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Erschienen in: Obesity Surgery 8/2018

12.03.2018 | Original Contributions

Modifications of Resting Energy Expenditure After Sleeve Gastrectomy

verfasst von: Silvia Bettini, Emanuel Bordigato, Roberto Fabris, Roberto Serra, Chiara Dal Pra’, Anna Belligoli, Marta Sanna, Chiara Compagnin, Mirto Foletto, Luca Prevedello, Paola Fioretto, Roberto Vettor, Luca Busetto

Erschienen in: Obesity Surgery | Ausgabe 8/2018

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Abstract

Objectives

Resting energy expenditure (REE) declines more than what is expected according to body composition changes after caloric restriction. This metabolic adaptation is considered one of the factors favoring weight regain. The aim of this study is to evaluate the changes of REE and calculate the degree of metabolic adaptation occurring after laparoscopic sleeve gastrectomy (LSG).

Methods

REE (by indirect calorimetry) and body composition (fat-free mass or FFM, fat mass or FM by bioelectrical impedance analysis) were determined before and after 12 months in 154 patients with obesity treated with laparoscopic sleeve gastrectomy (LSG).

Results

Weight loss was 29.8 ± 10.6%, with corresponding relative reductions in FM (44.5 ± 22.8%), FFM (13.7 ± 9.9%), and REE (27.3 ± 12.9%). A predictive equation for REE was computed by using the baseline FFM and FM values to account for body composition changes. A predicted post-weight loss REE was calculated by using this equation and entering post-weight loss body composition values. Observed post-surgery REE was significantly lower than predicted one (1410 ± 312 vs 1611 ± 340 kcal/day, P < 0.001) and metabolic adaptation, calculated as the difference between observed and predicted post-weight loss REE, was − 199 ± 238 kcal/day. The post-surgery level of metabolic adaptation was inversely related to postoperative percent weight loss (r = − 0.170; P < 0.05) and FM loss (r = − 0.245; P < 0.01).

Conclusions

A significant reduction of resting energy expenditure and a significant degree of metabolic adaptation both occur after sleeve gastrectomy. A greater metabolic adaptation could be partly responsible for a lower weight loss after surgery.
Literatur
1.
Zurück zum Zitat Ogden CL, Carroll MD, Fryar CD, et al. Prevalence of obesity among adults and youth: United States, 2011-2014. NCHS Data Brief. 2015;219:1–8. Ogden CL, Carroll MD, Fryar CD, et al. Prevalence of obesity among adults and youth: United States, 2011-2014. NCHS Data Brief. 2015;219:1–8.
2.
Zurück zum Zitat Finucane MM, Stevens GA, Cowan MJ, et al. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9·1 million participants. Lancet. 2011;377:557–67.CrossRefPubMedPubMedCentral Finucane MM, Stevens GA, Cowan MJ, et al. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9·1 million participants. Lancet. 2011;377:557–67.CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Lim SS, Vos T, Flaxman AD, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2224–60.CrossRefPubMedPubMedCentral Lim SS, Vos T, Flaxman AD, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2224–60.CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Colquitt JL, Pickett K, Loveman E, et al. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014;8:CD003641. Colquitt JL, Pickett K, Loveman E, et al. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014;8:CD003641.
5.
Zurück zum Zitat Bond DS, Phelan S, Leahey TM, et al. Weight-loss maintenance in successful weight losers: surgical vs non-surgical methods. Int J Obes. 2009;33:173–80.CrossRef Bond DS, Phelan S, Leahey TM, et al. Weight-loss maintenance in successful weight losers: surgical vs non-surgical methods. Int J Obes. 2009;33:173–80.CrossRef
6.
Zurück zum Zitat Greenway FL. Physiological adaptations to weight loss and factors favouring weight regain. Int J Obes. 2015;39(8):1188–96.CrossRef Greenway FL. Physiological adaptations to weight loss and factors favouring weight regain. Int J Obes. 2015;39(8):1188–96.CrossRef
7.
Zurück zum Zitat Müller MJ, Bosy-Westphal A. Adaptive thermogenesis with weight loss in humans. Obesity (Silver Spring) 2013; 21: 218–228. Müller MJ, Bosy-Westphal A. Adaptive thermogenesis with weight loss in humans. Obesity (Silver Spring) 2013; 21: 218–228.
8.
Zurück zum Zitat Leibel RL, Rosenbaum M, Hirsch J. Changes in energy expenditure resulting from altered body weight. N Engl J Med. 1995;332:621–8.CrossRefPubMed Leibel RL, Rosenbaum M, Hirsch J. Changes in energy expenditure resulting from altered body weight. N Engl J Med. 1995;332:621–8.CrossRefPubMed
9.
Zurück zum Zitat Müller MJ, Enderle J, Pourhassan M, et al. Metabolic adaptation to caloric restriction and subsequent refeeding: the Minnesota Starvation Experiment revisited. Am J Clin Nutr. 2015;102:807–19.CrossRefPubMed Müller MJ, Enderle J, Pourhassan M, et al. Metabolic adaptation to caloric restriction and subsequent refeeding: the Minnesota Starvation Experiment revisited. Am J Clin Nutr. 2015;102:807–19.CrossRefPubMed
10.
Zurück zum Zitat Karmali S, Brar B, Shi X, et al. Weight recidivism post-bariatric surgery: a systematic review. Obes Surg. 2013;23:1922–33.CrossRefPubMed Karmali S, Brar B, Shi X, et al. Weight recidivism post-bariatric surgery: a systematic review. Obes Surg. 2013;23:1922–33.CrossRefPubMed
11.
Zurück zum Zitat Sepúlveda M, Alamo M, Saba J, et al. Long-term weight loss in laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2017;13:1676–81.CrossRefPubMed Sepúlveda M, Alamo M, Saba J, et al. Long-term weight loss in laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2017;13:1676–81.CrossRefPubMed
12.
Zurück zum Zitat Sjöström L. Review of the key results from the Swedish Obese Subjects (SOS) trial—a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013;273:219–34.CrossRefPubMed Sjöström L. Review of the key results from the Swedish Obese Subjects (SOS) trial—a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013;273:219–34.CrossRefPubMed
13.
Zurück zum Zitat Stylopoulos N, Hoppin AG, Kaplan LM. Roux-en-Y gastric bypass enhances energy expenditure and extends lifespan in diet-induced obese rats. Obesity (Silver Spring). 2009;17:1839–47.CrossRef Stylopoulos N, Hoppin AG, Kaplan LM. Roux-en-Y gastric bypass enhances energy expenditure and extends lifespan in diet-induced obese rats. Obesity (Silver Spring). 2009;17:1839–47.CrossRef
14.
Zurück zum Zitat Hao Z, Mumphrey MB, Townsend RL, et al. Body composition, food intake, and energy expenditure in a murine model of Roux-en-Y gastric bypass surgery. Obes Surg. 2016;26:2173–82.CrossRefPubMedPubMedCentral Hao Z, Mumphrey MB, Townsend RL, et al. Body composition, food intake, and energy expenditure in a murine model of Roux-en-Y gastric bypass surgery. Obes Surg. 2016;26:2173–82.CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Hankir MK, Bronisch F, Hintschich C, et al. Differential effects of Roux-en-Y gastric bypass surgery on brown and beige adipose tissue thermogenesis. Metabolism. 2015;64:1240–9.CrossRefPubMed Hankir MK, Bronisch F, Hintschich C, et al. Differential effects of Roux-en-Y gastric bypass surgery on brown and beige adipose tissue thermogenesis. Metabolism. 2015;64:1240–9.CrossRefPubMed
16.
Zurück zum Zitat Faria SL, Faria OP, Buffington C, et al. Energy expenditure before and after Roux-en-Y gastric bypass. Obes Surg. 2012;22:1450–5.CrossRefPubMed Faria SL, Faria OP, Buffington C, et al. Energy expenditure before and after Roux-en-Y gastric bypass. Obes Surg. 2012;22:1450–5.CrossRefPubMed
17.
Zurück zum Zitat Rabl C, Rao MN, Schwarz JM, et al. Thermogenic changes after gastric bypass, adjustable gastric banding or diet alone. Surgery. 2014;156:806–12.CrossRefPubMedPubMedCentral Rabl C, Rao MN, Schwarz JM, et al. Thermogenic changes after gastric bypass, adjustable gastric banding or diet alone. Surgery. 2014;156:806–12.CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Werling M, Olbers T, Fändriks L, et al. Increased postprandial energy expenditure may explain superior long term weight loss after Roux-en-Y gastric bypass compared to vertical banded gastroplasty. PLoS One. 2013;8:e60280.CrossRefPubMedPubMedCentral Werling M, Olbers T, Fändriks L, et al. Increased postprandial energy expenditure may explain superior long term weight loss after Roux-en-Y gastric bypass compared to vertical banded gastroplasty. PLoS One. 2013;8:e60280.CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Knuth ND, Johannsen DL, Tamboli RA, et al. Metabolic adaptation following massive weight loss is related to the degree of energy imbalance and changes in circulating leptin. Obesity (Silver Spring). 2014;22:2563–9. Knuth ND, Johannsen DL, Tamboli RA, et al. Metabolic adaptation following massive weight loss is related to the degree of energy imbalance and changes in circulating leptin. Obesity (Silver Spring). 2014;22:2563–9.
20.
Zurück zum Zitat Butte NF, Brandt ML, Wong WW, et al. Energetic adaptations persist after bariatric surgery in severely obese adolescents. Obesity (Silver Spring) 2015; 23: 591–601. Butte NF, Brandt ML, Wong WW, et al. Energetic adaptations persist after bariatric surgery in severely obese adolescents. Obesity (Silver Spring) 2015; 23: 591–601.
21.
Zurück zum Zitat Tam CS, Rigas G, Heilbronn LK, et al. Energy adaptations persist 2 years after sleeve gastrectomy and gastric bypass. Obes Surg. 2016;26:459–63.CrossRefPubMed Tam CS, Rigas G, Heilbronn LK, et al. Energy adaptations persist 2 years after sleeve gastrectomy and gastric bypass. Obes Surg. 2016;26:459–63.CrossRefPubMed
23.
Zurück zum Zitat Bernante P, Foletto M, Busetto L, et al. Feasibility of laparoscopic sleeve gastrectomy as a revision procedure for prior laparoscopic gastric banding. Obes Surg. 2006;16:1327–30.CrossRefPubMed Bernante P, Foletto M, Busetto L, et al. Feasibility of laparoscopic sleeve gastrectomy as a revision procedure for prior laparoscopic gastric banding. Obes Surg. 2006;16:1327–30.CrossRefPubMed
24.
Zurück zum Zitat Sbraccia P, Nisoli E, Vettor R (eds). Clinical management of overweight and obesity. Recommendations of the Italian Society of Obesity (SIO). Springer International Publishing: Switzerland, 2016, pp 13–35. Sbraccia P, Nisoli E, Vettor R (eds). Clinical management of overweight and obesity. Recommendations of the Italian Society of Obesity (SIO). Springer International Publishing: Switzerland, 2016, pp 13–35.
25.
Zurück zum Zitat Ferrannini E. The theoretical bases of indirect calorimetry: a review. Metabolism. 1988;37:287–301.CrossRefPubMed Ferrannini E. The theoretical bases of indirect calorimetry: a review. Metabolism. 1988;37:287–301.CrossRefPubMed
26.
Zurück zum Zitat Branson RD, Johannigman JA. The measurement of energy expenditure. Nutr Clin Pract. 2004;19:622–36.CrossRefPubMed Branson RD, Johannigman JA. The measurement of energy expenditure. Nutr Clin Pract. 2004;19:622–36.CrossRefPubMed
28.
Zurück zum Zitat Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502.PubMed Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502.PubMed
29.
Zurück zum Zitat Matthews D, Hosker J, Rudenski A, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentration in man. Diabetologia. 1985;28:12–9.CrossRef Matthews D, Hosker J, Rudenski A, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentration in man. Diabetologia. 1985;28:12–9.CrossRef
30.
Zurück zum Zitat Fothergill E, Guo J, Howard L, et al. Persistent metabolic adaptation 6 years after “The Biggest Loser” competition. Obesity (Silver Spring). 2016;24:1612–9.CrossRef Fothergill E, Guo J, Howard L, et al. Persistent metabolic adaptation 6 years after “The Biggest Loser” competition. Obesity (Silver Spring). 2016;24:1612–9.CrossRef
31.
Zurück zum Zitat Bosy-Westphal A, Eichhorn C, Kutzner D, et al. The age-related decline in resting energy expenditure in humans is due to the loss of fat-free mass and to alterations in its metabolically active components. J Nutr. 2003;133:2356–62.CrossRefPubMed Bosy-Westphal A, Eichhorn C, Kutzner D, et al. The age-related decline in resting energy expenditure in humans is due to the loss of fat-free mass and to alterations in its metabolically active components. J Nutr. 2003;133:2356–62.CrossRefPubMed
32.
Zurück zum Zitat Rosenbaum M, Leibel R. The role of leptin in energy homeostasis in humans. J Endocrinol. 2015;223:T83–96.CrossRef Rosenbaum M, Leibel R. The role of leptin in energy homeostasis in humans. J Endocrinol. 2015;223:T83–96.CrossRef
33.
Zurück zum Zitat Rosenbaum M, Hirsch J, Gallagher DA, et al. Long-term persistence of adaptive thermogenesis in subjects who have maintained a reduced body weight. Am J Clin Nutr. 2008;88:906–12.CrossRefPubMed Rosenbaum M, Hirsch J, Gallagher DA, et al. Long-term persistence of adaptive thermogenesis in subjects who have maintained a reduced body weight. Am J Clin Nutr. 2008;88:906–12.CrossRefPubMed
Metadaten
Titel
Modifications of Resting Energy Expenditure After Sleeve Gastrectomy
verfasst von
Silvia Bettini
Emanuel Bordigato
Roberto Fabris
Roberto Serra
Chiara Dal Pra’
Anna Belligoli
Marta Sanna
Chiara Compagnin
Mirto Foletto
Luca Prevedello
Paola Fioretto
Roberto Vettor
Luca Busetto
Publikationsdatum
12.03.2018
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 8/2018
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-018-3190-3

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