营养治疗对减重术后身体成分及静息能量消耗的影响
Effect of nutritional therapy on body composition and resting energy expenditure post bariatric surgery
Received date: 2021-11-26
Online published: 2022-08-03
目的：探讨营养治疗对减重手术前后肥胖病人身体成分及静息能量消耗（resting energy expenditure, REE）的影响。方法：腹腔镜袖状胃切除减重手术的47例病人行术后3个月六阶段的营养治疗,分别于术前、术后1个月、术后3个月测量身体成分指标、REE及营养相关生化指标水平。应用Bernestin Formula公式计算预测REE。病人各指标的变化行重复测量方差分析。结果：术后1个月、3个月的肌肉量分别下降8.33%±3.49%、2.86%±3.96%。术后1个月、3个月体脂肪量分别下降14.73%±5.44%、16.61%±8.26%。病人术前及术后3个月REE与预测REE值的差异均无统计学意义：术前（9 339.16±2 620.59） kJ比（9 058.06±2 098.61） kJ,P=0.593;术后3个月（7 228.20±2 066.61） kJ 比（7 973.15±1 747.49） kJ,P=0.098。术后1个月,预测REE值明显高于REE值,（8 286.81±1 764.25） kJ 比（7 418.33±1 764.25） kJ,P=0.032。术前、术后1个月和术后3个月血清维生素（A、B1、B2、B6和C）以及血清铁蛋白水平的差异均无统计学意义（P>0.05）;而C反应蛋白水平显著下降。术前为（9.03±9.42） mg/L,术后1个月（6.61±7.89） mg/L与术后3个月（4.69±4.66） mg/L,P=0.020。结论：减重术后3个月内营养治疗措施可延缓骨骼肌量的减少和REE的适应,一定程度降低病人炎症水平。
宣呈杰, 卞冬生, 蒋咏梅, 陈宇菲, 金佳斌, 施咏梅 . 营养治疗对减重术后身体成分及静息能量消耗的影响[J]. 外科理论与实践, 2022 , 27(03) : 244 -248 . DOI: 10.16139/j.1007-9610.2022.03.012
Objectives To investigate the effect of nutritional therapy on body composition and resting energy expenditure(REE) post bariatric surgery in patients with obesity. Methods Six-step post-operative nutrition therapy during 3 months was performed for 47 patients undergoing bariatric surgery with laparoscopic sleeve gastrectomy. Body composition, REE and nutritonal biochemical indexes were determined in pre-surgery and post-surgery 1, 3 months. Predictive REE was calculated with Bernestin Formula. Repeated ANOVA analysis was done for the changes in the indicators of patients. Results Muscle mass reduced 8.33%±3.49% in post-surgery 1 month, and 2.86%±3.96% in post-surgery 3 months. Fat mass reduced 14.73%±5.44% in post-surgery 1 month and 16.61%±8.26% in post-surgery 3 months. There was no significant difference between REE and predicted REE with (9 339.16±2 620.59) kJ vs. (9 058.06±2 098.61) kJ in pre-surgery, P=0.593; and (7 228.20±2 066.61) kJ vs. (7 973.15±1 747.49) kJ in post-surgery 3 months, P=0.098. However, predicted REE (8 286.81±1 764.25) kJ was significant higher than REE (7 418.33±1 764.25) kJ in post-surgery 1 month, P=0.032. There was no significant difference in levels of vitamin-A, vitamin-B1, vitamin-B2, vitamin-B6, vitamin-C and serum ferritin between pre-surgery and post-surgery 1 month and post-surgery 3 months(P>0.05). A significant reduction of C-reactive protein was present with (9.03±9.42) mg/L in pre-surgery, (6.61±7.89) mg/L in post-surgery 1 month and (4.69±4.66) mg/L in post-surgery 3 months, P=0.020. Conclusions Nutritional therapy after bariatric surgery 3 months could delay the loss of skeletal muscle mass and adapt REE and reduce the inflammation level in patients with obesity.
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