Clinic for Visceral, Transplant, Thoracic and Vascular Surgery, Leipzig University, Liebigstr. 20, 04103, Leipzig, Germany.
Integrated Research and Treatment Center (IFB) Adiposity Diseases, 04103, Leipzig, Germany.
Obes Surg. 2022 Sep;32(9):2903-2913. doi: 10.1007/s11695-022-06180-z. Epub 2022 Jul 18.
Preoperative very low-calorie diets (VLCDs) have been shown to reduce liver volume and improve bariatric surgery safety. Here, we compare two VLCD that differ in macronutrient composition.
MATERIAL/METHODS: Ninety patients awaiting obesity surgery were included in a prospective, open-label, randomized mono-centre trial comparing the effects of 2-week preoperative VLCDs: BCM Diät™ (diet 1) versus Optifast™ (diet 2).
Data from 33 patients in diet 1 and 36 in diet 2 could be analysed. There was no significant difference between the two diet intervention arms on outcome parameters. Overall, both VLCD strategies led to a mean weight reduction of 5.24 [4.72-5.76] kg (p < 0.001), mean excess weight loss was 8.2 [7.4-9.1] % (p < 0.001). BMI reduction was 1.81 [1.63-1.99] kg/m (p < 0.001). Over all patients, the liver volume was reduced by 397 [329-466] ml (p < 0.001), which corresponds to 14.6 [12.4; 16.8] %. Liver fat content was significantly reduced by 18.35 [8.98-27.71] %. Reduction of body weight correlates with liver volume loss. In addition, hip/waist circumferences, body fat and fat-free mass decreased significantly. We found an increase of ALAT/ASAT and a significant decrease of triglycerides, LDL-cholesterol and HbA1c. Parameters of inflammatory were significantly reduced upon VLCD.
Independently of the macronutrient composition, VLCD leads to a significant decrease of body weight, reduction of liver volume and improved parameters of inflammation, glucose and lipid metabolism. Preoperative diets are widely used in conditioning; however, VLCD should be considered as option for patients with obesity undergoing other abdominal surgeries.
术前极低卡路里饮食（VLCD）已被证明可减少肝体积并提高减重手术的安全性。在这里，我们比较了两种在宏量营养素组成上有所不同的 VLCD。
材料/方法：90 名接受肥胖手术的患者被纳入一项前瞻性、开放标签、随机单中心试验，比较了两种为期 2 周的术前 VLCD 的效果：BCM Diät ™（饮食 1）与 Optifast ™（饮食 2）。
可分析饮食 1 组 33 例和饮食 2 组 36 例的数据。两种饮食干预组在结果参数上无显著差异。总体而言，两种 VLCD 策略均导致平均体重减轻 5.24 [4.72-5.76] kg（p<0.001），平均超重减轻 8.2 [7.4-9.1] %（p<0.001）。BMI 降低 1.81 [1.63-1.99] kg/m（p<0.001）。所有患者的肝体积减少 397 [329-466] ml（p<0.001），相当于 14.6 [12.4; 16.8] %。肝脂肪含量显著降低 18.35 [8.98-27.71] %。体重减轻与肝体积减少相关。此外，臀围/腰围、体脂肪和去脂体重明显减少。我们发现 ALAT/ASAT 升高，甘油三酯、LDL 胆固醇和 HbA1c 显著降低。VLCD 后炎症参数显著降低。
无论宏量营养素组成如何，VLCD 均可显著降低体重、减少肝体积并改善炎症、血糖和脂质代谢参数。术前饮食在调理中广泛应用；然而，VLCD 应被视为肥胖症患者接受其他腹部手术的选择。
