Vinjamuri Ramalakshmi Gayathri, Wu Vieon, Eng Alvin, Tan Jeremy, Lim Eugene, Lee Phong Ching, Kovalik Jean-Paul, Tan Hong Chang
Duke-NUS Medical School, Singapore, 169857, Singapore.
Department of Endocrinology, Singapore General Hospital, Singapore, 169608, Singapore.
Obes Surg. 2024 Jul;34(7):2363-2368. doi: 10.1007/s11695-024-07269-3. Epub 2024 May 15.
Obesity, defined as abnormal or excessive fat accumulation that presents a risk to health, rose from 8.6 to 10.5% in Singapore's residents. Bariatric surgery, the primary treatment for severe obesity, induces fat and muscle loss. Adequate protein intake is vital for preventing muscle loss. This study examines nitrogen balance in individuals with obesity pre- and post-surgery.
Sixteen participants with severe obesity (BMI ≥ 32.5 kg/m) undergoing bariatric surgery (14 sleeve gastrectomy, 2 Roux-en-Y gastric bypass) and 20 normal-weight controls (BMI < 25 kg/m) were recruited. Nitrogen balance, calculated from dietary protein intake and urine nitrogen excretion, was assessed. Participants with obesity were re-evaluated 6 months post-surgery. Data were analyzed using parametric methods.
At baseline, controls had a BMI of 20.8 ± 2.1 kg/m; those with obesity had 40.9 ± 7.3. Daily calorie and protein intake for participants with obesity were not statistically significantly different from controls (calorie intake at 1467 ± 430 vs. 1462 ± 391 kcal, p = 0.9701, protein intake 74.2 ± 28.7 vs. 64.6 ± 18.3 g, p = 0.2289). Post-surgery, BMI, fat-free mass, fat mass, total energy intake, carbohydrate, and protein intake decreased significantly (p < 0.01). Protein oxidation and urine nitrogen excretion did not change after bariatric surgery. However, nitrogen balance significantly reduced from 2.62 ± 5.07 to - 1.69 ± 5.07 g/day (p = 0.025).
Dietary protein intake is inadequate in individuals with obesity at 6 months post-bariatric surgery and contributes to a state of negative nitrogen balance.
肥胖被定义为异常或过度的脂肪堆积，对健康构成风险，新加坡居民的肥胖率从8.6%上升至10.5%。减重手术是重度肥胖的主要治疗方法，会导致脂肪和肌肉流失。充足的蛋白质摄入对于预防肌肉流失至关重要。本研究调查了肥胖个体在手术前后的氮平衡情况。
招募了16名接受减重手术的重度肥胖参与者（BMI≥32.5kg/m²）（14例行袖状胃切除术，2例行Roux-en-Y胃旁路术）以及20名体重正常的对照者（BMI<25kg/m²）。通过饮食蛋白质摄入量和尿氮排泄量计算氮平衡并进行评估。肥胖参与者在术后6个月进行重新评估。数据采用参数方法进行分析。
基线时，对照者的BMI为20.8±2.1kg/m²；肥胖者为40.9±7.3。肥胖参与者的每日热量和蛋白质摄入量与对照者相比无统计学显著差异（热量摄入量分别为1467±430与1462±391千卡，p=0.9701；蛋白质摄入量分别为74.2±28.7与64.6±18.3克，p=0.2289）。术后，BMI、去脂体重、脂肪量、总能量摄入量、碳水化合物和蛋白质摄入量均显著下降（p<0.01）。减重手术后蛋白质氧化和尿氮排泄量未发生变化。然而，氮平衡从2.62±5.07显著降至-1.69±5.07克/天（p=0.025）。
减重手术后6个月，肥胖个体的饮食蛋白质摄入量不足，导致负氮平衡状态。
