Simó-Servat Andreu, Ibarra Montse, Libran Mireia, Escobar Lilian, Perea Verónica, Quirós Carmen, Puig-Jové Carlos, Barahona Maria-José
Department of Endocrinology and Nutrition, Hospital Universitari MútuaTerrassa, Plaça del Doctor Robert, 5, 08221 Terrassa, Spain.
Department of General Surgery, Hospital Universitari MútuaTerrassa, 08221 Terrassa, Spain.
J Clin Med. 2024 Jun 27;13(13):3763. doi: 10.3390/jcm13133763.
Bariatric surgery (BS) has a significant impact on body composition (BC) and consequently may affect established sarcopenic obesity (SO) in candidate patients. The aim of this study was to assess the utility of muscle ultrasound (MUS) of rectus femoris thickness (RFT) for the evaluation of BC and skeletal muscle function in patients undergoing BS compared to bioimpedance analysis (BIA), dual-energy X-ray absorptiometry (DEXA) and dynamometry. On the other hand, we aimed to demonstrate how MUS of RFT correlates with quality of life (QoL) in this population, likely due to its ability to detect regional quadriceps muscle sarcopenia compared to the other mentioned methods. This was a prospective pilot study that included 77 participants (64.9% female, mean age: 53.2 ± 8.67 years) who underwent BS. Handgrip strength was measured using a dynamometer, fat-free mass index (iFFM) was assessed by BIA, appendicular muscle index (AMI) was calculated using DEXA, and RFT was measured by MUS. Moreover, homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. All these measurements were conducted 1 month prior to BS and at the 12-month follow-up. QoL was assessed using the Moorehead-Ardelt questionnaire. The mean BMI decreased by 12.95 ± 3.56 kg/m ( = 0.001). Firstly, we observed a positive correlation pre-surgery between HOMA and RFT (r = 0.27, = 0.02), iFFM (r = 0.36, = 0.001), AMI (r = 0.31, = 0.01) and dynamometer readings (r = 0.26, = 0.02). In addition, we found a correlation between RFT and iFFM (pre-surgery: r = 0.31, = 0.01; post-surgery: r = 0.25, = 0.05) and between RFT and lower-extremity AMI post-surgery (r = 0.27, = 0.04). Secondly, we observed significant reductions in iFFM, AMI and RFT ( = 0.001), but not in dynamometer readings ( = 0.94). Finally, a tendency to a positive correlation between QoL questionnaire and RFT post-surgery results (r = 0.23, = 0.079) was observed. Our results suggest that RFT measured by MUS is useful for evaluating SO and for the follow-up of these patients after BS. Moreover, RFT can provide relevant information about regional sarcopenia and probably has an accurate correlation with QoL in comparison with the other methods.
减重手术（BS）对身体成分（BC）有显著影响，因此可能会影响候选患者已有的肌少症性肥胖（SO）。本研究的目的是评估股直肌厚度（RFT）的肌肉超声（MUS）在评估接受BS手术患者的身体成分和骨骼肌功能方面的效用，并与生物电阻抗分析（BIA）、双能X线吸收法（DEXA）和肌力测定法进行比较。另一方面，我们旨在证明RFT的MUS与该人群生活质量（QoL）之间的相关性，这可能是由于它与其他提及的方法相比能够检测股四头肌区域的肌少症。这是一项前瞻性试点研究，纳入了77名接受BS手术的参与者（64.9%为女性，平均年龄：53.2±8.67岁）。使用握力计测量握力，通过BIA评估去脂体重指数（iFFM），使用DEXA计算四肢肌肉指数（AMI），并通过MUS测量RFT。此外，计算胰岛素抵抗的稳态模型评估（HOMA-IR）。所有这些测量均在BS手术前1个月和12个月随访时进行。使用穆尔黑德-阿德尔问卷评估生活质量。平均体重指数（BMI）下降了12.95±3.56kg/m²（P = 0.001）。首先，我们观察到术前HOMA与RFT（r = 0.27，P = 0.02）、iFFM（r = 0.36，P = 0.001）、AMI（r = 0.31，P = 0.01）和握力计读数（r = 0.26，P = 0.02）之间呈正相关。此外，我们发现RFT与iFFM之间存在相关性（术前：r = 0.31，P = 0.01；术后：r = 0.25，P = 0.05），术后RFT与下肢AMI之间也存在相关性（r = 0.27，P = 0.04）。其次，我们观察到iFFM、AMI和RFT显著降低（P = 0.001），但握力计读数未降低（P = 0.94）。最后，观察到生活质量问卷与术后RFT结果之间存在正相关趋势（r = 0.23，P = 0.079）。我们的结果表明，通过MUS测量的RFT可用于评估SO，并对这些患者在BS手术后进行随访。此外，与其他方法相比，RFT可以提供有关区域肌少症的相关信息，并且可能与生活质量有准确的相关性。
