Department of Surgery, Oregon Health & Science University, Portland, Oregon, USA.
Department of Nutritional Sciences, University of Wisconsin, Madison, Wisconsin, USA.
Obesity (Silver Spring). 2018 May;26(5):862-868. doi: 10.1002/oby.22138. Epub 2018 Mar 31.
Little is known about long-term metabolic (energy expenditure) adaptation after bariatric surgery.
Resting metabolic rate under basal conditions (RMR), total daily energy expenditure (TDEE), and body composition were measured in 25 participants in the Longitudinal Assessment of Bariatric Surgery-2.
Six months after surgery, BMI (±SD) decreased (47 ± 6 kg/m to 37 ± 5 kg/m ), body fat went from 48% ± 6% to 40% ± 6% fat, and fat-free mass went from 67 ± 9 kg to 60 ± 9 kg. In absolute terms, RMR and TDEE both decreased significantly (1,730 ± 278 kcal/d vs. 1,430 ± 200 kcal/d and 2,879 ± 544 kcal/d vs. 2,369 ± 304 kcal/d), and the achieved energy balance was -1,293 ± 355 kcal/d. Sixteen of these participants underwent repeated measures at ∼24 months; TDEE decreased 6 months postoperatively (2,957 ± 540 kcal/d to 2,423 ± 324 kcal/d; P = 0.0003), but at ∼24 months, TDEE (2,602 ± 471 kcal/d) was not significantly different compared with month 6. The average negative energy balance from baseline to month 24 was -379 ± 131 kcal/d.
RMR and TDEE fall precipitously in the first 6 months after bariatric surgery, but these adaptive changes were no longer significant after 2 years.
关于减重手术后长期代谢（能量消耗）适应性的信息知之甚少。
在纵向评估减重手术-2 中，对 25 名参与者测量了基础状态下的静息代谢率（RMR）、总每日能量消耗（TDEE）和身体成分。
手术后 6 个月，BMI（±SD）从（47±6kg/m2）降至（37±5kg/m2），体脂从 48%±6%降至 40%±6%，去脂体重从 67±9kg 降至 60±9kg。从绝对值来看，RMR 和 TDEE 均显著下降（1730±278kcal/d 比 1430±200kcal/d 和 2879±544kcal/d 比 2369±304kcal/d），实现的能量平衡为-1293±355kcal/d。其中 16 名参与者在大约 24 个月时进行了重复测量；TDEE 在手术后 6 个月时下降（2957±540kcal/d 比 2423±324kcal/d；P=0.0003），但在大约 24 个月时，TDEE（2602±471kcal/d）与 6 个月时相比没有显著差异。从基线到 24 个月的平均负能量平衡为-379±131kcal/d。
RMR 和 TDEE 在减重手术后的前 6 个月急剧下降，但这些适应性变化在 2 年后不再显著。
