通过双能 X 射线吸收法对肥胖患者进行身体成分评估，以了解其代谢特征和心血管风险，为减肥手术做准备。
BODY COMPOSITION ASSESSED BY DUAL-ENERGY X-RAY ABSORPTIOMETRY ON METABOLIC PROFILE AND CARDIOVASCULAR RISK IN OBESE PATIENTS PRIOR TO BARIATRIC SURGERY.
机构信息
Universidade Federal de Pernambuco, Postgraduate Program in Surgery - Recife (PE), Brazil.
Universidade Federal de Pernambuco, Nutrition Department - Recife (PE), Brazil.
出版信息
Arq Bras Cir Dig. 2023 May 26;36:e1734. doi: 10.1590/0102-672020230016e1734. eCollection 2023.
BACKGROUND
Fat, muscle, and bone are endocrine organs capable of affecting the metabolic profile and cardiovascular risk. Relating these components is important to the establishment of early intervention strategies for overweight patients.
AIMS
This study aimed to evaluate the influence of body mass components on the metabolic profile and cardiovascular risk in the preoperative period of bariatric surgery.
METHODS
A cross-sectional study was conducted with patients admitted for bariatric surgery at a university hospital in the city of Recife, Brazil, between 2018 and 2019. Body composition was determined using dual-energy x-ray absorptiometry. Cardiovascular risk was assessed using the Framingham risk score. Data were collected on anthropometric, clinical, and lifestyle characteristics. The lipid profile (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides), blood glucose, and vitamin D were determined using the standard methods of the hospital laboratory.
RESULTS
A total of 60 patients were analyzed, 86.7% of whom had comorbidities, 33.3% had moderate/high cardiovascular risk, and 71.4% had vitamin D insufficiency/deficiency. Lower lean body mass (adjusted PR 3.24; 95%CI 1.19-5.77) was independently associated with the severity of obesity. The body mass index and waist circumference were negatively correlated with lean body mass (r=-0.52; p<0.01)/r=-0.36; p<0.01). Lean body mass was negatively correlated with fat mass (r=-0.26; p<0.05), trunk fat (r=-0.29; p<0.05), fasting glucose (r=-0.26; p<0.05), and bone mineral density (r=-0.26; p<0.05). A total of 84.2% of individuals with less trunk fat tended to have low cardiovascular risk (p=0.05). However, physical inactivity (adjusted PR 2.14; 95%CI 1.19-5.54) and the risk of alcohol dependence (adjusted PR 2.41; 95%CI 1.76-4.15) were the only variables independently associated with cardiovascular risk.
CONCLUSION
Obese patients in the preoperative period of bariatric surgery with less trunk fat tended to have low cardiovascular risk. However, the other components of body mass were also not associated with cardiovascular risk.
背景
脂肪、肌肉和骨骼是能够影响代谢特征和心血管风险的内分泌器官。将这些成分联系起来对于超重患者的早期干预策略的建立很重要。
目的
本研究旨在评估肥胖患者术前体成分对代谢特征和心血管风险的影响。
方法
这是一项在巴西累西腓市一所大学医院接受减重手术的患者中进行的横断面研究。使用双能 X 射线吸收法测定身体成分。使用弗雷明汉风险评分评估心血管风险。收集了人体测量学、临床和生活方式特征的数据。使用医院实验室的标准方法测定血脂（总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和甘油三酯）、血糖和维生素 D。
结果
共分析了 60 例患者，其中 86.7%有合并症，33.3%有中/高心血管风险，71.4%有维生素 D 不足/缺乏。较低的瘦体重（调整后的 PR 3.24；95%CI 1.19-5.77）与肥胖严重程度独立相关。体重指数和腰围与瘦体重呈负相关（r=-0.52；p<0.01）/r=-0.36；p<0.01）。瘦体重与脂肪质量（r=-0.26；p<0.05）、躯干脂肪（r=-0.29；p<0.05）、空腹血糖（r=-0.26；p<0.05）和骨密度（r=-0.26；p<0.05）呈负相关。84.2%的躯干脂肪较少的个体倾向于有较低的心血管风险（p=0.05）。然而，体力活动不足（调整后的 PR 2.14；95%CI 1.19-5.54）和酒精依赖风险（调整后的 PR 2.41；95%CI 1.76-4.15）是唯一与心血管风险独立相关的变量。
结论
在接受减重手术的肥胖患者术前阶段，躯干脂肪较少的患者倾向于有较低的心血管风险。然而，体重的其他成分也与心血管风险无关。
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