The risk of sarcopenia 24 months after bariatric surgery - assessment by dual energy X-ray absorptiometry (DEXA): a prospective study.

Pekař, Matej; Pekařová, Anna; Bužga, Marek; Holéczy, Pavol; Šoltés, Marek

doi:10.5114/wiitm.2020.93463

Cited by 30 publications

(23 citation statements)

References 22 publications

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“…The retention and/or gain of fat-free mass, which largely reflects skeletal muscle, following bariatric surgery is important to maintain metabolism, support weight maintenance, and prevent complications such as sarcopenia [ 47 – 49 ]. Despite a loss of fat-free mass being expected following bariatric surgery [ 49 ] and observed early in the LSG cohort, the ESG cohort managed to increase fat-free mass at 6-months. Although the increase of approximately 0.3 kg was statistically significant, it is not clinically significant, so should be interpreted as maintaining fat-free mass only.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of endoscopic sleeve gastroplasty and laparoscopic sleeve gastrectomy with 12+ months of adjuvant multidisciplinary support

et al. 2022

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Background The laparoscopic sleeve gastrectomy (LSG) and the incisionless endoscopic sleeve gastroplasty (ESG) weight loss procedures require further investigation of their efficacy, safety and patient-centered outcomes in the Australian setting. Methods The aim was to examine the 6- and 12-month weight loss efficacy, safety, and weight-related quality of life (QoL) of adults with obesity who received the ESG or LSG bariatric procedure with 12+ months of adjuvant multidisciplinary pre- and postprocedural support. Data were from a two-arm prospective cohort study that followed patients from baseline to 12-months postprocedure from a medical center in Queensland. Percent excess weight loss (%EWL) was the primary outcome. Secondary outcomes were body composition (fat mass, fat-free mass, android:gynoid ratio, bone mineral content) via dual energy X-ray absorptiometry, weight-related QoL, lipid, glycemic, and hepatic biochemistry, and adverse events. Results 16 ESG (19% attrition; 81.2% female; aged:41.4 (SD: 10.4) years; BMI: 35.5 (SD: 5.2) kg/m2) and 45 LSG (9% attrition; 84.4% female; aged:40.4 (SD: 9.0) years; BMI: 40.7 (SD: 5.6) kg/m2) participants were recruited. At 12-months postprocedure, ESG %EWL was 57% (SD: 32%; p < 0.01) and LSG %EWL was 79% (SD: 24%; p < 0.001). ESG and LSG cohorts improved QoL (19.8% in ESG [p > 0.05]; 48.1% in LSG [p < 0.05]), liver function (AST: − 4.4 U/L in ESG [p < 0.05]; − 2.7 U/L in LSG [p < 0.05]), HbA1c (− 0.5% in ESG [p < 0.05]; − 0.1% in LSG [p < 0.05]) and triglycerides (− 0.6 mmol/L in ESG [p > 0.05]; − 0.4 mmol/L in LSG [P < 0.05]) at 12-months. Both cohorts reduced fat mass (p < 0.05). The ESG maintained but LSG decreased fat-free mass at 6-months (p < 0.05); and both cohorts lost fat-free mass at 12-months (p < 0.05). There were no adverse events directly related to the procedure. The ESG reported 25% mild-moderate adverse events possibly related to the procedure, and the LSG reported 27% mild-severe adverse events possibly related to the procedure. Conclusions In this setting, the ESG and LSG were safe and effective weight loss treatments for obese adults alongside multidisciplinary support. Patients who elected the ESG maintained fat-free mass at 6-months but both cohorts lost fat-free mass at 12-months postprocedure. Patients who elected the LSG had large and significant improvements to weight-related quality of life. Further well-powered studies are required to confirm these findings. Trial registration This study was registered prospectively at the Australia New Zealand Clinical Trials Registry on 06/03/2018, Registration Number ACTRN12618000337279.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of endoscopic sleeve gastroplasty and laparoscopic sleeve gastrectomy with 12+ months of adjuvant multidisciplinary support

et al. 2022

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“…Furthermore, studies have shown that although bariatric surgery is effective at lowering the BMI, this procedure may also induce sarcopenia post-operatively. 22,23 Thus, with the known risks of sarcopenia shown within our study, it may be inadvisable to recommend bariatric surgery to improve BMI prior to undergoing complex revision thoracolumbar spine surgery.…”

Section: Discussionmentioning

confidence: 79%

Obesity is Not Associated with Perioperative Adverse Events in Patients Undergoing Complex Revision Surgery for the Thoracolumbar Spine

Hirase¹,

Ling²,

Haghshenas³

et al. 2021

Preprint

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Study Design: Retrospective cohort studyObjective: This study sought to determine the relationship between obesity and perioperative adverse events (AEs) with patients undergoing complex revision thoracolumbar spine surgery while controlling for psoas muscle index (PMI) as a confounding variable.Methods: Between May 2016 and February 2020, a retrospective analysis of individuals undergoing complex revision surgery of the thoracolumbar spine was performed at a single institution. Obesity was defined as BMI ≥ 30.0 kg/m2. PMI < 500 mm2/m2 for males and < 412 mm2/m2 for females were used to define sarcopenia. A Spine Surgical Invasiveness Index (SSII) > 10 was used to define complex revision surgery. A multivariable logistic regression model was used to ascertain the effects of sarcopenia, obesity, age, and gender on the likelihood of the occurrence of any AE.Results: The study included 114 patients. 54 patients were in the obese cohort and 60 patients in the non-obese cohort. There was not a significant difference in perioperative outcomes of both the obese and non-obese patients. Multivariable analysis demonstrated that sarcopenic individuals had a significantly higher likelihood for an AE than non-sarcopenic individuals (OR: 7.53, 95% CI: 3.05-18.60). Obesity did not have a significant effect in predicting AEs.Conclusions: Obesity is not associated with perioperative AEs, 30-day readmission rates, 30-day re-operation rates, rate of discharge to a facility, or post-operative length of stay (LOS) among patients undergoing complex revision thoracolumbar spine surgery.Level of Evidence: III

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“…The necessity of controlling diabetes treatment and dietary recommendations is widely known. However, it should not be forgotten that the consequences of the bariatric surgery bring the need to monitor a wide range of factors, such as the psychological aspect, the level of physical activity [ 10 ], and even the risk assessment of a planned pregnancy [ 11 ].…”

Section: Resultsmentioning

confidence: 99%

Follow-up after bariatric surgery: are we effective enough?

Nurczyk¹,

Chan²,

Skoczylas³

et al. 2021

Videosurgery and Other Miniinvasive Techniques

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Over the years, the rise in the obesity epidemic has led to an increasing demand for bariatric surgery. Considering the rapidly growing number of bariatric surgery procedures performed, intensive development of postoperative care and surveillance programs should be expected. However, the effectiveness of follow-up after bariatric surgery appears to be surprisingly low. The purpose of this review is to draw attention to the quality of follow-up programs and to encourage health care providers to make efforts to ensure adequate post-operative data collection. Awareness should be raised about inadequate data collection to strengthen the credibility and authenticity of treatment results, thus providing a clearer picture of treatment efficacy.

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The risk of sarcopenia 24 months after bariatric surgery - assessment by dual energy X-ray absorptiometry (DEXA): a prospective study.

Cited by 30 publications

References 22 publications

Efficacy and safety of endoscopic sleeve gastroplasty and laparoscopic sleeve gastrectomy with 12+ months of adjuvant multidisciplinary support

Efficacy and safety of endoscopic sleeve gastroplasty and laparoscopic sleeve gastrectomy with 12+ months of adjuvant multidisciplinary support

Obesity is Not Associated with Perioperative Adverse Events in Patients Undergoing Complex Revision Surgery for the Thoracolumbar Spine

Follow-up after bariatric surgery: are we effective enough?

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