Chou Ju-Jun, Lee Wei-Jei, Almalki Owaid, Chen Jung-Chien, Tsai Pei-Ling, Yang Shwu-Huey
School of Nutrition and Health Sciences, Taipei Medical University, No 250, Wuxing St, Xinyi District, Taipei, 110, Taiwan.
Central Clinic and Hospital, Taipei, Taiwan.
Obes Surg. 2017 Dec;27(12):3240-3246. doi: 10.1007/s11695-017-2765-8.
Laparoscopic sleeve gastrectomy (LSG) is becoming a leading primary bariatric surgery but long-term outcome remains unclear. The amount of food eaten is drastically reduced after LSG and may lead to nutritional deficiencies potentially. The aim of this study is to investigate long-term dietary intake and weight status after LSG.
Forty patients underwent LSG had more than 5-year follow-up with complete clinical data and food frequency questionnaires were analyzed.
The mean age of subjects is 33.5 years old with mean body mass index (BMI) 37.9 kg/m. Mean BMI loss at 5 years after LSG is 10.6 kg/m. Weight regain appeared in 20% of patients. Dietary composition analysis at 5 years showed mean calorie intake of 1230 kcal/day, protein 70 g/day (22.5% of calorie), fat 50 g/day (36.1%), carbohydrate 126 g (41.4%), iron 7.5 mg/day, calcium 536.2 mg/day, and fiber 11.7 g/day. Calorie intake at 5 years after LSG is correlated with weight loss but weight regain is not related to a higher calorie intake. All comorbidities were significantly improved after LSG but hemoglobin and parathyroid hormone significantly changed. Incidence of iron deficiency anemia increased from 7.5% at pre-operation to 41.2% after LSG. Incidence of secondary hyperparathyroidism increased from 17.5 to 60.7%.
LSG is an effective and durable bariatric procedure but with significant changes in nutritional status. Dietary instruction for LSG should include foods rich in protein, iron, calcium, and fiber.
腹腔镜袖状胃切除术（LSG）正成为主要的减重手术，但长期效果仍不明确。LSG术后进食量大幅减少，可能会导致潜在的营养缺乏。本研究旨在调查LSG术后的长期饮食摄入和体重状况。
对40例行LSG且有完整临床数据并进行了5年以上随访的患者进行食物频率问卷调查分析。
受试者平均年龄33.5岁，平均体重指数（BMI）为37.9kg/m²。LSG术后5年平均BMI下降10.6kg/m²。20%的患者出现体重反弹。5年时的饮食成分分析显示，平均每日热量摄入1230千卡，蛋白质70克/天（占热量的22.5%），脂肪50克/天（36.1%），碳水化合物126克（41.4%），铁7.5毫克/天，钙536.2毫克/天，纤维11.7克/天。LSG术后5年的热量摄入与体重减轻相关，但体重反弹与较高的热量摄入无关。LSG术后所有合并症均显著改善，但血红蛋白和甲状旁腺激素有显著变化。缺铁性贫血的发生率从术前的7.5%升至LSG术后的41.2%。继发性甲状旁腺功能亢进的发生率从17.5%升至60.7%。
LSG是一种有效且持久的减重手术，但营养状况有显著变化。LSG的饮食指导应包括富含蛋白质、铁、钙和纤维的食物。
