习惯的变化。

材料与方法

研究对象包括37名年龄在24至68岁之间、体重指数为43.0±4.9kg/m²的受试者(29名女性和8名男性)。术前检查包括身体成分的基线测量。通过问卷调查法监测饮食习惯和摄入频率。分别在术后6个月和12个月进行与术前检查范围相同的随访检查。

结果

术后12个月患者平均体重减轻31.7kg。超重减轻率为55.2±20.6%。患者报告食欲下降(p<0.001),饮食摄入愈发规律(p<0.001),每天用餐次数增加(p=0.003),下午和晚上摄入最大份量食物的情况减少(p=0.030)。空腹血糖、瘦素和胃饥饿素的血浆水平显著降低(p=0.006;p=0.043);相反,脂联素水平显著升高(p<0.001)。

结论

袖状胃切除术及后续营养治疗在术后1年内导致体重显著减轻。患者的某些饮食习惯得到改善。术后12个月,食欲未改变的患者与报告食欲下降的患者在胃饥饿素和瘦素浓度降低方面无统计学显著差异。

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