Acute and longer-term body composition changes after bariatric surgery.


Journal

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
ISSN: 1878-7533
Titre abrégé: Surg Obes Relat Dis
Pays: United States
ID NLM: 101233161

Informations de publication

Date de publication:
11 2019
Historique:
received: 22 03 2019
revised: 05 07 2019
accepted: 09 07 2019
pubmed: 15 9 2019
medline: 26 8 2020
entrez: 15 9 2019
Statut: ppublish

Résumé

Bariatric surgery induces weight loss but its acute and longer-term effects on body composition (BC) are largely unknown. To determine the BC changes in obese French patients after sleeve gastrectomy (SG) at 1 and 12 months. Obesity Reference Center, University Hospital of Montpellier, France. Whole and localized BC (lean tissue mass [LTM] and fat mass [FM]) and abdominal adiposity, including total adipose tissue, visceral adipose tissue, and subcutaneous adipose tissue, were determined by dual-energy X-ray absorptiometry in 30 obese patients (25 women, 83.3%) just before SG and 1 and 12 months later. The mean weight loss was -9.7 ± 2.6 kg at 1 month and -32.1 ± 10.3 kg at 12 months. This weight loss was due to an equivalent decrease in LTM and FM in the acute phase, while FM loss appeared to be the main cause in the chronic phase. For each component (LTM and FM), the loss was relatively homogeneous across sites. Compared with the presurgical values, android and gynoid tissue and total adipose tissue, visceral adipose tissue, and subcutaneous adipose tissue changed significantly over the 12-month period. No basal clinical parameter was predictive of the variation in LTM, whereas age and the whole-body LTM/FM ratio were associated with the decrease in FM. This study demonstrates that SG induces a clear modification in BC, characterized by a decrease in LTM in the acute phase and sustained FM loss in the first year. These results suggest that the early phase should be targeted for strategies to reduce LTM loss, which is a longer-term weight-regain criterion. Further studies to investigate the potential advantages of visceral adipose tissue compared with whole-body FM for improving post-SG co-morbidities should be performed.

Sections du résumé

BACKGROUND
Bariatric surgery induces weight loss but its acute and longer-term effects on body composition (BC) are largely unknown.
OBJECTIVES
To determine the BC changes in obese French patients after sleeve gastrectomy (SG) at 1 and 12 months.
SETTING
Obesity Reference Center, University Hospital of Montpellier, France.
METHODS
Whole and localized BC (lean tissue mass [LTM] and fat mass [FM]) and abdominal adiposity, including total adipose tissue, visceral adipose tissue, and subcutaneous adipose tissue, were determined by dual-energy X-ray absorptiometry in 30 obese patients (25 women, 83.3%) just before SG and 1 and 12 months later.
RESULTS
The mean weight loss was -9.7 ± 2.6 kg at 1 month and -32.1 ± 10.3 kg at 12 months. This weight loss was due to an equivalent decrease in LTM and FM in the acute phase, while FM loss appeared to be the main cause in the chronic phase. For each component (LTM and FM), the loss was relatively homogeneous across sites. Compared with the presurgical values, android and gynoid tissue and total adipose tissue, visceral adipose tissue, and subcutaneous adipose tissue changed significantly over the 12-month period. No basal clinical parameter was predictive of the variation in LTM, whereas age and the whole-body LTM/FM ratio were associated with the decrease in FM.
CONCLUSION
This study demonstrates that SG induces a clear modification in BC, characterized by a decrease in LTM in the acute phase and sustained FM loss in the first year. These results suggest that the early phase should be targeted for strategies to reduce LTM loss, which is a longer-term weight-regain criterion. Further studies to investigate the potential advantages of visceral adipose tissue compared with whole-body FM for improving post-SG co-morbidities should be performed.

Identifiants

pubmed: 31519485
pii: S1550-7289(19)30329-6
doi: 10.1016/j.soard.2019.07.006
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1965-1973

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2019 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Auteurs

Laurent Maïmoun (L)

Service de Médecine Nucléaire, Hôpital Lapeyronie, CHU de Montpellier, Montpellier, France; PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France, Médicale, CHU de Montpellier, Montpellier, France. Electronic address: l-maimoun@chu-montpellier.fr.

Patrick Lefebvre (P)

Departement d'Endocrinologie, Diabetes, Nutrition, Hôpital Lapeyronie, CHU de Montpellier, Montpellier, France.

Safa Aouinti (S)

Unité de Recherche Clinique, Biostatistiques et Epidémiologie, Département de l'Information.

Marie-Christine Picot (MC)

Unité de Recherche Clinique, Biostatistiques et Epidémiologie, Département de l'Information.

Denis Mariano-Goulart (D)

Service de Médecine Nucléaire, Hôpital Lapeyronie, CHU de Montpellier, Montpellier, France; PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France, Médicale, CHU de Montpellier, Montpellier, France.

David Nocca (D)

Service de Chirurgie Digestive A, Hôpital Saint Eloi, CHU de Montpellier, Montpellier, France.

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