Artículos de revistas
Changes in Resting Energy Expenditure and Body Composition after Weight Loss following Roux-en-Y Gastric Bypass
Fecha
2007Registro en:
Obesity Surgery, 17, 2007: 608-616
Autor
Carrasco, Fernando
Papapietro Vallejo, Karin
Csendes Juhasz, Attila
Salazar Rodríguez, Gabriela
Echeñique Rivera, Constanza
Lisboa, Cecilia
Díaz, Emma
Rojas Caro, Jorge
Institución
Resumen
Background: The objective of this study was to evaluate
changes in resting energy expenditure (REE), body
composition and metabolic parameters, and to investigate
predictors of the results in seriously obese
patients after Roux-en-Y gastric bypass (RYGBP).
Methods: 31 patients (BMI 44.4 ± 4.8 kg/m2; 27
female, 4 male; 37.3 ± 11.1 y) were evaluated at baseline
and 6 months after RYGBP. Weight, REE, waist
circumference (WC), fat mass (FM) and fat-free mass
(FFM), physical activity, food intake, fasting glucose
(GLU), insulin (INS), HOMA-IR and lipid concentrations
were measured.
Results: At 6 months, percentage of weight loss
(%WL) was 29.0 ± 4.4% and percentage of excess
weight loss was (%EWL) 59.7 ± 12.3%. FM loss corresponded
to 77.1 ± 12.2% of the weight loss. REE
decreased from 33.4 ± 4.1 to 30.1±2.6 kcal/kg FFM
(P<0.05). Significant decreases (P<0.001) were
observed in GLU, INS, HOMA-IR, LDL-cholesterol and
triglycerides. %EWL was correlated with baseline INS
(r=0.44; P=0.014), baseline HOMA (r=0.43; P=0.017),
change in %FM (r=0.67; P<0.001) and change in WC
(r=0.5; P<0.01). Decrease in REE/FFM (%) was positively
correlated with baseline REE/FFM% (r=0.51;
P<0.005) and change in %FM (r=0.69; P<0.001). Initial
REE/FFM, baseline energy balance and FM change
explain 90% of REE/FFM decrease.
Conclusion: RYGBP was an effective procedure to
induce significant weight loss, fat mass loss and
improvement in metabolic parameters in the short
term. Metabolic adaptation was not related to FFM
wasting but to a higher baseline REE. Fasting hyperinsulinemia
was the best single predictor of weight
loss after RYGBP.