腹腔镜 Roux-en-Y 胃旁路手术后 BMI<32.5kg/m2 的 2 型糖尿病患者的体成分 5 年变化。

Five-year Changes in Body Composition in Type 2 Diabetes Mellitus Patients with a BMI < 32.5 kg/m Undergoing Laparoscopic Roux-en-Y Gastric Bypass Surgery.

机构信息

Department of General Surgery, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China.

出版信息

Obes Surg. 2021 Aug;31(8):3565-3570. doi: 10.1007/s11695-021-05430-w. Epub 2021 Apr 28.

DOI:10.1007/s11695-021-05430-w

PMID:33909267

Abstract

PURPOSE

Information is scarce on the five-year effect of laparoscopic Roux-en-Y Gastric Bypass (LRYGB) on body composition for Type 2 diabetes mellitus (T2DM) patients with a low BMI. This study aimed to evaluate the five-year changes in body composition in a Chinese T2DM cohort with a BMI < 32.5 kg/m after LRYGB.

METHODS

Twenty-seven T2DM patients were assessed preoperatively (baseline) and 3 months, 6 months, 1 year, 3 years, and 5 years after LRYGB with dual-energy X-ray absorptiometry (DXA).

RESULTS

DXA assessments were completed in 100%, 85%, 85%, 85%, 48%, and 37% at baseline and 3 months, 6 months, 1 year, 3 years, and 5 years, respectively. For the whole body, fat-free mass and muscle mass decreased from 6 months to 5 years after LRYGB (P < 0.05), while bone mineral content decreased at 5 years after LRYGB (P < 0.05). Fat mass of different regions decreased from 3 months to 1 year (P < 0.05), and a similar magnitude of variation was observed in body fat mass percentage. A fat redistribution characterized by the regional fat proportion of trunk and android decreasing and the regional fat proportion of limbs gaining (P < 0.05) occurred at 5 years after LRYGB.

CONCLUSION

For low BMI patients with T2DM, LRYGB led to a short-term reduction in FM and a lasting reduction in FFM. A metabolically healthy fat redistribution occurring 5 years after LRYGB might be a promising mechanism to explain the lasting benefits of LRYGB for T2DM patients with a low BMI.

摘要

目的

对于 BMI 较低的 2 型糖尿病（T2DM）患者，腹腔镜 Roux-en-Y 胃旁路术（LRYGB）对身体成分的五年影响相关信息有限。本研究旨在评估 LRYGB 后 BMI<32.5kg/m2的中国 T2DM 患者五年内身体成分的变化。

方法

27 例 T2DM 患者分别在术前（基线）和 LRYGB 后 3 个月、6 个月、1 年、3 年和 5 年时采用双能 X 线吸收法（DXA）进行评估。

结果

DXA 评估在基线和 3 个月、6 个月、1 年、3 年和 5 年时分别完成了 100%、85%、85%、85%、48%和 37%。LRYGB 后 6 个月至 5 年间，全身无脂肪质量和肌肉质量下降（P<0.05），而骨矿物质含量在 LRYGB 后 5 年下降（P<0.05）。不同区域的脂肪量从 3 个月至 1 年减少（P<0.05），体脂百分比也出现了类似的变化幅度。LRYGB 后 5 年，出现了以躯干和内脏区域脂肪比例下降、四肢区域脂肪比例增加为特征的代谢健康型脂肪再分布（P<0.05）。