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，对健康和社会有着广泛的影响。减肥手术是实现和维持体重减轻和改善肥胖合并症的成功疗法。本研究将探讨胃旁路减肥手术患者体重减轻的能量机制，迄今为止尚未明确定义。在能量储存发生重大变化的任何情况下，都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，特别是活动产热是如何变化的信息很少。这不是一个微不足道的问题。事实上，身体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掉更多的体重至关重要。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）。后者甚至比前者更难衡量。大多数美国人，以及世界卫生组织（World Health Organization）第三类肥胖的绝大多数人，从事的有目的的运动相对较少，因此，体力活动消耗的大部分能量是通过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是否活动产热增加。我们将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性活动产热，立即术前，并在术后6个月和18个月再次进行。PAMS已在瘦弱和肥胖个体中得到验证。这是为了评估能量消耗，活动产热和NEAT在最大的减肥阶段和一旦减肥达到稳定。这将使我们能够解决我们的主要假设，即与术前相比，在术后6个月和12个月接受减肥手术的患者，活动产热率作为每日总能量消耗的一部分增加。总的来说，肥胖是个人健康和保健的主要负担。减肥手术已被证明是有益的，但没有明确的了解其机制。科学的需求是存在的，技术是可用的，以揭示活动产热和能量消耗在减肥手术后体重减轻中的作用。这可能会对减肥手术和肥胖管理产生重大影响。