Changes in resting energy expenditure and body composition after weight loss following Roux-en-Y gastric bypass
Changes in resting energy expenditure and body composition after weight loss following Roux-en-Y gastric bypass
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DOI：
10.1007/s11695-007-9117-z
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发表时间：
2007-05-01
期刊：
影响因子：
2.9
通讯作者：
Rojas, Jorge
中科院分区：
文献类型：
--
作者：
Carrasco, Fernando;Papapietro, Karin;Rojas, Jorge
工作背景：本研究的目的是评估重度肥胖患者Roux-en-Y胃旁路术（RYGBP）后静息能量消耗（REE）、身体成分和代谢参数的变化，并探讨其结果的预测因素。（BMI 44.4 +/- 4.8 kg/m（2）; 27名女性，4名男性; 37.3 +/- 11.1岁）在基线和RYGBP后6个月进行评估。测量体重、REE、腰围（WC）、脂肪量（FM）和无脂肪量（FFM）、体力活动、食物摄入、空腹血糖（GLU）、胰岛素（INS）、HOMA-IR和血脂浓度。结果：6个月时，体重减轻百分比（%WL）为29.0 +/- 4.4%，过度体重减轻百分比（%EWL）为59.7 +/-12.3%。FM损失相当于重量损失的77.1 +/-12.2%。REE从33.4 ± 4.1千卡/千克FFM降至30.1 ± 2.6千卡/千克FFM（P < 0.05）。GLU、INS、HOMA-IR、LDL-胆固醇和甘油三酯显著降低（P < 0.001）。%EWL与基线INS（r = 0.44; P = 0.014）、基线HOMA（r = 0.43; P = 0.017）、%FM变化（r = 0.67; P < 0.001）和WC变化（r = 0.5; P < 0.01）相关。REE/FFM（%）的降低与基线REE/FFM%（r = 0.51; P < 0.005）和%FM的变化（r = 0.69; P < 0.001）呈正相关。初始REE/FFM，基线能量平衡和FM的变化解释了90%的REE/FFM reduction.Conclusion：RYGBP是一种有效的程序，在短期内诱导显着的体重减轻，脂肪量减少和代谢参数的改善。代谢适应与FFM消耗无关，但与较高的基线REE有关。空腹高胰岛素血症是RYGBP后体重减轻的最佳单一预测因素。
Background: The objective of this study was to evaluate changes in resting energy expenditure (REE), body composition and metabolic parameters, and to investigate predictors of the results in seriously obese patients after Roux-en-Y gastric bypass (RYGBP).Methods: 31 patients (BMI 44.4 +/- 4.8 kg/m(2); 27 female, 4 male; 37.3 +/- 11.1 y) were evaluated at baseline and 6 months after RYGBP. Weight, REE, waist circumference (WC), fat mass (FM) and fat-free mass (FFM), physical activity, food intake, fasting glucose (GLU), insulin (INS), HOMA-IR and lipid concentrations were measured.Results: At 6 months, percentage of weight loss (%WL) was 29.0 +/- 4.4% and percentage of excess weight loss was (%EWL) 59.7 +/- 12.3%. FM loss corresponded to 77.1 +/- 12.2% of the weight loss. REE decreased from 33.4 +/- 4.1 to 30.1 +/- 2.6 kcal/kg FFM (P < 0.05). Significant decreases (P < 0.001) were observed in GLU, INS, HOMA-IR, LDL-cholesterol and triglycerides. %EWL was correlated with baseline INS (r = 0.44; P = 0.014), baseline HOMA (r = 0.43; P = 0.017), change in %FM (r = 0.67; P < 0.001) and change in WC (r = 0.5; P < 0.01). Decrease in REE/FFM (%) was positively correlated with baseline REE/FFM% (r = 0.51; P < 0.005) and change in %FM (r = 0.69; P < 0.001). Initial REE/FFM, baseline energy balance and FM change explain 90% of REE/FFM decrease.Conclusion: RYGBP was an effective procedure to induce significant weight loss, fat mass loss and improvement in metabolic parameters in the short term. Metabolic adaptation was not related to FFM wasting but to a higher baseline REE. Fasting hyperinsulinemia was the best single predictor of weight loss after RYGBP.