Análise da evolução da composição corporal segmentar em bariátricos com reganho de peso submetidos à terapêutica farmacológica com liraglutida

Autores

DOI:

https://doi.org/10.33448/rsd-v11i11.32535

Palavras-chave:

Obesidade; Pós-bariátrica; Liraglutida.

Resumo

A obesidade é uma doença crônica, multifatorial, responsável por diversas morbidades, sendo a cirurgia bariátrica uma alternativa eficiente para a perda de peso. Cerca de 20% a 25% dos pacientes, mesmo perdendo peso após o procedimento, tendem a apresentar reganho de peso após o segundo ano. Este estudo teve como objetivo central analisar a evolução da composição corporal segmentar em bariátricos com reganho de peso e submetidos à terapêutica farmacológica com liraglutida. Trata-se de um estudo retrospectivo, longitudinal, por meio de análise de dados em prontuário de uma instituição especializada em terapêutica clínica e cirúrgica da obesidade. A amostra foi composta por 22 pacientes bariátricos atendidos entre janeiro de 2016 a dezembro de 2019. Foram coletados dados antropométricos de impedanciometria segmentar, bem como dados da evolução clínica referente ao tratamento proposto. Em ambas as doses, a perda de massa se mostrou relevante em todos os segmentos, apontando significância. O IMC reduziu 9,3% em todos os pacientes nas 24 semanas analisadas. Com 2,4mg/dia de liraglutida, houve perda de 7,2% do peso e, com dose de 3,0mg/dia, esta perda foi de 9,84%. Considerando ambas as doses, a perda de peso geral foi de 9,2%. As porcentagens de diferenças médias de gordura foram similares entre o tronco e os membros. Com relação à massa magra, embora não houve significância estatística, encontrou-se uma significância clínica de proteção.

Referências

Abdulla, H., Phillips, B., Smith, K., Wilkinson, D., Atherton, P. J., & Idris, I. (2014). Physiological mechanisms of action of incretin and insulin in regulating skeletal muscle metabolism. Current diabetes reviews, 10(5), 327–335. https://doi.org/10.2174/1573399810666141017153749

Bastos, E. C., Barbosa, E. M., Soriano, G. M., dos Santos, E. A., & Vasconcelos, S. M. (2013). Determinants of weight regain after bariatric surgery. Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery, 26 Suppl 1, 26–32. https://doi.org/10.1590/s0102-67202013000600007

Blackman, A., Foster, G. D., Zammit, G., Rosenberg, R., Aronne, L., Wadden, T., Claudius, B., Jensen, C. B., & Mignot, E. (2016). Effect of liraglutide 3.0 mg in individuals with obesity and moderate or severe obstructive sleep apnea: the SCALE Sleep Apnea randomized clinical trial. International journal of obesity (2005), 40(8), 1310–1319. https://doi.org/10.1038/ijo.2016.52

Bray, G. A., Frühbeck, G., Ryan, D. H., & Wilding, J. P. (2016). Management of obesity. Lancet (London, England), 387(10031), 1947–1956. https://doi.org/10.1016/S0140-6736(16)00271-3

Cadegiani, F. A., Diniz, G. C., & Alves, G. (2017). Aggressive clinical approach to obesity improves metabolic and clinical outcomes and can prevent bariatric surgery: a single center experience. BMC obesity, 4, 9. https://doi.org/10.1186/s40608-017-0147-3

Camilleri, M., & Acosta, A. (2018). Combination Therapies for Obesity. Metabolic syndrome and related disorders, 16(8), 390–394. https://doi.org/10.1089/met.2018.0075

Cintra Junior, W., Modolin, M., Colferai, D. R., Rocha, R. I., & Gemperli, R. (2021). Post-bariatric body contouring surgery: analysis of complications in 180 consecutive patients. Revista do Colegio Brasileiro de Cirurgioes, 48, e20202638. https://doi.org/10.1590/0100-6991e-20202638

Cotugno, M., Nosso, G., Saldalamacchia, G., Vitagliano, G., Griffo, E., Lupoli, R., Angrisani, L., Riccardi, G., & Capaldo, B. (2015). Clinical efficacy of bariatric surgery versus liraglutide in patients with type 2 diabetes and severe obesity: a 12-month retrospective evaluation. Acta diabetologica, 52(2), 331–336. https://doi.org/10.1007/s00592-014-0644-5

Crane, J., & McGowan, B. (2016). The GLP-1 agonist, liraglutide, as a pharmacotherapy for obesity. Therapeutic advances in chronic disease, 7(2), 92–107. https://doi.org/10.1177/2040622315620180.

Davies, M. J., Bergenstal, R., Bode, B., Kushner, R. F., Lewin, A., Skjøth, T. V., Andreasen, A. H., Jensen, C. B., DeFronzo, R. A., & NN8022-1922 Study Group (2015). Efficacy of Liraglutide for Weight Loss Among Patients With Type 2 Diabetes: The SCALE Diabetes Randomized Clinical Trial. JAMA, 314(7), 687–699. https://doi.org/10.1001/jama.2015.9676

Dias, P. C., Henriques, P., Anjos, L., & Burlandy, L. (2017). Obesity and public policies: the Brazilian government's definitions and strategies. Obesidade e políticas públicas: concepções e estratégias adotadas pelo governo brasileiro. Cadernos de saude publica, 33(7), e00006016. https://doi.org/10.1590/0102-311X00006016

El Ansari, W., & Elhag, W. (2021). Weight Regain and Insufficient Weight Loss After Bariatric Surgery: Definitions, Prevalence, Mechanisms, Predictors, Prevention and Management Strategies, and Knowledge Gaps-a Scoping Review. Obesity surgery, 31(4), 1755–1766. https://doi.org/10.1007/s11695-020-05160-5

Faria G. R. (2017). A brief history of bariatric surgery. Porto biomedical journal, 2(3), 90–92. https://doi.org/10.1016/j.pbj.2017.01.008

Gadde, K. M., Martin, C. K., Berthoud, H. R., & Heymsfield, S. B. (2018). Obesity: Pathophysiology and Management. Journal of the American College of Cardiology, 71(1), 69–84. https://doi.org/10.1016/j.jacc.2017.11.011.

Grannell, A., Martin, W. P., Dehestani, B., Al-Najim, W., Murphy, J. C., & le Roux, C. W. (2021). Liraglutide Does Not Adversely Impact Fat-Free Mass Loss. Obesity (Silver Spring, Md.), 29(3), 529–534. https://doi.org/10.1002/oby.23098

Harder, H., Nielsen, L., Tu, D. T., & Astrup, A. (2004). The effect of liraglutide, a long-acting glucagon-like peptide 1 derivative, on glycemic control, body composition, and 24-h energy expenditure in patients with type 2 diabetes. Diabetes care, 27(8), 1915–1921. https://doi.org/10.2337/diacare.27.8.1915

Isaacs, D., Prasad-Reddy, L., & Srivastava, S. B. (2016). Role of glucagon-like peptide 1 receptor agonists in management of obesity. American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 73(19), 1493–1507. https://doi.org/10.2146/ajhp150990

Jimenez, J. M., Ruiz-Tovar, J., López, M., Marc-Hernandez, A., Carbajo, M. A., Cao, M. J., Garcia, S., & Castro, M. J. (2020). Assessment of body composition in obese patients undergoing one anastomosis gastric bypass: cross-sectional study. Scientific reports, 10(1), 18884. https://doi.org/10.1038/s41598-020-75589-2

Kadouh, H., Chedid, V., Halawi, H., Burton, D. D., Clark, M. M., Khemani, D., Vella, A., Acosta, A., & Camilleri, M. (2020). GLP-1 Analog Modulates Appetite, Taste Preference, Gut Hormones, and Regional Body Fat Stores in Adults with Obesity. The Journal of clinical endocrinology and metabolism, 105(5), 1552–1563. https://doi.org/10.1210/clinem/dgz140

Kushner, R. F. (2018). Weight Loss Strategies for Treatment of Obesity: Lifestyle Management and Pharmacotherapy. Progress in cardiovascular diseases, 61(2), 246–252. https://doi.org/10.1016/j.pcad.2018.06.001

Ladenheim, E. E. (2015). Liraglutide and obesity: a review of the data so far. Drug design, development and therapy, 9, 1867–1875. https://doi.org/10.2147/DDDT.S58459

Lattari, T. G., Onzi, T. R., Stedile, L. J. M., & Pincelli, M. P. (2020). Evaluation of quality of life in patients undergoing bariatric surger. R. bras. Qual. Vida, Ponta Grossa, v. 12, n. 1, e10492. https://dói.org/10.3895/rbqv.v12n0.10492.

Mancini, M. C. Tratado de Obesidade. (2ª. ed.): Guanabara Koogan, 2015.

Mancini, M. C., & Halpern, A. Tratamento farmacológico da obesidade. Arquivos Brasileiros de Endocrinologia & Metabologia, v. 46, p. 497-512, 2002.

Modi, R., Rye, P., Cawsey, S., Birch, D. W., & Sharma, A. M. (2018). Liraglutide Effects on Upper Gastrointestinal Investigations: Implications Prior to Bariatric Surgery. Obesity surgery, 28(7), 2113–2116. https://doi.org/10.1007/s11695-018-3249-1

Montesi, L., El Ghoch, M., Brodosi, L., Calugi, S., Marchesini, G., & Dalle Grave, R. (2016). Long-term weight loss maintenance for obesity: a multidisciplinary approach. Diabetes, metabolic syndrome and obesity : targets and therapy, 9, 37–46. https://doi.org/10.2147/DMSO.S89836

Nuijten, M., Tettero, O. M., Wolf, R. J., Bakker, E. A., Eijsvogels, T., Monpellier, V. M., Hazebroek, E. J., Janssen, I., & Hopman, M. (2021). Changes in Physical Activity in Relation to Body Composition, Fitness and Quality of Life after Primary Bariatric Surgery: a Two-Year Follow-Up Study. Obesity surgery, 31(3), 1120–1128. https://doi.org/10.1007/s11695-020-05009-x

Pajecki, D., Halpern, A., Cercato, C., Mancini, M., de Cleva, R., & Santo, M. A. (2013). Short-term use of liraglutide in the management of patients with weight regain after bariatric surgery. Revista do Colegio Brasileiro de Cirurgioes, 40(3), 191–195. https://doi.org/10.1590/s0100-69912013000300005

Pereira A. S., et al. (2018). Metodologia da pesquisa científica. [free e-book]. Santa Maria/RS. Ed. UAB/NTE/UFSM.

Ryan, D. H., & Kahan, S. (2018). Guideline Recommendations for Obesity Management. The Medical clinics of North America, 102(1), 49–63. https://doi.org/10.1016/j.mcna.2017.08.006

Rye, P., Modi, R., Cawsey, S., & Sharma, A. M. (2018). Efficacy of High-Dose Liraglutide as an Adjunct for Weight Loss in Patients with Prior Bariatric Surgery. Obesity surgery, 28(11), 3553–3558. https://doi.org/10.1007/s11695-018-3393-7

Sampaio-Neto, J., Branco-Filho, A. J., Nassif, L. S., Nassif, A. T., Masi, F. D., & Gasperin, G. (2016). Proposal Of A Revisional Surgery To Treat Severe Nutritional Deficiency Post-Gastric Bypass. Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery, 29Suppl 1(Suppl 1), 98–101. https://doi.org/10.1590/0102-6720201600S100

De-Souza, D. A., & Greene, L. J. (2015). Nutritional issues in obese patients submitted to bariatric surgery. Re. "Bariatric surgery may not achieve intended outcomes in all patients". Nutrition (Burbank, Los Angeles County, Calif.), 31(9), 1184–1185. https://doi.org/10.1016/j.nut.2015.06.003

Suliman, M., Buckley, A., Al Tikriti, A., Tan, T., le Roux, C. W., Lessan, N., & Barakat, M. (2019). Routine clinical use of liraglutide 3 mg for the treatment of obesity: Outcomes in non-surgical and bariatric surgery patients. Diabetes, obesity & metabolism, 21(6), 1498–1501. https://doi.org/10.1111/dom.13672

Tonatto-Filho, A. J., Gallotti, F. M., Chedid, M. F., Grezzana-Filho, T., & Garcia, A. (2019). Bariatric Surgery In Brazilian Public Health System: The Good, The Bad And The Ugly, Or A Long Way To Go. Yellow Sign!. Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery, 32(4), e1470. https://doi.org/10.1590/0102-672020190001e1470

Webb, D. L., Abrahamsson, N., Sundbom, M., & Hellström, P. M. (2017). Bariatric surgery - time to replace with GLP-1?. Scandinavian journal of gastroenterology, 52(6-7), 635–640. https://doi.org/10.1080/00365521.2017.1293154

Wharton, S., Kuk, J. L., Luszczynski, M., Kamran, E., & Christensen, R. (2019). Liraglutide 3.0 mg for the management of insufficient weight loss or excessive weight regain post-bariatric surgery. Clinical obesity, 9(4), e12323. https://doi.org/10.1111/cob.12323

Wharton, S., Kamran, E., Muqeem, M., Khan, A., & Christensen, R. (2019). The effectiveness and safety of pharmaceuticals to manage excess weight post-bariatric surgery: a systematic literature review. Journal of drug assessment, 8(1), 184–191. https://doi.org/10.1080/21556660.2019.1678478.

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23/08/2022

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BONGESTAB , R.; ANDRADE, T. U. de . Análise da evolução da composição corporal segmentar em bariátricos com reganho de peso submetidos à terapêutica farmacológica com liraglutida . Research, Society and Development, [S. l.], v. 11, n. 11, p. e306111132535, 2022. DOI: 10.33448/rsd-v11i11.32535. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/32535. Acesso em: 17 jul. 2024.

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Ciências da Saúde