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减肥手术后的身体组成变化:过度无脂肪质量损失的幅度,时间和决定因素
Noelia Perez-Romero1,2, Montse Adell Trapé1, Assumpta Caixàs2,3,4
1Esophagogastric and Bariatric Unit, General Surgery Department, Parc Taulí Hospital Universitari, 08208 Sabadell, Spain.
腹部外科手术导致显著的脂肪质量和无脂肪质量损失,近一半的患者失去过多的无脂肪质量 (FFM). 手术后的FFM监测可以识别有针对性干预的风险人群.
科学领域:
- 代谢和腹部手术 代谢和腹部手术
- 身体组成分析 身体成分分析
- 肥胖医学 肥胖医学
背景情况:
- 减肥手术对于严重的肥胖是有效的,但导致脂肪质量 (FM) 和无脂肪质量 (FFM) 的术后显著减少.
- 过度的FFM损失与肉症,虚弱和潜在的体重恢复有关,但其流行率和预测因素需要进一步阐明.
- 了解FFM后腹腔外科手术的动态对于优化患者的治疗结果和长期健康至关重要.
研究的目的:
- 为了量化Roux-en-Y胃绕道术 (RYGB) 后的无脂肪质量损失的大小.
- 根据已确定的值,确定患有过度无脂肪质量损失的患者比例.
- 为了确定脱脂手术后无脂肪质量保存的预测因素.
主要方法:
- 对179名接受腹腔镜或机器人RYGB.患者的回顾性分析.
- 通过生物电阻分析进行人体参数和身体组成的手术前和6个月和12个月的术后测量.
- 计算无脂肪质量损失相对于总体重损失 (%FFML/WL) 的百分比,并使用逐步回归来评估预测因素.
主要成果:
- 患者在手术后6个月和12个月经历了BMI,FM和FFM显著降低 (p < 0.001).
- 6个月后FFML/WL的中位数为26.4%,12个月后为28.7%,其中41-46%的患者超过了≥25%的值.
- 6个月后的术后FFM是12个月后FFM的唯一独立预测因素.
结论:
- 鲁克斯-en-Y胃绕道术导致FM和FFM的大量损失,过度FFM损失的流行率很高.
- 早期术后对身体组成的监测对于识别患有FFM耗尽风险的患者至关重要.
- 侧重于足够的蛋白质摄入量和抵抗训练的干预措施可以减轻过度的FFM损失并改善长期结果.
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