Long-term changes in energy expenditure and body composition after massive weight loss induced by gastric bypass surgery
Long-term changes in energy expenditure and body composition after massive weight loss induced by gastric bypass surgery
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DOI：
10.1093/ajcn/78.1.22
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发表时间：
2003-07-01
影响因子：
7.1
通讯作者：
Saltzman, E
中科院分区：
文献类型：
--
作者：
Das, SK;Roberts, SB;Saltzman, E
工作背景：关于胃旁路手术后体重和脂肪减少的个体差异性的决定因素或关于该手术引起的大量体重减少对能量需求的影响知之甚少。目的：目的是确定胃旁路手术引起的体重减少引起的能量消耗和身体成分的变化，并确定体重减少的术前预测因素。设计：30名极度肥胖的女性和男性，平均（± SD）年龄为39.0 ± 9.6岁，体重指数（BMI; kg/m2）为50.1 ± 9.3，在手术前和体重减轻和稳定后（14 ± 2个月），在体重稳定的条件下进行纵向测试。结果：受试者体重减轻53.2 +/- 22.2 kg，REE（-2.4 +/- 1.0 MJ/d; P < 0.001）和TEE（-3.6 +/- 2.5 MJ/d; P < 0.001）显著降低。REE的变化可以通过去脂质量和脂肪质量的变化来预测。基线和随访时的平均体力活动水平（TEE/REE）均为1.61（P = 0.98）。体重减轻可以通过基线脂肪量和BMI来预测，但不能通过任何能量消耗变量或瘦素来预测。测量REE在后续没有显着不同的预测REE.Conclusions：TEE和REE平均下降了25%，胃旁路手术引起的大规模减肥后。REE的变化是通过身体组织的损失来预测的;因此，能量效率没有显著的长期变化，这将独立地促进体重的恢复。
Background: Little is known about the determinants of individual variability in body Weight and fat loss after gastric bypass surgery or about the effects of massive weight loss induced by this surgery on energy requirements.Objectives: The objectives were to determine changes in energy expenditure and body composition with weight loss induced by gastric bypass surgery and to identify presurgery predictors of weight loss.Design: Thirty extremely obese women and men with a mean (+/-SD) age of 39.0 +/- 9.6 y and a body mass index (BMI; in kg/m(2)) of 50.1 +/- 9.3 were tested longitudinally under weight-stable conditions before surgery and after weight loss and stabilization (14 +/- 2 mo). Total energy expenditure (TEE), resting energy expenditure (REE), body composition, and fasting leptin were measured.Results: Subjects lost 53.2 +/- 22.2 kg body weight and had significant decreases in REE (-2.4 +/- 1.0 MJ/d; P < 0.001) and TEE (-3.6 +/- 2.5 MJ/d; P < 0.001). Changes in REE were predicted by changes in fat-free mass and fat mass. The average physical activity level (TEE/REE) was 1.61 at both baseline and follow-up (P = 0.98). Weight loss was predicted by baseline fat mass and BMI but not by any energy expenditure variable or leptin. Measured REE at follow-up was not significantly different from predicted REE.Conclusions: TEE and REE decreased by 25% on average after massive weight loss induced by gastric bypass surgery. REE changes were predicted by loss of body tissue; thus, there was no significant long-term change in energy efficiency that would independently promote weight regain.