From the Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY.
the Institute of Human Nutrition, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY.
J Pediatr Gastroenterol Nutr. 2022 Dec 1;75(6):761-767. doi: 10.1097/MPG.0000000000003607. Epub 2022 Sep 6.
Metabolic and bariatric surgery is the most effective weight loss treatment for severe obesity. The number of adolescents undergoing sleeve gastrectomy is increasing. We investigated changes in body composition in adolescents undergoing sleeve gastrectomy 12-26 weeks post-operatively using whole-body magnetic resonance imaging (WB-MRI).
This prospective cohort study assessed changes in adipose tissue compartments (ie, visceral, subcutaneous, and intermuscular) and muscle in 18 obese adolescents, ages 14-19, 89% female, with body mass index z -score of 2.6 ± 0.25 (range 2.16-3.2). All underwent WB-MRI 1.5-17 weeks pre-operatively and 12-26 weeks post-operatively.
Pre- and post-operative WB-MRI showed decreases in all adipose tissue compartments, as well as decreased skeletal muscle and liver fat fraction ( P < 0.0001). The post-operative percentage loss of adipose tissue in subcutaneous, visceral, and intermuscular compartments (89.0%, 5.8%, 5.2%, respectively) was similar to the pre-operative percentages of corresponding adipose tissue compartments (90.5%, 5.0%, 4.5%, respectively). Of note, participants with obstructive sleep apnea had significantly higher pre-operative volume of subcutaneous and intermuscular adipose tissue than participants without obstructive sleep apnea ( P = 0.003).
We found, contrary to what is reported to occur in adults, that pre-operative percentage loss of adipose tissue in subcutaneous, visceral, and intermuscular compartments was similar to the post-operative percentage loss of corresponding adipose tissue compartments in adolescents 12-26 weeks after sleeve gastrectomy.
代谢和减重手术是治疗严重肥胖的最有效方法。越来越多的青少年接受袖状胃切除术。我们通过全身磁共振成像（WB-MRI）研究了青少年接受袖状胃切除术后 12-26 周的身体成分变化。
这项前瞻性队列研究评估了 18 名肥胖青少年（年龄 14-19 岁，89%为女性，体重指数 z 评分为 2.6±0.25[范围 2.16-3.2]）的脂肪组织隔室（即内脏、皮下和肌肉间）和肌肉在术前 1.5-17 周和术后 12-26 周的变化。所有患者均接受 WB-MRI 检查。
术前和术后的 WB-MRI 显示所有脂肪组织隔室均减少，骨骼肌和肝脏脂肪分数也减少（P＜0.0001）。术后皮下、内脏和肌肉间脂肪组织的百分比减少（分别为 89.0%、5.8%和 5.2%）与术前相应脂肪组织隔室的百分比相似（分别为 90.5%、5.0%和 4.5%）。值得注意的是，患有阻塞性睡眠呼吸暂停的参与者的皮下和肌肉间脂肪组织体积明显高于没有阻塞性睡眠呼吸暂停的参与者（P=0.003）。
与成人报道的情况相反，我们发现青少年在接受袖状胃切除术后 12-26 周，皮下、内脏和肌肉间脂肪组织的术前百分比减少与术后相应脂肪组织隔室的百分比减少相似。
