Division of Physiology, Department of Clinical Medicine and Surgery, Federico II University of Naples, Via Pansini n°5, 80131, Naples, Italy.
Federico II University Hospital, Naples, Italy.
J Endocrinol Invest. 2018 Nov;41(11):1307-1315. doi: 10.1007/s40618-018-0868-2. Epub 2018 Mar 24.
Laparoscopic sleeve gastrectomy (LSG) is one of the most frequently performed bariatric surgery interventions because of its safety and efficacy. Nevertheless, concerns have been raised on its detrimental effect on patient nutritional state that can ultimately lead to the loss of fat-free mass (FFM). There is interest in identifying predictors for the early identification of patients at risk of this highly unwanted adverse because they could benefit of nutritional preventive interventions. Therefore, we investigated whether anthropometric parameters, body composition or resting energy expenditure (REE) measured before surgery could predict FFM loss 1 year after LSG.
Study design was retrospective observational. We retrieved data on body weight, BMI, body composition and REE before and 1 year after LSG from the medical files of 36 patients operated on by LSG at our institutions. Simple regression, the Oldham's method and multilevel analysis were used to identify predictors of FFM loss.
Averaged percentage FFM loss 1 year after LSG was 17.0 ± 7.7% with significant differences between sexes (20.8 ± 6.6 in males and 12.2 ± 6.1% in females, p < 0.001). FFM loss was strongly predicted by pre-surgery FFM and this effect persisted also after correcting for the contribution of sex.
High FFM values before surgery predict a more severe FFM loss after LSG. This factor could also account for the higher FFM loss in men than in women. Our finding could help in the early identification of patient requiring a nutritional support after LSG.
腹腔镜袖状胃切除术（LSG）是最常施行的减重手术之一，因为其具有安全性和有效性。然而，人们对其对患者营养状态的有害影响表示担忧，这最终可能导致去脂体重（FFM）的损失。人们有兴趣确定预测因素，以便早期识别有这种高风险不良后果的患者，因为他们可能受益于营养预防干预。因此，我们研究了术前测量的人体测量参数、身体成分或静息能量消耗（REE）是否可以预测 LSG 后 1 年 FFM 的损失。
研究设计为回顾性观察。我们从在我们机构接受 LSG 手术的 36 名患者的病历中检索了手术前和 LSG 后 1 年的体重、BMI、身体成分和 REE 数据。使用简单回归、Oldham 法和多水平分析来确定 FFM 损失的预测因素。
LSG 后 1 年的平均 FFM 损失百分比为 17.0±7.7%，男女之间存在显著差异（男性为 20.8±6.6%，女性为 12.2±6.1%，p<0.001）。术前 FFM 强烈预测 FFM 损失，即使在校正性别贡献后，这种影响仍然存在。
术前高 FFM 值预测 LSG 后 FFM 损失更严重。这一因素也可以解释男性 FFM 损失高于女性的原因。我们的发现可以帮助早期识别需要 LSG 后营养支持的患者。
