Kun Li1, Lei Zheng1, Jing Guo2, Wentao Shi3, Feng Zhao1, Chengcan Yang1, Qiancheng Dai1, Bing Wang4, Yousheng Li5. 1. Department of General Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, No. 639 Zhizaoju Road, HuangPu District, Shanghai, 200011, China. 2. Discipline Planning Department, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, No. 639 Zhizaoju Road, HuangPu District, Shanghai, 200011, China. 3. Clinical Research Center, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, No. 639 Zhizaoju Road, HuangPu District, Shanghai, 200011, China. 4. Department of General Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, No. 639 Zhizaoju Road, HuangPu District, Shanghai, 200011, China. wingbing_01@163.com. 5. Department of General Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, No. 639 Zhizaoju Road, HuangPu District, Shanghai, 200011, China. guttx@hotmail.com.
Abstract
BACKGROUND: Although bariatric surgery can achieve sustained weight loss, there are major differences in the magnitude of weight change post-operatively. Reduced resting energy expenditure (REE) plays an important role in unsatisfactory weight loss effect by contributing to positive energy balance. OBJECTIVES: To identify pre- and post-surgical predictors related to satisfactory percent of total weight loss (%TWL) in Chinese individuals with obesity after laparoscopic sleeve gastrectomy (LSG). METHODS: A retrospective cohort study was conducted in 97 ethnic Chinese with mean body mass index (BMI) of 37.2 kg/m2, focusing on body composition, anthropometric and metabolic energy expenditure parameters, and %TWL before and 6 months after LSG. Patients were divided post-operatively into those with or without satisfactory %TWL (%TWL ≥ 20%). Multiple stepwise logistic regression analysis was used to identify predictors. RESULTS: Satisfactory %TWL was achieved in 53 (54.6%) patients 6 months after surgery. The univariate analysis of post-operative variables showed that patients with satisfactory %TWL had significantly higher resting energy expenditure/body weight (REE/BW) and lower respiratory quotient (RQ) than those who did not (P < 0.001). Multiple stepwise logistic regression analysis indicated that REE/BW and RQ were closely associated with satisfactory %TWL (P = 0.004, P = 0.023, respectively). %TWL was positively correlated with changes in BMI, percent of fat-free mass (FFM%), REE/BW, and RQ. CONCLUSIONS: Higher REE/BW and lower RQ resulting from LSG correlated with satisfactory %TWL in Chinese patients with obesity. The maintenance of FFM might be an important factor linking %TWL and REE/BW.
BACKGROUND: Although bariatric surgery can achieve sustained weight loss, there are major differences in the magnitude of weight change post-operatively. Reduced resting energy expenditure (REE) plays an important role in unsatisfactory weight loss effect by contributing to positive energy balance. OBJECTIVES: To identify pre- and post-surgical predictors related to satisfactory percent of total weight loss (%TWL) in Chinese individuals with obesity after laparoscopic sleeve gastrectomy (LSG). METHODS: A retrospective cohort study was conducted in 97 ethnic Chinese with mean body mass index (BMI) of 37.2 kg/m2, focusing on body composition, anthropometric and metabolic energy expenditure parameters, and %TWL before and 6 months after LSG. Patients were divided post-operatively into those with or without satisfactory %TWL (%TWL ≥ 20%). Multiple stepwise logistic regression analysis was used to identify predictors. RESULTS: Satisfactory %TWL was achieved in 53 (54.6%) patients 6 months after surgery. The univariate analysis of post-operative variables showed that patients with satisfactory %TWL had significantly higher resting energy expenditure/body weight (REE/BW) and lower respiratory quotient (RQ) than those who did not (P < 0.001). Multiple stepwise logistic regression analysis indicated that REE/BW and RQ were closely associated with satisfactory %TWL (P = 0.004, P = 0.023, respectively). %TWL was positively correlated with changes in BMI, percent of fat-free mass (FFM%), REE/BW, and RQ. CONCLUSIONS: Higher REE/BW and lower RQ resulting from LSG correlated with satisfactory %TWL in Chinese patients with obesity. The maintenance of FFM might be an important factor linking %TWL and REE/BW.
Entities:
Keywords:
Fat-free mass; Percent of total weight loss; Respiratory quotient; Resting energy expenditure; Sleeve gastrectomy
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