Singhal Vibha, Pedreira Clarissa C, Tuli Shubhangi, Abou Haidar Lea, Lopez Ana Lopez, Lauze Meghan, Lee Hang, Bredella Miriam A, Misra Madhusmita
Division of Pediatric Endocrinology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
Nutrients. 2024 Dec 28;17(1):75. doi: 10.3390/nu17010075.
Weight loss is associated with reductions in resting energy expenditure (REE), which are impacted by changes in body composition following sleeve gastrectomy (SG). Current data regarding changes in measured REE (mREE) and metabolic adaptation in adolescents after SG are limited. We evaluated changes in mREE, metabolic adaptation, and body composition in youths after SG vs. non-surgical (NS) controls over two years. Youths 14-22 years old undergoing SG ( = 24) and NS controls with severe obesity ( = 28) were recruited. mREE was determined using indirect calorimetry. Predicted REE (pREE) was calculated using regression equation derived from baseline data of our cohort and used to calculate pREE at follow up. Metabolic adaptation was calculated as mREE - pREE. We normalized REE to fat-free mass (FFM) and total body weight (TBW). Dual energy X-ray absorptiometry was used to measure body composition. Measurements were performed at baseline and two-years. Baseline age, sex, and BMI were similar between groups. Greater decreases in BMI in SG vs. NS (-12.4 (-14.4, -9.8) vs. 2.2 (0.3, 3.5) kg/m, < 0.0001) and within-group decreases in mREE (401.0 ± 69.5 kcal/d; < 0.0001) in SG were seen. mREE/FFM decreased within the SG group ( = 0.006), the two-year change in mREE/FFM and mREE/TBW did not differ between groups ( = 0.14 and 0.24). There was no metabolic adaptation within SG. Despite significant decreases in BMI after SG in youths, no metabolic adaptation was present at two years. This implies that by two years, metabolism has reached a steady state and weight changes after this should be addressed in an unbiased way.
体重减轻与静息能量消耗（REE）的降低有关，而袖状胃切除术（SG）后身体成分的变化会影响静息能量消耗。目前关于青少年SG术后实测REE（mREE）变化和代谢适应的资料有限。我们评估了SG术后青少年与非手术（NS）对照者在两年内mREE、代谢适应和身体成分的变化。招募了14 - 22岁接受SG手术的青少年（n = 24）和患有严重肥胖症的NS对照者（n = 28）。使用间接测热法测定mREE。预测REE（pREE）通过从我们队列的基线数据推导的回归方程计算得出，并用于计算随访时的pREE。代谢适应计算为mREE - pREE。我们将REE标准化为去脂体重（FFM）和总体重（TBW）。使用双能X线吸收法测量身体成分。在基线和两年时进行测量。两组之间的基线年龄、性别和BMI相似。SG组的BMI下降幅度大于NS组（-12.4（-14.4，-9.8）与2.2（0.3，3.5）kg/m²，P < 0.0001），并且SG组内mREE有下降（401.0 ± 69.5 kcal/d；P < 0.0001）。SG组内mREE/FFM下降（P = 0.006），两组之间mREE/FFM和mREE/TBW的两年变化无差异（P = 0.14和0.24）。SG组内不存在代谢适应。尽管青少年SG术后BMI显著下降，但两年时不存在代谢适应。这意味着到两年时，代谢已达到稳定状态，此后的体重变化应以无偏倚的方式处理。
