Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xin-Quan Road, Fuzhou, 350001, Fujian Province, China.
Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China.
Obes Surg. 2024 May;34(5):1479-1490. doi: 10.1007/s11695-024-07146-z. Epub 2024 Mar 15.
Sarcopenic obesity may affect the health outcome of people with obesity after laparoscopic sleeve gastrectomy (LSG). To assess the impact of sarcopenic obesity (SO) on weight loss outcomes and improvement of quality of life after LSG.
This observational study included patients who underwent LSG with SO (99 patients) or without SO (146 patients) from a single center. The primary endpoint was weight loss and disease-specific quality of life in patients with or without SO after the operation. Fat-free mass (FFM) and fat mass (FM) were calculated based on the L3-level images of preoperative CT scans. SO was diagnosed if FM/FFM ≥ 0.80.
Operative time and postoperative hospital stay days were longer in the SO group (p < 0.001). After LSG, weight, BMI, and EBMI were significantly lower in the NSO group than in the SO group (all P < 0.05), while %EWL and the number of patients with %EWL ≥ 100% were significantly lower in the SO group (both p < 0.05). The total BAROS scores of patients in the NSO group were higher than those in the SO group (p < 0.05). Additionally, the MA II questionnaire assessment showed a lower percentage of "very good" and "good" outcomes in the SO group (p < 0.05).
Patients with SO take a slower rate, longer time to reach the ideal weight, and lower quality of life self-ratings than NSO patients after LSG. Thus, preoperative evaluation and tailoring rehabilitation guidance for people with SO should be accounted.
肌少症性肥胖可能会影响肥胖患者腹腔镜袖状胃切除术（LSG）后的健康结局。评估肌少症性肥胖（SO）对 LSG 后体重减轻效果和生活质量改善的影响。
这项观察性研究纳入了来自单一中心的接受 LSG 治疗且伴有（99 例）或不伴有（146 例）SO 的患者。主要终点是手术后伴有或不伴有 SO 的患者的体重减轻和疾病特异性生活质量。基于术前 CT 扫描的 L3 水平图像计算无脂肪质量（FFM）和脂肪质量（FM）。如果 FM/FFM≥0.80，则诊断为 SO。
SO 组的手术时间和术后住院天数较长（p<0.001）。LSG 后，NSO 组的体重、BMI 和 EBMI 均显著低于 SO 组（均 P<0.05），而 SO 组的%EWL 和%EWL≥100%的患者数量显著较低（均 p<0.05）。NSO 组患者的总 BAROS 评分高于 SO 组（p<0.05）。此外，MA II 问卷评估显示 SO 组的“非常好”和“好”结果比例较低（p<0.05）。
与 NSO 患者相比，SO 患者在 LSG 后达到理想体重的速度较慢、时间更长，生活质量自评较低。因此，术前评估和为 SO 患者量身定制康复指导应该得到重视。
