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[减肥手术后患者身体成分的变化:胃旁路手术和袖状胃切除术]

[Changes in body composition in patients following bariatric surgery: gastric bypass and sleeve gastrectomy].

作者信息

Palacio Ana, Quintiliano Daiana, Lira Isidora, Navarro Paula, Orellana Valentina, Reyes Alejandra, Henriquez Daniela

机构信息

Facultad de Medicina. Universidad del Desarrollo.

Centro Integral Nutrición-Obesidad. Clínica Tabancura.

出版信息

Nutr Hosp. 2019 Apr 10;36(2):334-349. doi: 10.20960/nh.2255.

Abstract

Introduction: among the surgical techniques that promote greater weight loss are Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). These procedures generate changes in muscle mass (MM) and fat mass (FM). Objective: the aim of this study was to determine changes in body composition in patients undergoing RYGB and SG in a period of one-year after surgery. Methods: a cross-sectional retrospective study was conducted in three clinical centers of bariatric surgery in the Metropolitan Region, Chile. Information on MM and FM was obtained through bioimpedance analysis of 96 women and 32 men, operated between 2013 and 2017. Results: RYGB operated subjects presented higher MM content preoperatively and at the end of the first year compared to SG. In the first six months, the loss for MM, FM and % total fat (%FM) was similar in both techniques. Men with RYGB present greater loss of MM and FM in the first trimester post-surgery than those who submitted to SG (p = 0.0453). Subjects submitted to RYGB presented higher weight and body mass index (BMI) in the preoperative (p = 0.0109); the BMI at the end was similar in both surgical techniques (p = 0.6936). The lost kilos of MM were greater in the subjects submitted to RYGB (p = 0.0042), however, the % loss of MM exceeds the recommended (up to 22%) in both techniques. Conclusion: the nutritional approach is necessary to increase protein intake pre- and post-surgery as well as physical activity in order to preserve this compartment.

摘要

引言

促进更大程度体重减轻的外科手术技术包括Roux-en-Y胃旁路术(RYGB)和袖状胃切除术(SG)。这些手术会引起肌肉量(MM)和脂肪量(FM)的变化。目的:本研究旨在确定接受RYGB和SG手术的患者在术后一年时间内身体成分的变化。方法:在智利首都大区的三个减肥手术临床中心进行了一项横断面回顾性研究。通过对96名女性和32名男性进行生物电阻抗分析获取MM和FM信息,这些患者于2013年至2017年接受手术。结果:与SG相比,接受RYGB手术的受试者术前和第一年末的MM含量更高。在前六个月,两种技术的MM、FM和总脂肪百分比(%FM)的减少情况相似。接受RYGB手术的男性在术后头三个月的MM和FM损失比接受SG手术的男性更大(p = 0.0453)。接受RYGB手术的受试者术前体重和体重指数(BMI)更高(p = 0.0109);两种手术技术术后的BMI相似(p = 0.6936)。接受RYGB手术的受试者MM减少的千克数更多(p = 0.0042),然而,两种技术中MM的损失百分比均超过了推荐值(高达22%)。结论:为了维持这一身体组成部分,术前和术后增加蛋白质摄入量以及进行体育活动的营养方法是必要的。

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