Skip to main content
Erschienen in: Obesity Surgery 4/2012

01.04.2012 | Clinical Research

Lean and Fat Mass Loss in Obese Patients Before and After Roux-en-Y Gastric Bypass: A New Application for Ultrasound Technique

verfasst von: A. Z. Pereira, J. S. Marchini, G. Carneiro, C. H. Arasaki, M. T. Zanella

Erschienen in: Obesity Surgery | Ausgabe 4/2012

Einloggen, um Zugang zu erhalten

Abstract

Objective

This study aims to evaluate the thickness of the femoral quadriceps and biceps brachii and brachialis muscles bilaterally and the adjacent subcutaneous fat in patients undergoing gastric bypass Roux-en-Y before and after surgery, using ultrasound as the diagnostic method of choice.

Methods

We studied 12 patients undergoing this surgical method preoperatively and during the first, third, and sixth postoperative months. During these periods, patients were evaluated by ultrasound to determine the thickness of subcutaneous adipose tissue and muscle of the upper and lower limbs.

Results

Postoperatively, these patients showed a reduction in the thickness of the upper and lower extremities muscle and adipose tissue as compared to their preoperative values. There was a significant difference in the loss of muscle thickness in all postoperative months and in the thickness of fatty tissue in the sixth month after surgery, compared to the preoperative muscle and fatty tissue thickness.

Conclusions

Ultrasound can be considered as the diagnostic method of choice when assessment of the fat and lean body mass is required in morbidly obese patients before and after bariatric surgery.
Literatur
1.
Zurück zum Zitat Buckley O, Ward E, Ryan A, et al. European obesity and the radiology department. What can we do to help? Eur Radiol. 2009;19:298–309.PubMedCrossRef Buckley O, Ward E, Ryan A, et al. European obesity and the radiology department. What can we do to help? Eur Radiol. 2009;19:298–309.PubMedCrossRef
2.
Zurück zum Zitat Sabir N, Pakdemirli E, Kazil S, et al. Sonographic assessment of changes in thickness of different abdominal fat layers in response to diet in obese women. J Clin Ultrasound. 2002;42(1):26–30. Sabir N, Pakdemirli E, Kazil S, et al. Sonographic assessment of changes in thickness of different abdominal fat layers in response to diet in obese women. J Clin Ultrasound. 2002;42(1):26–30.
3.
Zurück zum Zitat Pontiroli AE, Pizzocri P, Ferla G, et al. Ultrasound measurement of visceral and subcutaneous fat in morbidly obese patients before and after laparoscopic adjustable gastric banding: comparison with computerized tomography and with anthropometric measurements. Obes Surg. 2002;12:648–51.PubMedCrossRef Pontiroli AE, Pizzocri P, Ferla G, et al. Ultrasound measurement of visceral and subcutaneous fat in morbidly obese patients before and after laparoscopic adjustable gastric banding: comparison with computerized tomography and with anthropometric measurements. Obes Surg. 2002;12:648–51.PubMedCrossRef
4.
Zurück zum Zitat Stefan N, Kantartzis K, Thamer C, et al. Identification and characterization of metabolically benign obesity in humans. Arch Intern Med. 2008;168(15):1609–16.PubMedCrossRef Stefan N, Kantartzis K, Thamer C, et al. Identification and characterization of metabolically benign obesity in humans. Arch Intern Med. 2008;168(15):1609–16.PubMedCrossRef
5.
Zurück zum Zitat Serap S, Erçin O, Nuran S, et al. Body fat distribution in childhood obesity: association with metabolic risk factors. Indian Ped 2008; 457(45). Serap S, Erçin O, Nuran S, et al. Body fat distribution in childhood obesity: association with metabolic risk factors. Indian Ped 2008; 457(45).
6.
Zurück zum Zitat Ribeiro-Filho FF, Faria NA, Ferreira SRG, et al. Ultrasonography for the evaluation of visceral fat and cardiovascular risk. Hypertension. 2001;38(2):713–7.PubMed Ribeiro-Filho FF, Faria NA, Ferreira SRG, et al. Ultrasonography for the evaluation of visceral fat and cardiovascular risk. Hypertension. 2001;38(2):713–7.PubMed
7.
Zurück zum Zitat Donadelli S, Salgado Jr W, Nonino CB, et al. Change in predicted 10-year cardiovascular risk following Roux-en-Y gastric bypass surgery: who benefits? Obes Surg. 2011;21:569–73.PubMedCrossRef Donadelli S, Salgado Jr W, Nonino CB, et al. Change in predicted 10-year cardiovascular risk following Roux-en-Y gastric bypass surgery: who benefits? Obes Surg. 2011;21:569–73.PubMedCrossRef
8.
Zurück zum Zitat Carey DG, Pilego GJ, Raymond RL, et al. Body composition and metabolic changes following bariatric surgery: effects on fat mass, lean mass and basal metabolic rate. Obes Surg. 2006;16:469–77.PubMedCrossRef Carey DG, Pilego GJ, Raymond RL, et al. Body composition and metabolic changes following bariatric surgery: effects on fat mass, lean mass and basal metabolic rate. Obes Surg. 2006;16:469–77.PubMedCrossRef
9.
Zurück zum Zitat Zalesin KC, Franklin BA, Lillystone MA, et al. Differential loss of fat and lean mass in the morbidly obese after bariatric surgery. Metabol Synd Relat Dis. 2010;8(1):15–20.CrossRef Zalesin KC, Franklin BA, Lillystone MA, et al. Differential loss of fat and lean mass in the morbidly obese after bariatric surgery. Metabol Synd Relat Dis. 2010;8(1):15–20.CrossRef
10.
Zurück zum Zitat Pineau JC, Filliard JR, Bocquet M, et al. Ultrasound techniques applied to body fat measurement in male and female athletes. J Athl Train. 2009;44(2):142–7.PubMedCrossRef Pineau JC, Filliard JR, Bocquet M, et al. Ultrasound techniques applied to body fat measurement in male and female athletes. J Athl Train. 2009;44(2):142–7.PubMedCrossRef
11.
Zurück zum Zitat Plank LD. Dual-energy X-ray absorptiometry and body composition. Curr Opin Clin Nutr Metab Care. 2005;8:305–9.PubMedCrossRef Plank LD. Dual-energy X-ray absorptiometry and body composition. Curr Opin Clin Nutr Metab Care. 2005;8:305–9.PubMedCrossRef
12.
Zurück zum Zitat Pineau JC, Lalys L, Dabbas-Tyan M, et al. Ultrasound measurement of total body fat in obese adolescents. Ann Nutr Metab. 2010;56:36–44.PubMedCrossRef Pineau JC, Lalys L, Dabbas-Tyan M, et al. Ultrasound measurement of total body fat in obese adolescents. Ann Nutr Metab. 2010;56:36–44.PubMedCrossRef
13.
Zurück zum Zitat Genton L, Hans D, Kyle U G et al. Dual-energy X-ray absorptiometry and body composition: differences between devices and comparison with reference methods. Nutrition 2002; 18(1). Genton L, Hans D, Kyle U G et al. Dual-energy X-ray absorptiometry and body composition: differences between devices and comparison with reference methods. Nutrition 2002; 18(1).
14.
Zurück zum Zitat Gray DS, Bray GA, Kirk S, et al. Skinfold thickness measurements in obese subjects. Am J Clin Nutr. 1990;51:571–7.PubMed Gray DS, Bray GA, Kirk S, et al. Skinfold thickness measurements in obese subjects. Am J Clin Nutr. 1990;51:571–7.PubMed
15.
Zurück zum Zitat Selkow NM, Pietrosimone BG, Saliba SA. Subcutaneous thigh fat assessment: a comparison of skinfold calipers and ultrasound imaging. J Athl Train. 2011;46(1):50–4.PubMedCrossRef Selkow NM, Pietrosimone BG, Saliba SA. Subcutaneous thigh fat assessment: a comparison of skinfold calipers and ultrasound imaging. J Athl Train. 2011;46(1):50–4.PubMedCrossRef
16.
Zurück zum Zitat Kuczmarski RJ, Faneii MT, Koch GG. Ultrasonic assessment of body composition in obese adults: overcoming the limitations of the skinfold. Am J Clin Nutr. 1987;45:717–24.PubMed Kuczmarski RJ, Faneii MT, Koch GG. Ultrasonic assessment of body composition in obese adults: overcoming the limitations of the skinfold. Am J Clin Nutr. 1987;45:717–24.PubMed
17.
Zurück zum Zitat Pineau JC, Guihard-Costa AM, Bocquet M. Validation of ultrasound techniques applied to body fat measurement a comparison between ultrasound techniques, air displacement plethysmography and bioelectrical impedance vs. dual-energy X-ray absorptiometry. Ann Nutr Metab. 2007;51:421–7.PubMedCrossRef Pineau JC, Guihard-Costa AM, Bocquet M. Validation of ultrasound techniques applied to body fat measurement a comparison between ultrasound techniques, air displacement plethysmography and bioelectrical impedance vs. dual-energy X-ray absorptiometry. Ann Nutr Metab. 2007;51:421–7.PubMedCrossRef
18.
Zurück zum Zitat Port AM, Apovian C. Metabolic support of the obese intensive care unit patient: a current perspective. Curr Opin Clin Nutr Metab Care. 2010;13(2):184–91.PubMedCrossRef Port AM, Apovian C. Metabolic support of the obese intensive care unit patient: a current perspective. Curr Opin Clin Nutr Metab Care. 2010;13(2):184–91.PubMedCrossRef
19.
Zurück zum Zitat Dickerson RN. Hypocaloric feeding of obese patients in the intensive care unit. Curr Opin Clin Nutr Metab Care. 2005;8(2):189–96.PubMedCrossRef Dickerson RN. Hypocaloric feeding of obese patients in the intensive care unit. Curr Opin Clin Nutr Metab Care. 2005;8(2):189–96.PubMedCrossRef
20.
Zurück zum Zitat Thornell LE. Sarcopenic obesity: satellite cells in the aging muscle. Curr Opin Clin Nutr Metab Care. 2011;14:22–7.PubMedCrossRef Thornell LE. Sarcopenic obesity: satellite cells in the aging muscle. Curr Opin Clin Nutr Metab Care. 2011;14:22–7.PubMedCrossRef
21.
Zurück zum Zitat Trip J, Pillen S, Drost G, et al. Muscle ultrasound measurements and functional muscle parameters in non-dystrophic myotonias suggest structural muscle changes. Neuromuscul Disord. 2009;19:462–7.PubMedCrossRef Trip J, Pillen S, Drost G, et al. Muscle ultrasound measurements and functional muscle parameters in non-dystrophic myotonias suggest structural muscle changes. Neuromuscul Disord. 2009;19:462–7.PubMedCrossRef
22.
Zurück zum Zitat Maurits N, Alexander E, Beenaker C, et al. Muscle ultrasound in children: normal values and application to neuromuscular disorders. Ultrasound Med Biol. 2004;30(8):1017–27.PubMedCrossRef Maurits N, Alexander E, Beenaker C, et al. Muscle ultrasound in children: normal values and application to neuromuscular disorders. Ultrasound Med Biol. 2004;30(8):1017–27.PubMedCrossRef
23.
Zurück zum Zitat American Diabetes Association (ADA). Diagnosis and classification of diabetes mellitus. Diabetes Care. 2011;34:S62–9.CrossRef American Diabetes Association (ADA). Diagnosis and classification of diabetes mellitus. Diabetes Care. 2011;34:S62–9.CrossRef
24.
Zurück zum Zitat Mechanick JI, Kushner RF, Spitz AF, et al. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Medical Guidelines for Clinical Practice for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery. Obesity. 2009;17(1):S1–S70.PubMedCrossRef Mechanick JI, Kushner RF, Spitz AF, et al. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Medical Guidelines for Clinical Practice for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery. Obesity. 2009;17(1):S1–S70.PubMedCrossRef
25.
Zurück zum Zitat Wadstrom C, Backman L, Forsberg AM, et al. Body composition and muscle constituents during weight loss: studies in obese patients following gastroplasty. Obes Surg. 2000;10:203–13.PubMedCrossRef Wadstrom C, Backman L, Forsberg AM, et al. Body composition and muscle constituents during weight loss: studies in obese patients following gastroplasty. Obes Surg. 2000;10:203–13.PubMedCrossRef
26.
Zurück zum Zitat Rubenoff R, Castaneda C. Sarcopenia—understanding the dynamics of aging muscle. JAMA. 2011;286(10):1230–1.CrossRef Rubenoff R, Castaneda C. Sarcopenia—understanding the dynamics of aging muscle. JAMA. 2011;286(10):1230–1.CrossRef
27.
Zurück zum Zitat Savastano S, Di Somma C, Colao A, et al. Growth hormone treatment prevents loss of lean mass after bariatric surgery in morbidly obese patients: results of a pilot, open, prospective, randomized, controlled study. J Clin Endocrinol Metab. 2009;94(3):817–26.PubMedCrossRef Savastano S, Di Somma C, Colao A, et al. Growth hormone treatment prevents loss of lean mass after bariatric surgery in morbidly obese patients: results of a pilot, open, prospective, randomized, controlled study. J Clin Endocrinol Metab. 2009;94(3):817–26.PubMedCrossRef
28.
Zurück zum Zitat Stevens-Simon C, Thureen P, Stamm E, et al. Skinfold caliper and ultrasound assessments of change in the distribution of subcutaneous fat during adolescent pregnancy. Int J Obes. 2001;25:1340–5.CrossRef Stevens-Simon C, Thureen P, Stamm E, et al. Skinfold caliper and ultrasound assessments of change in the distribution of subcutaneous fat during adolescent pregnancy. Int J Obes. 2001;25:1340–5.CrossRef
29.
Zurück zum Zitat Radominski R, Verozzo DP, Halpern A, et al. O Uso da ultra-sonografia na avaliação da distribuição de gordura abdominal. Arq Bras Endocrinol Metab. 2000;44(1):5–12.CrossRef Radominski R, Verozzo DP, Halpern A, et al. O Uso da ultra-sonografia na avaliação da distribuição de gordura abdominal. Arq Bras Endocrinol Metab. 2000;44(1):5–12.CrossRef
Metadaten
Titel
Lean and Fat Mass Loss in Obese Patients Before and After Roux-en-Y Gastric Bypass: A New Application for Ultrasound Technique
verfasst von
A. Z. Pereira
J. S. Marchini
G. Carneiro
C. H. Arasaki
M. T. Zanella
Publikationsdatum
01.04.2012
Verlag
Springer-Verlag
Erschienen in
Obesity Surgery / Ausgabe 4/2012
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-011-0538-3

Weitere Artikel der Ausgabe 4/2012

Obesity Surgery 4/2012 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.