Analysis of Loss of Skeletal Muscle Mass from bioimpedance findings in a cohort of patients undergoing Bariatric Surgery
DOI:
https://doi.org/10.33448/rsd-v9i11.9874Keywords:
Obesity; Bariatric surgery; Malnutrition; Skeletal muscle mass.Abstract
Objectives: The present study aims to investigate the development of MME loss in individuals undergoing bariatric surgery using bioimpedance. Method: Retrospective and observational cohort study, data were only collected and analyzed after approval by the Research Ethics Committee. The patients included were followed up with clinical and bioimpedance assessments for at least 6 months. The variables of interest were: epidemiological, anthropometric, pre- and post-surgery data, and results of serial bioimpedances. The data are presented in relative and absolute frequency, the comparison of means was done by the Student's T test. The average survival time until the development of low MME was estimated by the Kaplan-Meier model. Α = 5% was defined. Results: 30 patients were included, 80% of whom were female. The sample had an average age of 39 years. An average difference of 27.4 kg in body mass was found, when compared to the last anthropometric assessment with the values prior to surgery, which proved to be statistically significant (p <0.001). The average MME in the first post-surgical bioimpedance was 27.5 kg. After a period of 6 months, the individuals were again evaluated and had an average of 26.7 kg, the loss of MME was statistically significant (p = 0.033). It was observed that 20% of the individuals had MME values below the lower limit of normality, the Kaplan-Meier survival model estimates an incidence of 40% of this outcome in 30 months of follow-up. Conclusion: Patients undergoing bariatric surgery demonstrate a greater risk of developing nutritional deficiencies, mainly due to the excision of structures that impair nutrient absorption. Protein deficiency resulting from this process can manifest itself with reduced MME.
References
Apovian, C. M. (2016). Obesity: definition, comorbidities, causes, and burden. The American Journal of Managed Care, 22(7), s176–s185.
Beato, G. C., Ravelli, M. N., Crisp, A. H., & de Oliveira, M. R. M. (2019). Agreement Between Body Composition Assessed by Bioelectrical Impedance Analysis and Doubly Labeled Water in Obese Women Submitted to Bariatric Surgery: Body Composition, BIA, and DLW. Obesity Surgery, 29(1), 183–189. https://doi.org/10.1007/s11695-018-3505-4
Bordalo, L. A., Mourão, D. M., & Bressan, J. (2011). Deficiências nutricionais após cirurgia bariátrica: Por que ocorrem? Acta Medica Portuguesa, 24(SUPPL.4), 1021–1028.
Chaston, T. B., Dixon, J. B., & Brien, P. E. O. (2007). Changes in fat-free mass during significant weight loss : a systematic review. 743–750. https://doi.org/10.1038/sj.ijo.0803483
Ciangura, C., Bouillot, J. L., Lloret-Linares, C., Poitou, C., Veyrie, N., Basdevant, A., & Oppert, J. M. (2010). Dynamics of change in total and regional body composition after gastric bypass in obese patients. Obesity, 18(4), 760–765. https://doi.org/10.1038/oby.2009.348
Da Cunha, S. F. C., Sanches, M., Faria, A., Dos Santos, J. E., & Nonino-Borges, C. B. (2010). Evolução da massa corporal magra após 12 meses da cirurgia bariátrica. Revista de Nutricao, 23(4), 535–541. https://doi.org/10.1590/S1415-52732010000400004
Das, S. K., Roberts, S. B., Kehayias, J. J., Wang, J., Hsu, L. K. G., Shikora, S. A., Saltzman, E., & McCrory, M. A. (2003). Body composition assessment in extreme obesity and after massive weight loss induced by gastric bypass surgery. American Journal of Physiology - Endocrinology and Metabolism, 284(6 47-6), 1080–1088. https://doi.org/10.1152/ajpendo.00185.2002
de-Mateo-Silleras, B., Camina-Martín, M. A., de-Frutos-Allas, J. M., de-la-Cruz-Marcos, S., Carreño-Enciso, L., & Redondo-del-Río, M. P. (2018). Bioimpedance analysis as an indicator of muscle mass and strength in a group of elderly subjects. Experimental Gerontology, 113(September), 113–119. https://doi.org/10.1016/j.exger.2018.09.025
DeMaria, E. J., Sugerman, H. J., Kellum, J. M., Meador, J. G., & Wolfe, L. G. (2002). Results of 281 consecutive total laparoscopic Roux-en-Y gastric bypasses to treat morbid obesity. Annals of Surgery, 235(5), 640–647. https://doi.org/10.1097/00000658-200205000-00005
Fandiño, J., Benchimol, A. K., Coutinho, W. F., & Appolinário, J. C. (2004). Cirurgia bariátrica: aspectos clínico-cirúrgicos e psiquiátricos. Revista de Psiquiatria Do Rio Grande Do Sul, 26(1), 47–51. https://doi.org/10.1590/s0101-81082004000100007
Faucher, P., Aron-wisnewsky, J., Ciangura, C., Genser, L., Torcivia, A., Bouillot, J., Poitou, C., Oppert, J., & Aron-wisnewsky, J. (2019). Changes in Body Composition , Comorbidities , and Nutritional Status Associated with Lower Weight Loss After Bariatric Surgery in Older Subjects.
Halverson, J. (1986). Micronutrient deficiencies after gastric bypass for morbid obesity. Am Surg, 52(11), 594–598.
Heymsfield, S. B., Gonzalez, M. C. C., Shen, W., Redman, L., & Thomas, D. (2014). Weight loss composition is one-fourth fat-free mass : a critical review and critique of this widely cited rule. https://doi.org/10.1111/obr.12143
Ishii, S., Tanaka, T., Shibasaki, K., Ouchi, Y., Kikutani, T., Higashiguchi, T., Obuchi, S. P., Ishikawa-Takata, K., Hirano, H., Kawai, H., Tsuji, T., & Iijima, K. (2014). Development of a simple screening test for sarcopenia in older adults. Geriatrics and Gerontology International, 14(SUPPL.1), 93–101. https://doi.org/10.1111/ggi.12197
James, P. T., Leach, R., Kalamara, E., Shayeghi, M., Philip, T., Leach, R., & The, M. S. (2001). The Worldwide Obesity Epidemic. 9(November).
Ji, A.-L. (2004). Nutrient deficiencies secondary to bariatric. Curr Opin Clin Nutr Metab Care, 7(5).
Kanso, Z. M., & Echegaray, N. (2012). 5 years follow-up. 3(December), 80–87.
Khwaja, H. A., & Bonanomi, G. (2010). Bariatric surgery: techniques, outcomes and complications. Current Anaesthesia and Critical Care, 21(1), 31–38. https://doi.org/10.1016/j.cacc.2009.10.005
Maclean, L., RHODE, B., & SHIZGAL, H. (1983). Nutrition following gastric operations for morbid obesity. Ann Surg, 198(3), 347–355.
MacMahon, S., Baigent, C., Duffy, S., Rodgers, A., Tominaga, S., Chambless, L., De Backer, G., De Bacquer, D., Kornitzer, M., Whincup, P., Wannamethee, S. G., Morris, R., Wald, N., Morris, J., Law, M., Knuiman, M., Bartholomew, H., Davey Smith, G., Sweetnam, P., … Whitlock, G. (2009). Body-mass index and cause-specific mortality in 900 000 adults: Collaborative analyses of 57 prospective studies. The Lancet, 373(9669), 1083–1096. https://doi.org/10.1016/S0140-6736(09)60318-4
Mazzeo, S. E., Saunders, R., & Mitchell, K. S. (2018). Binge eating among African American and Caucasian bariatric surgery candidates. 6(2005), 189–196. https://doi.org/10.1016/j.eatbeh.2004.12.001
Melo, L. C. ost., Silva, M. A. layd. M. da, & Calles, A. C. arolin. do N. (2014). Obesity and lung function: a systematic review. Einstein (São Paulo, Brazil), 12(1), 120–125. https://doi.org/10.1590/S1679-45082014RW2691
Nuijten, M. A. H., Monpellier, V. M., Eijsvogels, T. M. H., Janssen, I. M. C., Hazebroek, E. J., & Hopman, M. T. E. (2020). Rate and Determinants of Excessive Fat-Free Mass Loss After Bariatric Surgery.
Papini-Berto, S. J., MAIO, R., MÓDOLO, A. K., SANTOS, M. D. B. dos, DICHI, I., & BURINI, R. C. (2002). Desnutrição protéico-energética no paciente gastrectomizado. Arquivos de Gastroenterologia, 39(1), 3–10. https://doi.org/10.1590/s0004-28032002000100002
Pereira, A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Metodologia da pesquisa científica. [E-book]. Santa Maria. Ed. UAB/NTE/UFSM. https://www.ufs m.br/app/uploads/sites/358/2019/02/Metodologia-da-Pesquisa-Cientifica_final.pdf.
Robinder JS Dhillon, MD, M., & Sarfaraz Hasni, M. (2018). Pathogenesis and management of Sarcopenia. Clinics in Geriatric Medicine, 176(1), 139–148. https://doi.org/10.1016/j.physbeh.2017.03.040
Wadström, C., Backman, L., Forsberg, A. M., Nilsson, E., Hultman, E., Reizenstein, P., & Ekman, M. (2000). Body composition and muscle constituents during weight loss: Studies in obese patients following gastroplasty. Obesity Surgery, 10(3), 203–213. https://doi.org/10.1381/096089200321643313
Weismann, D., Pelka, T., Bender, G., Jurowich, C., Fassnacht, M., Thalheimer, A., & Allolio, B. (2013). Bariatric surgery for morbid obesity in craniopharyngioma. Clinical Endocrinology, 78(3), 385–390. https://doi.org/10.1111/j.1365-2265.2012.04409.x
World Healthy Organization (WHO). (2003). Obesity and overweight. Genebra: WHO.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 Bruna dos Santos Silva Azevedo; Filipe Azevedo e Silva; Bárbara Klein Bisinella Dias; Matheus Rodrigues de Souza; Caroline Ferreira Fagundes; Vilson Rosa de Almeida
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.