Changes in liver volume and body composition during 4 weeks of low calorie diet before laparoscopic gastric bypass
Changes in liver volume and body composition during 4 weeks of low calorie diet before laparoscopic gastric bypass
复制标题
DOI：
10.1016/j.soard.2014.07.018
复制
发表时间：
2015-05-01
影响因子：
3.1
通讯作者：
Sundbom, Magnus
中科院分区：
文献类型：
--
作者：
Edholm, David;Kullberg, Joel;Sundbom, Magnus
背景：在腹腔镜Roux-en-Y胃分流术(LRYGB)前减肥是可取的，因为它可以减少肝脏体积，从而简化手术。低卡路里饮食(LCD)的最佳持续时间尚未确定。方法：10例女性患者，年龄43±8.9岁，体重114±12.1 kg，体重指数42±2.6 kg/m(2)，分别于术后0、3、7、14、28 d进行检查。在每次评估中，通过生物电阻抗分析评估身体成分，并通过磁共振成像评估肝脏体积和肝内脂肪含量。取血、尿标本。结果：治疗后体重平均下降7.4+/-1.2 kg(5.7~9.1 kg)，生物电阻抗分析显示71%的体重下降为脂肪团。从第0天到第3天，体重损失(2.0 kg)主要以水为主。在前两周，肝脏体积减少了18%+/-6.2%，从2.1升降至1.7升(P<；.01)，此后没有进一步的变化。肝内脂肪含量连续下降51%+/-16%。结论：在接受LCD治疗的前2周内，肝脏体积显著缩小(18%)，肝内脂肪逐渐减少。对于类似的患者，术前两周的LCD治疗似乎足够了。(C)2015年美国新陈代谢和减肥外科学会。版权所有。
Background: Weight loss before laparoscopic Roux-en-Y gastric bypass (LRYGB) is desirable, because it can reduce liver volume and thereby facilitate the procedure. The optimal duration of a low-calorie diet (LCD) has not been established. The objective of this study was to assess changes in liver volume and body composition during 4 weeks of LCD.Methods: Ten women (aged 43 +/- 8.9 years, 114 +/- 12.1 kg, and body mass index 42 +/- 2.6 kg/m(2)) were examined on days 0, 3, 7, 14, and 28 after commencing the LCD. At each evaluation, body composition was assessed through bioelectric impedance analysis, and liver volume and intrahepatic fat content were assessed by magnetic resonance imaging. Serum and urine samples were obtained. Questionnaires regarding quality of life and LCD-related symptoms were administered.Results: In total, mean weight decreased by 7.4 +/- 1.2 kg (range 5.7-9.1 kg), and 71% of the weight loss consisted of fat mass according to bioelectric impedance analysis. From day 0 to day 3, the weight loss (2.0 kg) consisted mainly of water. Liver volume decreased by 18% +/- 6.2%, from 2.1 to 1.7 liters (P < .01), during the first 2 weeks with no further change thereafter. A continuous 51% +/- 16% decrease was seen in intrahepatic fat content. Systolic blood pressure, insulin, and lipids improved, while liver enzymes, glucose levels, and quality of life were unaffected.Conclusion: A significant decrease in liver volume (18%) occurred during the first 2 weeks of LCD treatment, and intrahepatic fat gradually decreased throughout the study period. A preoperative 2-week LCD treatment seems sufficient in similar patients. (C) 2015 American Society for Metabolic and Bariatric Surgery. All rights reserved.