Silva Luís Bernardo, Oliveira Bruno M P M, Correia Flora
Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Portugal; Sociedade Portuguesa de Ciências da Nutrição e Alimentação, Portugal.
Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Portugal; LIAAD, INESC TEC, Portugal.
Clin Nutr ESPEN. 2019 Jun;31:95-99. doi: 10.1016/j.clnesp.2019.02.002. Epub 2019 Mar 20.
BACKGROUND & AIMS: Bariatric surgery is increasingly common in the fight against morbid obesity. However, after this intervention, it is not fully understood the evolution of weight loss and how body composition changes. The objective of this work is to study the evolution after surgery of weight and body composition of obese patients that underwent bariatric surgery.
In this retrospective and prospective study, we studied initially BMI and body composition of obese patients who attended nutritional appointments at Centro Hospitalar São João E.P.E. We collected personal data and anthropometric measurements between the pre-surgery appointment up to 60 months after surgery.
The sample consisted of 793 patients, of which 86.5% were female and 13.5% were male, with a mean age of 43 years (SD = 10.5 years) and mean height of 1.62 m (SD = 0.079 m). Patients undergoing gastric band, sleeve gastrectomy and gastric bypass had, respectively, an initial BMI reduction of 6.3 kg/m, 13.2 kg/m and 15.4 kg/m and an initial fat mass% reduction of 4.4%, 14.3% and 17.3%. On the other hand, they had an initial increase of 3.2%, 10.8% and 12.4% of water%, 1.4%, 3.9% and 4.6% of fat and water-free mass%, and 1.9%, 7.3% and 8.9% of skeletal muscle mass%, respectively. BMI and fat mass% on average had a large decrease in the first 12 months, increasing slightly from 24 months onwards. The opposite behaviour was observed for water%, fat and water-free mass% and skeletal muscle mass%.
Bariatric surgery initially allows a substantial decrease in BMI as well as beneficial changes in the overall body composition of the individuals. Gastric bypass was the method that caused the most changes, followed by sleeve gastrectomy and, finally, gastric band. On average, after 24 months of follow-up, and for all surgical procedures studied, we observed a reversion in BMI and body composition values, showing the difficulties in maintaining weight and fat loss.
减肥手术在对抗病态肥胖方面越来越普遍。然而，在这种干预之后，体重减轻的演变过程以及身体成分如何变化尚不完全清楚。这项工作的目的是研究接受减肥手术的肥胖患者术后体重和身体成分的变化情况。
在这项回顾性和前瞻性研究中，我们最初研究了在圣若昂医院中心营养门诊就诊的肥胖患者的体重指数（BMI）和身体成分。我们收集了术前门诊直至术后60个月的个人数据和人体测量数据。
样本包括793名患者，其中86.5%为女性，13.5%为男性，平均年龄43岁（标准差=10.5岁），平均身高1.62米（标准差=0.079米）。接受胃束带术、袖状胃切除术和胃旁路手术的患者，初始BMI分别降低6.3kg/m²、13.2kg/m²和15.4kg/m²，初始脂肪量百分比分别降低4.4%、14.3%和17.3%。另一方面，他们的初始水分百分比分别增加3.2%、10.8%和12.4%，去脂体重百分比分别增加1.4%、3.9%和4.6%，骨骼肌量百分比分别增加1.9%、7.3%和8.9%。BMI和脂肪量百分比在前12个月平均大幅下降，从24个月起略有增加。水分百分比、去脂体重和骨骼肌量百分比则表现出相反的变化趋势。
减肥手术最初能使BMI大幅下降，并使个体的整体身体成分发生有益变化。胃旁路手术引起的变化最大，其次是袖状胃切除术，最后是胃束带术。平均而言，在随访24个月后，对于所有研究的手术程序，我们观察到BMI和身体成分值出现逆转，表明维持体重和减肥存在困难。
