Energy Expenditure and Gastric-Bypass Surgery

能量消耗和胃绕道手术

• 批准号: 7102114
• 负责人: JAMES A LEVINE
• 金额: $ 54.52万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-06-01 至 2010-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7102114
• 关键词: bariatric surgery; basal metabolism; bioenergetics; body physical activity; caloric dietary content; clinical research; human subject; nutrition related tag; obesity; patient oriented research; stomach /intestine bypass; thermogenesis; weight gain; weight loss

DESCRIPTION (provided by applicant): Obesity is an epidemic with widereaching implications for health and society. Bariatric surgery is a successful therapy for achieving and maintaining weight loss and improving obesity comorbidiities. This study will explore the energetic mechanisms of weight loss in subjects undergoing gastric bypass bariatric surgery, which until now has not been clearly defined. In any scenario where there are substantial changes in energy stores, it is necessary to examine the role of changes in food intake and energy expenditure. After bariatric surgery, it is evident that energy intake declines. However, there is very little information as to how the components of energy expenditure, and in particular activity thermogenesis, change. This is not a trivial issue. In fact, changes in physical activity and activity thermogenesis could be crucial for understanding why some people lose more weight than others with bariatric surgery. Energy balance comprises energy intake and energy expenditure. Energy expenditure includes basal metabolic rate, thermic effect of food, and activity thermogenesis. Activity thermogenesis can be further divided into exercise activity thermogenesis and non-exercise activity thermogenesis (NEAT). The latter is even more difficult to measure than the former. Most Americans, and the vast majority of those with World Health Organization Class III obesity engage in relatively little purposeful exercise, and hence the majority of energy expended in physical activity is through NEAT. The aim of this study is to assess whether activity thermogenesis increases in patients undergoing bariatric surgery post-operatively compared to pre-operatively. We will assess non-exercise activity thermogenesis using a validated Physical Activity Monitoring System and doubly labeled water, immediately pre-operatively and again at 6 and 18 months post-operatively. PAMS has been validated in lean and obese individuals. This is to assess energy expenditure, activity thermogenesis and NEAT during the phase of greatest weight loss and once weight loss has plateaued. This will permit us to address our primary hypothesis that activity thermogenesis as a fraction of total daily energy expenditure increases in patients undergoing bariatric surgery 6 and 12 months post-operatively, compared to pre-operatively. Overall, obesity is a major personal health and health care burden. Bariatric surgery has been shown to be beneficial without a clear understanding of the mechanism. The scientific need exists and the technology is available to uncover the role of activity thermogenesis and energy expenditure in weight loss after bariatric surgery. This may have dramatic implications for bariatric surgery and obesity management in general.

描述（由申请人提供）：肥胖是一种流行病，对健康和社会具有广泛影响。减肥手术是实现和维持体重减轻以及改善肥胖合并症的成功疗法。这项研究将探讨接受胃绕道减肥手术的受试者减肥的能量机制，该机制迄今为止尚未明确定义。在任何能量储存发生重大变化的情况下，有必要检查食物摄入和能量消耗变化的作用。减肥手术后，能量摄入明显下降。然而，关于能量消耗的组成部分，特别是活动生热作用如何变化的信息很少。这不是一个小问题。事实上，体力活动和活动产热的变化对于理解为什么有些人通过减肥手术比其他人减重更多至关重要。能量平衡包括能量摄入和能量消耗。能量消耗包括基础代谢率、食物的热效应和活动产热。活动产热可进一步分为运动活动产热和非运动活动产热（NEAT）。后者比前者更难衡量。大多数美国人，以及绝大多数患有世界卫生组织 III 级肥胖症的人，进行的有目的的锻炼相对较少，因此体力活动中消耗的大部分能量都是通过 NEAT 消耗的。本研究的目的是评估接受减肥手术的患者术后与术前相比活动产热是否增加。我们将在术前立即使用经过验证的身体活动监测系统和双标记水评估非运动活动生热作用，并在术后 6 个月和 18 个月再次评估非运动活动生热作用。 PAMS 已在瘦人和肥胖个体中得到验证。这是为了评估体重减轻最大阶段以及体重减轻达到稳定状态时的能量消耗、活动产热和 NEAT。这将使我们能够解决我们的主要假设，即与术前相比，接受减肥手术的患者在术后 6 个月和 12 个月时，活动产热占每日总能量消耗的比例有所增加。总体而言，肥胖是个人健康和医疗保健的主要负担。在不清楚其机制的情况下，减肥手术已被证明是有益的。存在科学需求并且有技术可以揭示活动产热和能量消耗在减肥手术后减肥中的作用。这可能对减肥手术和一般肥胖管理产生巨大影响。