Centre for Obesity Research, Rayne Institute, Department of Medicine, University College London, London WC1E 6JF, United Kingdom; University College London Hospital Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital, Ground Floor West Wing, 250 Euston Road, London NW1 2PG, United Kingdom; National Institute of Health Research, University College London Hospital Biomedical Research Centre, London W1T 7DN, United Kingdom.
Centre for Obesity Research, Rayne Institute, Department of Medicine, University College London, London WC1E 6JF, United Kingdom.
Appetite. 2016 Dec 1;107:93-105. doi: 10.1016/j.appet.2016.07.029. Epub 2016 Jul 22.
Reduced energy intake drives weight loss following Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) procedures. Post-operative changes in subjective appetite, taste, and smell and food preferences are reported and suggested to contribute to reduced energy intake. We aimed to investigate the prevalence of these changes following RYGB and SG and to evaluate their relationship with weight loss. 98 patients post-RYGB and 155 post-SG from a single bariatric centre were recruited to a cross-sectional study. Participants completed a questionnaire, previously utilised in post-operative bariatric patients, to assess the prevalence of post-operative food aversions and subjective changes in appetite, taste and smell. Anthropometric data were collected and percentage weight loss (%WL) was calculated. The relationship between food aversions, changes in appetite, taste and smell and %WL was assessed. The influence of time post-surgery, gender and type 2 diabetes (T2D) were evaluated. Following RYGB and SG the majority of patients reported food aversions (RYGB = 62%, SG = 59%), appetite changes (RYGB = 91%, SG = 91%) and taste changes (RYGB = 64%, SG = 59%). Smell changes were more common post-RYGB than post-SG (RYGB = 41%, SG = 28%, p = 0.039). No temporal effect was observed post-RYGB. In contrast, the prevalence of appetite changes decreased significantly with time following SG. Post-operative appetite changes associated with and predicted higher %WL post-SG but not post-RYGB. Taste changes associated with and predicted higher %WL following RYGB but not post-SG. There was no gender effect post-RYGB. Post-SG taste changes were less common in males (female = 65%, males = 40%, p = 0.008). T2D status in females did not influence post-operative subjective changes. However, in males with T2D, taste changes were less common post-SG than post-RYGB together with lower %WL (RYGB = 27.5 ± 2.7, SG = 14.6 ± 2.1, p = 0.003). Further research is warranted to define the biology underlying these differences and to individualise treatments.
减少能量摄入可促进 Roux-en-Y 胃旁路术（RYGB）和袖状胃切除术（SG）后的体重减轻。术后报告了主观食欲、味觉和嗅觉以及食物偏好的变化，并认为这些变化有助于减少能量摄入。我们旨在调查 RYGB 和 SG 术后这些变化的发生率，并评估其与体重减轻的关系。从一家减肥中心招募了 98 例 RYGB 术后和 155 例 SG 术后患者进行横断面研究。参与者完成了一份调查问卷，该问卷以前用于术后肥胖症患者，以评估术后食物厌恶和食欲、味觉和嗅觉主观变化的发生率。收集人体测量数据并计算体重减轻百分比（%WL）。评估食物厌恶、食欲、味觉和嗅觉变化与%WL 的关系。评估手术时间、性别和 2 型糖尿病（T2D）的影响。RYGB 和 SG 后，大多数患者报告了食物厌恶（RYGB=62%，SG=59%）、食欲变化（RYGB=91%，SG=91%）和味觉变化（RYGB=64%，SG=59%）。RYGB 后嗅觉变化比 SG 后更常见（RYGB=41%，SG=28%，p=0.039）。RYGB 术后未观察到时间效应。相比之下，SG 术后食欲变化随时间显著减少。SG 术后食欲变化与预测较高的%WL 相关，但 RYGB 术后则不然。RYGB 术后味觉变化与预测较高的%WL 相关，但 SG 术后则不然。RYGB 术后无性别影响。SG 术后男性味觉变化较少（女性=65%，男性=40%，p=0.008）。T2D 状态对女性术后主观变化无影响。然而，在男性 T2D 患者中，SG 术后味觉变化比 RYGB 术后少见，同时体重减轻百分比也较低（RYGB=27.5±2.7，SG=14.6±2.1，p=0.003）。需要进一步研究以确定这些差异的生物学基础，并对治疗进行个体化。
