Prospective Longitudinal Trends in Body Composition and Clinical Outcomes 3 Years Following Sleeve Gastrectomy.


Journal

Obesity surgery
ISSN: 1708-0428
Titre abrégé: Obes Surg
Pays: United States
ID NLM: 9106714

Informations de publication

Date de publication:
12 2019
Historique:
pubmed: 14 7 2019
medline: 29 5 2020
entrez: 14 7 2019
Statut: ppublish

Résumé

Longitudinal assessment of body composition following bariatric surgery allows monitoring of health status. Our aim was to elucidate trends of anthropometric and clinical outcomes 3 years following sleeve gastrectomy (SG). A prospective cohort study of 60 patients who underwent SG. Anthropometrics including body composition analysis measured by multi-frequency bioelectrical impedance analysis, blood tests, liver fat content measured by abdominal ultrasound and habitual physical activity were evaluated at baseline and at 6 (M6), 12 (M12), and 36 (M36) months post-surgery. Sixty patients (55% women, age 44.7 ± 8.7 years) who completed the entire follow-up were included. Fat mass (FM) was reduced significantly 1 year post-surgery (55.8 ± 11.3 to 26.7 ± 8.3 kg; P < 0.001) and then increased between 1 and 3 years post-operatively, but remained below baseline level (26.7 ± 8.3 to 33.1 ± 11.1 kg; P < 0.001). Fat free mass (FFM) decreased significantly during the first 6 months (64.7 ± 14.3 to 56.9 ± 11.8 kg; P < 0.001), slightly decreased between M6 and M12 and then reached a plateau through M36. Weight loss "failure" (< 50% excess weight loss) was noticed in 5.0% and 28.3% of patients at M12 and M36, respectively. Markers of lipid and glucose metabolism changed thereafter in parallel to the changes observed in FM, with the exception of HDL-C, which increased continuingly from M6 throughout the whole period analyzed (45.0 ± 10.2 to 59.5 ± 15.4 mg/dl; P < 0.001) and HbA1c which continued to decrease between M12 and M36 (5.5 ± 0.4 to 5.3 ± 0.4%; P < 0.001). There were marked within-person variations in trends of anthropometric and clinical parameters during the 3-year follow-up. Weight regain primarily attributed to FM with no further decrease in FFM occurs between 1 and 3 years post-SG. FM increase at mid-term may underlie the recurrence of metabolic risk factors and can govern clinical interventions.

Sections du résumé

BACKGROUND AND AIMS
Longitudinal assessment of body composition following bariatric surgery allows monitoring of health status. Our aim was to elucidate trends of anthropometric and clinical outcomes 3 years following sleeve gastrectomy (SG).
METHODS
A prospective cohort study of 60 patients who underwent SG. Anthropometrics including body composition analysis measured by multi-frequency bioelectrical impedance analysis, blood tests, liver fat content measured by abdominal ultrasound and habitual physical activity were evaluated at baseline and at 6 (M6), 12 (M12), and 36 (M36) months post-surgery.
RESULTS
Sixty patients (55% women, age 44.7 ± 8.7 years) who completed the entire follow-up were included. Fat mass (FM) was reduced significantly 1 year post-surgery (55.8 ± 11.3 to 26.7 ± 8.3 kg; P < 0.001) and then increased between 1 and 3 years post-operatively, but remained below baseline level (26.7 ± 8.3 to 33.1 ± 11.1 kg; P < 0.001). Fat free mass (FFM) decreased significantly during the first 6 months (64.7 ± 14.3 to 56.9 ± 11.8 kg; P < 0.001), slightly decreased between M6 and M12 and then reached a plateau through M36. Weight loss "failure" (< 50% excess weight loss) was noticed in 5.0% and 28.3% of patients at M12 and M36, respectively. Markers of lipid and glucose metabolism changed thereafter in parallel to the changes observed in FM, with the exception of HDL-C, which increased continuingly from M6 throughout the whole period analyzed (45.0 ± 10.2 to 59.5 ± 15.4 mg/dl; P < 0.001) and HbA1c which continued to decrease between M12 and M36 (5.5 ± 0.4 to 5.3 ± 0.4%; P < 0.001). There were marked within-person variations in trends of anthropometric and clinical parameters during the 3-year follow-up.
CONCLUSIONS
Weight regain primarily attributed to FM with no further decrease in FFM occurs between 1 and 3 years post-SG. FM increase at mid-term may underlie the recurrence of metabolic risk factors and can govern clinical interventions.

Identifiants

pubmed: 31301031
doi: 10.1007/s11695-019-04057-2
pii: 10.1007/s11695-019-04057-2
doi:

Banques de données

ClinicalTrials.gov
['NCT01922830']

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

3833-3841

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Auteurs

Shiri Sherf-Dagan (S)

Department Gastroenterology, Tel-Aviv Medical Center, Tel Aviv, Israel. shirisherf@gmail.com.
Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel. shirisherf@gmail.com.
Department of Nutrition, Assuta Medical Center, 20 Habarzel St., 69710, Tel Aviv, Israel. shirisherf@gmail.com.

Shira Zelber-Sagi (S)

Department Gastroenterology, Tel-Aviv Medical Center, Tel Aviv, Israel.
School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.

Assaf Buch (A)

Institute of Endocrinology, Metabolism and Hypertension, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.
School of Nutritional Sciences, The Hebrew University of Jerusalem, Rehovot, Israel.

Nir Bar (N)

Department Gastroenterology, Tel-Aviv Medical Center, Tel Aviv, Israel.
Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.

Muriel Webb (M)

Department Gastroenterology, Tel-Aviv Medical Center, Tel Aviv, Israel.

Nasser Sakran (N)

Israeli Center for Bariatric Surgery (ICBS), Assia Medical Group, Assuta Medical Center, Tel Aviv, Israel.
Department of Surgery A, Emek Medical Center, Afula, Israel.
Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel.

Asnat Raziel (A)

Israeli Center for Bariatric Surgery (ICBS), Assia Medical Group, Assuta Medical Center, Tel Aviv, Israel.

David Goitein (D)

Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Israeli Center for Bariatric Surgery (ICBS), Assia Medical Group, Assuta Medical Center, Tel Aviv, Israel.
Department of Surgery C, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.

Andrei Keidar (A)

Department of General Surgery, Assuta Ashdod Public Hospital, The Ben-Gurion University, Be'er Sheva, Israel.

Oren Shibolet (O)

Department Gastroenterology, Tel-Aviv Medical Center, Tel Aviv, Israel.
Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.

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