Roux-en-Y胃旁路术后静息能量消耗早期降低及体重成功减轻

Early reduction of resting energy expenditure and successful weight loss after Roux-en-Y gastric bypass.

作者信息

Moehlecke Milene, Andriatta Blume Carina, Rheinheimer Jakeline, Trindade Manoel Roberto Maciel, Crispim Daisy, Leitão Cristiane Bauermann

机构信息

Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.

出版信息

Surg Obes Relat Dis. 2017 Feb;13(2):204-209. doi: 10.1016/j.soard.2016.08.027. Epub 2016 Aug 18.

DOI:10.1016/j.soard.2016.08.027

PMID:27692914

Abstract

BACKGROUND

Weight loss and body composition changes after Roux-en-Y gastric bypass (RYGB) may influence resting energy expenditure (REE). The effect of lower REE after the procedure on long-term weight remains to be elucidated.

OBJECTIVE

To evaluate the effects of RYGB on REE and body composition 6 months after RYGB and to find out whether postsurgery REE affects weight at 12 and 18 months SETTING: Tertiary referral hospital, southern Brazil METHOD: A prospective study involving 30 RYGB patients aged>18 years was performed. Body composition was evaluated by X-ray absorptiometry and REE by indirect calorimetry. All patients were assessed before RYGB and 6 months postoperatively. Further analysis of weight was carried out at 12 and 18 months.

RESULTS

Baseline body mass index was 49±9 kg/m² and mean weight was 128±19 kg, half of which comprised fat mass (50±5%). Baseline mean REE was 2297±182 kcal/d. The percent total weight loss was 26±7%, 32±9%, and 34±9% at 6, 12, and 18 months, respectively. The percent excess weight loss gradually increased from 54 ± 12% at 6 months, to 67 ± 18% at 12 months, and 71 ± 19% at 18 months. REE was significantly lower at follow-up (-405±108 kcal/d; P<.001). Furthermore, an inverse correlation between REE at 6 months and percent excess weight loss at 18 months (r =-.612; P = .035) was observed in the subgroup of patients whose REE decreased>405 kcal/d at 6 months.

CONCLUSION

Patients undergoing RYGB who had a substantial drop in REE at 6 months may exhibit less long-term weight loss.

摘要

背景

Roux-en-Y胃旁路术（RYGB）后体重减轻和身体成分变化可能会影响静息能量消耗（REE）。该手术后REE降低对长期体重的影响尚待阐明。

目的

评估RYGB术后6个月对REE和身体成分的影响，并确定术后REE是否会影响12个月和18个月时的体重。

地点

巴西南部的三级转诊医院

方法

对30例年龄大于18岁的RYGB患者进行了一项前瞻性研究。通过双能X线吸收法评估身体成分，通过间接测热法评估REE。所有患者在RYGB术前和术后6个月进行评估。在12个月和18个月时对体重进行进一步分析。

结果

基线体重指数为49±9kg/m²，平均体重为128±19kg，其中一半为脂肪量（50±5%）。基线平均REE为2297±182kcal/d。在6个月、12个月和18个月时，总体重减轻百分比分别为26±7%、32±9%和34±9%。超重减轻百分比从6个月时的54±12%逐渐增加到12个月时的67±18%和18个月时的71±19%。随访时REE显著降低（-405±108kcal/d；P<.001）。此外，在6个月时REE下降>405kcal/d的患者亚组中，观察到6个月时的REE与18个月时的超重减轻百分比之间存在负相关（r = -0.612；P = 0.035）。