机体能量代谢变化对腹腔镜袖状胃切除术后体重下降量的影响

Effect of energy metabolism on weight loss after laparoscopic sleeve gastrectomy

目的:探讨机体能量代谢变化对腹腔镜袖状胃切除术后体重下降量的影响。方法:选择67例行腹腔镜袖状胃切除术的肥胖患者作为研究对象,术后6个月将其分为获得理想减重效果组,即多余体重减少百分比(%EWL)≥50%及未获得理想减重效果组(%EWL<50%)。对比分析术前及术后6个月能量代谢与体成分指标。结果:术后6个月,33例获得理想减重效果。相关性分析得出,%EWL与术后静息能量代谢(REE)/体重(BW)、△REE/BW、△去脂体重百分比呈正相关(r=0.473,P<0.001;r=0.372,P=0.002;r=0.493,P=0.003),%EWL与△呼吸商(RQ)、术后RQ呈现负相关(r=-0.613,P<0.001;r=-0.553,P<0.001)。多元逐步Logistic回归分析显示,术后REE/BW、RQ与获得理想减重效果密切相关。结论:术后REE/BW的增加及术后RQ的下降是获得理想减重效果的有效预测因子。

Objective:To explore the influence of energy metabolism on weight loss after laparoscopic sleeve gastrectomy.Methods:A total of 67 obese subjects undergoing laparoscopic sleeve gastrectomy were included.Patients were divided postoperatively into those with or without satisfactory percent excess weight loss(%EWL)≥50%.Energy metabolism and body composition were assessed before and 6 months after surgery through independent-samples t test and correlation analysis.Multiple stepwise logistic regression analysis was used to identify predictors.Results:Satisfactory%EWL was achieved in 33 patients 6 months after surgery.Correlation analysis revealed that%EWL had a positive correlation with post-REE/BW,△REE/BW and△FFM%(r=0.473,P<0.001;r=0.372,P=0.002;r=0.493,P=0.003).%EWL had a negative correlation with△RQ and post-RQ(r=-0.613,P<0.001;r=-0.553,P<0.001).Multiple stepwise logistic regression analysis indicated that REE/BW and RQ were closely associated with satisfactory%EWL.Conclusions:Higher REE/BW and lower RQ are the predictor of satisfactory%EWL in Chinese obese patients after laparoscopic sleeve gastrectomy.