TY - JOUR T1 - Bariatrik cerrahi sonrası akut dönem vücut kompozisyon değişimlerinin cinsiyet ve anatomik bölgeye göre değerlendirilmesi TT - Evaluation of body composition changes after bariatric surgery according to gender and anatomical region AU - Aykota, Muhammed Raşid AU - Atabey, Mustafa AU - Yılmaz, Sevda PY - 2020 DA - September Y2 - 2020 DO - 10.31362/patd.742674 JF - Pamukkale Medical Journal JO - Pam Med J PB - Pamukkale Üniversitesi WT - DergiPark SN - 1308-0865 SP - 665 EP - 675 VL - 13 IS - 3 LA - tr AB - Amaç: Bariatrik cerrahi (BC) akut kilokaybına neden olur, ancak vücut kompozisyonundaki postoperatif erken dönemdeğişiklikler üzerindeki etkisi hakkında yeterli bilgi yoktur. Bu çalışmada,Mini gastrik bypas (MGB) ve Sleeve gastrektomi (SG) sonrası ilk aydaki vücutkompozisyon değişiklikleri cinsiyet ve anatomik bölgeye göre incelenmiştir.Gereç ve yöntem: MGB ve SG öncesi ve postoperatif 1 aysonra 100 morbid obez hastada (70 kadın, 30 erkek) vücut kompozisyonu (üstekstremite, alt ekstremite, gövde kas ve yağ oranları) ayrıca tüm vücut yağdoku ve yağsız doku kütlesi Biyoelektrik Empedans Analizi (BIA) teknolojisikullanılarak ölçüldü.Bulgular: MGB sonrası kadın ve erkeklerde hem tüm vücutyağ kütlesinde (p=0,071) hem de yağsız doku kütlesinde (p=0,781)azalma gerçekleşmiştir. Ayrıca MGB sonrası tüm gruplarda kas kütle kaybıistatistiksel olarak anlamlı değildir. Ancak SG sonrası kadınlarda anlamlı yağdoku kaybı oluşurken (p=0,014) erkeklerde yağsız doku kütlesinde (p=0,029)ve üst ekstremite kas kütlesinde (p=0,001)anlamlı azalma tespit edilmiştir.Sonuç: Çalışmamız bariatrik cerrahinin akut kilo kaybına nedenolduğunu ve hem tüm vücut yağ kütlesi hem de yağsız doku kütlesininetkilendiğini ve bazı anatomik bölgelerde kas kaybının yağ kaybından dahayüksek olduğunu açıkça göstermektedir. Bariatrik cerrahi sonrası akut dönemdevücut kompozisyonundaki değişimlerin cinsiyet ve yapılan cerrahi prosedüre görefarklılıklar içerebileceği bulunmuştur. Kas kütle kaybının uzun vadede zararlısonuçları olabileceğinden, bariatrik cerrahi sonrası beslenme stratejilerininmümkün olan en kısa sürede belirlenmesi gerekmektedir. KW - Mini Gastrik Bypas KW - sleeve gastrektomi KW - vücut kompozisyonu KW - yağ doku kütlesi KW - yağsız doku kütlesi N2 - Purpose: Bariatric surgery induces acuteweight loss, but there is insufficient information about its effect onpostoperative early changes in body composition (BC). In this study, BC changesin the first month after Mini gastric bypass (MGB) and Sleeve gastrectomy (SG)were examined according to gender and anatomical region.Materials and methods: Body compositionchanges in 100 morbidly obese patients (70 women, 30 men) after MGB and SG weremeasured using Bioelectrical Impedance Analysis (BIA) technology.Results: After MGB, both men and women had areduction in both their body fat (p=0.071) and lean tissue mass (p=0.781).In addition, muscle mass loss was not statistically significant in all groupsafter MGB. However, after SG, significant fat tissue loss occurred in women (p=0.014),whereas in men, there was a significant decrease in lean tissue mass (p=0.029)and upper limb muscle mass (p=0.001).Conclusion: Our study clearly shows thatbariatric surgery induces acute weight loss and that both whole-body fat andlean tissue mass are affected, and muscle loss in some anatomical regions ishigher than fat loss. It has been found that changes in body composition in theearly period after bariatric surgery may include differences according togender and surgical procedure. Since muscle mass loss can have harmfulconsequences in the long term, nutritional strategies should be determined assoon as possible after bariatric surgery. CR - 1. Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: A systematic analysis for the Global Burden of Disease Study 2013. The Lancet. 2014;384(9945):766-781. doi:10.1016/S0140-6736(14)60460-8. CR - 2. Hales CM. Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017–2018. 2020;(360):8. CR - 3. Lancaster RT, Hutter MM. Bands and bypasses: 30-day morbidity and mortality of bariatric surgical procedures as assessed by prospective, multi-center, risk-adjusted ACS-NSQIP data. Surg Endosc. 2008;22(12):2554-2563. doi:10.1007/s00464-008-0074-y. CR - 4. Kehagias I, Karamanakos SN, Argentou M, Kalfarentzos F. Randomized clinical trial of laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for the management of patients with BMI  < 50 kg/m2. Obes Surg. 2011;21(11):1650-1656. doi:10.1007/s11695-011-0479-x. CR - 5. Sjöström L, Narbro K, Sjöström CD, et al. Effects of Bariatric Surgery on Mortality in Swedish Obese Subjects. New England Journal of Medicine. 2007;357(8):741-752. doi:10.1056/NEJMoa066254. CR - 6. Buchwald H, Ikramuddin S, Dorman RB, Schone JL, Dixon JB. Management of the metabolic/bariatric surgery patient. Am J Med. 2011;124(12):1099-1105. doi:10.1016/j.amjmed.2011.05.035. CR - 7. Nocca D, Krawczykowsky D, Bomans B, et al. A Prospective Multicenter Study of 163 Sleeve Gastrectomies: Results at 1 and 2 Years. OBES SURG. 2008;18(5):560-565. doi:10.1007/s11695-007-9288-7. CR - 8. Overs SE, Freeman RA, Zarshenas N, Walton KL, Jorgensen JO. Food tolerance and gastrointestinal quality of life following three bariatric procedures: adjustable gastric banding, Roux-en-Y gastric bypass, and sleeve gastrectomy. Obes Surg. 2012;22(4):536-543. doi:10.1007/s11695-011-0573-0. CR - 9. Dogan K, Gadiot RPM, Aarts EO, et al. Effectiveness and Safety of Sleeve Gastrectomy, Gastric Bypass, and Adjustable Gastric Banding in Morbidly Obese Patients: a Multicenter, Retrospective, Matched Cohort Study. Obes Surg. 2015;25(7):1110-1118. doi:10.1007/s11695-014-1503-8. CR - 10. Georgiadou D, Sergentanis TN, Nixon A, Diamantis T, Tsigris C, Psaltopoulou T. Efficacy and safety of laparoscopic mini gastric bypass. A systematic review. Surg Obes Relat Dis. 2014;10(5):984-991. doi:10.1016/j.soard.2014.02.009. CR - 11. Noria SF, Grantcharov T. Biological effects of bariatric surgery on obesity-related comorbidities. Can J Surg. 2013;56(1):47-57. doi:10.1503/cjs.036111. CR - 12. Mahawar KK, Carr WRJ, Balupuri S, Small PK. Controversy surrounding “mini” gastric bypass. Obes Surg. 2014;24(2):324-333. doi:10.1007/s11695-013-1090-0. CR - 13. Mahawar KK, Jennings N, Brown J, Gupta A, Balupuri S, Small PK. “Mini” gastric bypass: systematic review of a controversial procedure. Obes Surg. 2013;23(11):1890-1898. doi:10.1007/s11695-013-1026-8. CR - 14. Freedman DS, Khan LK, Serdula MK, Galuska DA, Dietz WH. Trends and correlates of class 3 obesity in the United States from 1990 through 2000. JAMA. 2002;288(14):1758-1761. doi:10.1001/jama.288.14.1758. CR - 15. Suter M, Giusti V. [Surgical options for obesity: results and complications]. Rev Med Suisse. 2005;1(12):832-836. CR - 16. Schiavo L, Scalera G, Pilone V, et al. A Comparative Study Examining the Impact of a Protein-Enriched Vs Normal Protein Postoperative Diet on Body Composition and Resting Metabolic Rate in Obese Patients after Sleeve Gastrectomy. Obes Surg. 2017;27(4):881-888. doi:10.1007/s11695-016-2382-y. CR - 17. K A, D T, M N, L A, G Z, E L. The impact of laparoscopic sleeve gastrectomy on weight loss and obesity-associated comorbidities: the results of 3 years of follow-up. Surg Endosc. 2015;30(2):699-705. doi:10.1007/s00464-015-4262-2. CR - 18. Aquino L, Pereira S, Silva J, Sobrinho C, Ramalho A. Bariatric Surgery: Impact on Body Composition After Roux-en-Y Gastric Bypass. Obesity surgery. 2011;22:195-200. doi:10.1007/s11695-011-0500-4. CR - 19. Maïmoun L, Lefebvre P, Jaussent A, Fouillade C, Mariano-Goulart D, Nocca D. Body composition changes in the first month after sleeve gastrectomy based on gender and anatomic site. Surg Obes Relat Dis. 2017;13(5):780-787. doi:10.1016/j.soard.2017.01.017. CR - 20. Danaei G, Finucane MM, Lu Y, et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2·7 million participants. Lancet. 2011;378(9785):31-40. doi:10.1016/S0140-6736(11)60679-X. CR - 21. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity among adults: United States, 2011-2012. NCHS Data Brief. 2013;(131):1-8. CR - 22. Fontaine KR, Redden DT, Wang C, Westfall AO, Allison DB. Years of life lost due to obesity. JAMA. 2003;289(2):187-193. doi:10.1001/jama.289.2.187. CR - 23. Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K. The burden and costs of chronic diseases in low-income and middle-income countries. Lancet. 2007;370(9603):1929-1938. doi:10.1016/S0140-6736(07)61696-1. CR - 24. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724-1737. doi:10.1001/jama.292.14.1724. CR - 25. Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes--3-year outcomes. N Engl J Med. 2014;370(21):2002-2013. doi:10.1056/NEJMoa1401329. CR - 26. Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142(7):547-559. doi:10.7326/0003-4819-142-7-200504050-00013. CR - 27. Lee W-J, Chong K, Ser K-H, et al. Gastric bypass vs sleeve gastrectomy for type 2 diabetes mellitus: a randomized controlled trial. Arch Surg. 2011;146(2):143-148. doi:10.1001/archsurg.2010.326. CR - 28. Li J, Lai D, Wu D. Laparoscopic Roux-en-Y Gastric Bypass Versus Laparoscopic Sleeve Gastrectomy to Treat Morbid Obesity-Related Comorbidities: a Systematic Review and Meta-analysis. Obes Surg. 2016;26(2):429-442. doi:10.1007/s11695-015-1996-9. CR - 29. Albeladi B, Bourbao-Tournois C, Huten N. Short- and midterm results between laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy for the treatment of morbid obesity. J Obes. 2013;2013:934653. doi:10.1155/2013/934653. CR - 30. Rubino F, Forgione A, Cummings DE, et al. The mechanism of diabetes control after gastrointestinal bypass surgery reveals a role of the proximal small intestine in the pathophysiology of type 2 diabetes. Ann Surg. 2006;244(5):741-749. doi:10.1097/01.sla.0000224726.61448.1b. CR - 31. Musella M, Milone M. Still “controversies” about the mini gastric bypass? Obes Surg. 2014;24(4):643-644. doi:10.1007/s11695-014-1193-2. CR - 32. Mostafa EA, Wahab EMA, Sayed YGA, Gafar MH. Laparoscopic sleeve gastrectomy versus laparoscopic mini‑gastric bypass in management of morbid obesity and its comorbidities. :6. CR - 33. Després J-P, Lemieux I. Abdominal obesity and metabolic syndrome. Nature. 2006;444(7121):881-887. doi:10.1038/nature05488. CR - 34. Friedrich AE, Damms-Machado A, Meile T, et al. Laparoscopic sleeve gastrectomy compared to a multidisciplinary weight loss program for obesity--effects on body composition and protein status. Obes Surg. 2013;23(12):1957-1965. doi:10.1007/s11695-013-1036-6. CR - 35. Belfiore A, Cataldi M, Minichini L, et al. Short-Term Changes in Body Composition and Response to Micronutrient Supplementation After Laparoscopic Sleeve Gastrectomy. Obes Surg. 2015;25(12):2344-2351. doi:10.1007/s11695-015-1700-0. CR - 36. Moizé V, Andreu A, Rodríguez L, et al. Protein intake and lean tissue mass retention following bariatric surgery. Clin Nutr. 2013;32(4):550-555. doi:10.1016/j.clnu.2012.11.007. CR - 37. Schollenberger AE, Karschin J, Meile T, Küper MA, Königsrainer A, Bischoff SC. Impact of protein supplementation after bariatric surgery: A randomized controlled double-blind pilot study. Nutrition. 2016;32(2):186-192. doi:10.1016/j.nut.2015.08.005. UR - https://doi.org/10.31362/patd.742674 L1 - https://dergipark.org.tr/tr/download/article-file/1119572 ER -