减重手术后绝经后妇女长期的身体成分改善：一项横断面和病例对照研究。

Long-term body composition improvement in post-menopausal women following bariatric surgery: a cross-sectional and case-control study.

机构信息

Division of Endocrinology, Diabetology, and Metabolism, Lausanne University Hospital, Lausanne, Switzerland.

Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.

出版信息

Eur J Endocrinol. 2022 Jan 6;186(2):255-263. doi: 10.1530/EJE-21-0895.

DOI:10.1530/EJE-21-0895

PMID:34879003

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8789027/

Abstract

OBJECTIVE

Bariatric surgery (BS) induces loss of body fat mass (FM) with an inexorable loss of lean mass (LM). Menopause leads to deleterious changes in body composition (BC) related to estrogen deficiency including LM loss and increase in total and visceral adipose tissue (VAT). This study aims to describe the long-term weight evolution of post-menopausal women after Roux-en-Y gastric bypass (RYGB) and to compare the BC between BS patients vs post-menopausal non-operated women.

DESIGN

Cross-sectional study of 60 post-menopausal women who underwent RYGB ≥2 years prior to the study with nested case-control design.

METHODS

Post-menopausal BS women were matched for age and BMI with controls. Both groups underwent DXA scan, lipids and glucose metabolism markers assessment.

RESULTS

Median follow-up was 7.5 (2-18) years. Percentage of total weight loss (TWL%) was 28.5 ± 10%. After RYGB, LM percentage of body weight (LM%) was positively associated with TWL% and negatively associated with nadir weight. Forty-one post-BS women were age- and BMI-matched with controls. Post-BS patients showed higher LM% (57.7% (±8%) vs 52.5% (±5%), P = 0.001), reduced FM% (39.4% (±8.4%) vs 45.9% (±5.4%), P < 0.01) and lower VAT (750.6 g (±496) vs 1295.3 g (±688), P < 0.01) with no difference in absolute LM compared to controls. While post-BS women showed a better lipid profile compared to controls, no difference was found in glucose markers.

CONCLUSIONS

Post-menopausal women after RYGB have a lower FM and VAT, preserved LM and a better lipid profile compared to controls. Weight loss after RYGB seems to have a persistent positive impact on metabolic health.

摘要

目的

减重手术（BS）会导致体脂肪量（FM）不可避免地减少，同时也会导致去脂体重（LM）减少。绝经会导致与雌激素缺乏相关的身体成分（BC）发生有害变化，包括 LM 减少和总脂肪组织和内脏脂肪组织（VAT）增加。本研究旨在描述绝经后女性接受 Roux-en-Y 胃旁路术（RYGB）后长期的体重变化，并比较 BS 患者与未接受手术的绝经后女性之间的 BC。

设计

对 60 名绝经后女性进行回顾性研究，这些女性在研究前至少接受了 2 年的 RYGB，采用嵌套病例对照设计。

方法

绝经后 BS 女性按年龄和 BMI 与对照组匹配。两组均接受 DXA 扫描、血脂和葡萄糖代谢标志物评估。

结果

中位随访时间为 7.5（2-18）年。总减重百分比（TWL%）为 28.5±10%。RYGB 后，LM 体重百分比（LM%）与 TWL%呈正相关，与体重最低点呈负相关。41 名 BS 后女性与对照组按年龄和 BMI 匹配。BS 后患者的 LM%更高（57.7%（±8%）比 52.5%（±5%），P=0.001），FM%更低（39.4%（±8.4%）比 45.9%（±5.4%），P<0.01），VAT 更低（750.6g（±496）比 1295.3g（±688），P<0.01），与对照组相比，LM 的绝对值没有差异。虽然 BS 后女性的血脂谱优于对照组，但血糖标志物无差异。