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Published in: Journal of Gastrointestinal Surgery 3/2019

01-03-2019 | Original Article

Sleeve Gastrectomy and Roux-En-Y Gastric Bypass Lead to Comparable Changes in Body Composition in a Multiethnic Asian Population

Authors: Guowei Kim, Chuen Seng Tan, Kah Wei Tan, Serene P. Y. Lim, Jimmy B. Y. So, Asim Shabbir

Published in: Journal of Gastrointestinal Surgery | Issue 3/2019

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Abstract

Background

Changes in body composition after bariatric surgery such as a sustained loss of body fat are often associated with an inevitable loss of fat free mass. This can contribute to an undesirable disturbance in resting metabolic rate and weight maintenance. Our aim was to study changes in body composition in a multiethnic Asian cohort following bariatric surgery and to identify differences between laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass.

Methods

A retrospective review of prospectively collected data on 295 patients who underwent either laparoscopic sleeve gastrectomy (256 patients) or laparoscopic Roux-en-Y gastric bypass (39 patients) was performed. Body composition variables were measured with the analyzer, GAIA 359 PLUS, which included the parameters; total body weight, body mass index, excess weight, basal metabolic rate, fat-free mass, fat mass, and total body water.

Results

There were no statistical differences in gender, ethnicity, age, weight, height, and body mass index between laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass. At each time point (6, 12, 24, and 36 months) post-operation, there was no significant differences in % total body weight loss, basal metabolic rate, fat mass, fat percentage, and total body water between sleeve gastrectomy and bypass patients. There was significant difference (p < 0.05) in fat free mass only at 3 years post-operation, with sleeve gastrectomy patients having 9.79 kg less fat-free mass than bypass patients. However, after multivariate analysis, we found no statistically significant differences.

Conclusion

Sleeve gastrectomy and gastric bypass seemed to give similar changes to body composition.
Literature
1.
go back to reference De Luca M, Angrisani L, Himpens J, et al. Indications for Surgery for Obesity and Weight-Related Diseases: Position Statements from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) Final Recommendations. Obes Surg. 2016;26:1659–96.CrossRefPubMedPubMedCentral De Luca M, Angrisani L, Himpens J, et al. Indications for Surgery for Obesity and Weight-Related Diseases: Position Statements from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) Final Recommendations. Obes Surg. 2016;26:1659–96.CrossRefPubMedPubMedCentral
2.
go back to reference Angrisani L, Santonicola A, Iovino P, Formisano G, Buchwald H, Scopinaro N. Bariatric Surgery Worldwide 2013. Obes Surg. 2015;25(10):1822–32.CrossRefPubMed Angrisani L, Santonicola A, Iovino P, Formisano G, Buchwald H, Scopinaro N. Bariatric Surgery Worldwide 2013. Obes Surg. 2015;25(10):1822–32.CrossRefPubMed
3.
4.
go back to reference Lomanto D, Lee WJ, Goel R, et al. Bariatric surgery in asia in the last 5 years (2005-2009). Obes Surg. 2012;22(3):502–6.CrossRefPubMed Lomanto D, Lee WJ, Goel R, et al. Bariatric surgery in asia in the last 5 years (2005-2009). Obes Surg. 2012;22(3):502–6.CrossRefPubMed
5.
go back to reference Adamczyk P, Bužga M, Holéczy P, et al. Bone mineral density and body composition after laparoscopic sleeve gastrectomy in men: A short-term longitudinal study. Int J Surg. 2015;23:101–7.CrossRefPubMed Adamczyk P, Bužga M, Holéczy P, et al. Bone mineral density and body composition after laparoscopic sleeve gastrectomy in men: A short-term longitudinal study. Int J Surg. 2015;23:101–7.CrossRefPubMed
6.
go back to reference Otto M, Elrefai M, Krammer J, Weiß C, Kienle P, Hasenberg T. Sleeve Gastrectomy and Roux-en-Y Gastric Bypass Lead to Comparable Changes in Body Composition after Adjustment for Initial Body Mass Index. Obes Surg; 2016;26(3):479–85.CrossRefPubMed Otto M, Elrefai M, Krammer J, Weiß C, Kienle P, Hasenberg T. Sleeve Gastrectomy and Roux-en-Y Gastric Bypass Lead to Comparable Changes in Body Composition after Adjustment for Initial Body Mass Index. Obes Surg; 2016;26(3):479–85.CrossRefPubMed
7.
go back to reference Frige’ F, Laneri M, Veronelli A, et al. Bariatric surgery in obesity: Changes of glucose and lipid metabolism correlate with changes of fat mass. Nutr Metab Cardiovasc Dis. Elsevier Ltd; 2009;19(3):198–204.CrossRefPubMed Frige’ F, Laneri M, Veronelli A, et al. Bariatric surgery in obesity: Changes of glucose and lipid metabolism correlate with changes of fat mass. Nutr Metab Cardiovasc Dis. Elsevier Ltd; 2009;19(3):198–204.CrossRefPubMed
8.
go back to reference Belfiore A, Cataldi M, Minichini L, et al. Short-Term Changes in Body Composition and Response to Micronutrient Supplementation After Laparoscopic Sleeve Gastrectomy. Obes Surg. 2015;25(12):2344–51.CrossRefPubMed Belfiore A, Cataldi M, Minichini L, et al. Short-Term Changes in Body Composition and Response to Micronutrient Supplementation After Laparoscopic Sleeve Gastrectomy. Obes Surg. 2015;25(12):2344–51.CrossRefPubMed
9.
go back to reference Fischer L, Hildebrandt C, Bruckner T, et al. Excessive weight loss after sleeve gastrectomy: A systematic review. Obes Surg. 2012;22(5):721–31.CrossRefPubMed Fischer L, Hildebrandt C, Bruckner T, et al. Excessive weight loss after sleeve gastrectomy: A systematic review. Obes Surg. 2012;22(5):721–31.CrossRefPubMed
10.
go back to reference Salminen P, Helmiö M, Ovaska J, et al. Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss at 5 Years Among Patients With Morbid Obesity. JAMA. 2018;319(3):241.CrossRefPubMedPubMedCentral Salminen P, Helmiö M, Ovaska J, et al. Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss at 5 Years Among Patients With Morbid Obesity. JAMA. 2018;319(3):241.CrossRefPubMedPubMedCentral
11.
go back to reference Peterli R, Wölnerhanssen BK, Peters T, et al. Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss in Patients With Morbid Obesity. JAMA. 2018;319(3):255.CrossRefPubMedPubMedCentral Peterli R, Wölnerhanssen BK, Peters T, et al. Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss in Patients With Morbid Obesity. JAMA. 2018;319(3):255.CrossRefPubMedPubMedCentral
12.
go back to reference Shoar S, Saber AA. Long-term and midterm outcomes of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass: a systematic review and meta-analysis of comparative studies. Surg Obes Relat Dis. 2017;13(2):170–80.CrossRefPubMed Shoar S, Saber AA. Long-term and midterm outcomes of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass: a systematic review and meta-analysis of comparative studies. Surg Obes Relat Dis. 2017;13(2):170–80.CrossRefPubMed
13.
go back to reference Colquitt JL, Pickett K, Loveman E, Frampton GK. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014;(8):CD003641. Colquitt JL, Pickett K, Loveman E, Frampton GK. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014;(8):CD003641.
14.
go back to reference Miras AD, le Roux CW. Mechanisms underlying weight loss after bariatric surgery. Nat Rev Gastroenterol Hepatol. 2013;10(10):575–84.CrossRefPubMed Miras AD, le Roux CW. Mechanisms underlying weight loss after bariatric surgery. Nat Rev Gastroenterol Hepatol. 2013;10(10):575–84.CrossRefPubMed
15.
go back to reference Scott WR, Batterham RL. Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: understanding weight loss and improvements in type 2 diabetes after bariatric surgery. Am J Physiol Regul Integr Comp Physiol. 2011;301(1):R15–27.CrossRefPubMed Scott WR, Batterham RL. Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: understanding weight loss and improvements in type 2 diabetes after bariatric surgery. Am J Physiol Regul Integr Comp Physiol. 2011;301(1):R15–27.CrossRefPubMed
16.
go back to reference Savastano S, Belfiore A, Di Somma C, et al. Validity of bioelectrical impedance analysis to estimate body composition changes after bariatric surgery in premenopausal morbidly women. Obes Surg. 2010;20(3):332–9.CrossRefPubMed Savastano S, Belfiore A, Di Somma C, et al. Validity of bioelectrical impedance analysis to estimate body composition changes after bariatric surgery in premenopausal morbidly women. Obes Surg. 2010;20(3):332–9.CrossRefPubMed
17.
go back to reference Boneva-Asiova Z, Boyanov MA. Body composition analysis by leg-to-leg bioelectrical impedance and dual-energy X-ray absorptiometry in non-obese and obese individuals. Diabetes, Obes Metab. 2008;10(11):1012–8.CrossRef Boneva-Asiova Z, Boyanov MA. Body composition analysis by leg-to-leg bioelectrical impedance and dual-energy X-ray absorptiometry in non-obese and obese individuals. Diabetes, Obes Metab. 2008;10(11):1012–8.CrossRef
18.
go back to reference Haverkort EB, Reijven PLM, Binnekade JM, et al. Bioelectrical impedance analysis to estimate body composition in surgical and oncological patients: a systematic review. Eur J Clin Nutr. 2015;69(1):3–13.CrossRefPubMed Haverkort EB, Reijven PLM, Binnekade JM, et al. Bioelectrical impedance analysis to estimate body composition in surgical and oncological patients: a systematic review. Eur J Clin Nutr. 2015;69(1):3–13.CrossRefPubMed
19.
go back to reference Ngoh CLY, So JBY, Tiong HY, Shabbir A, Teo BW. Effect of weight loss after bariatric surgery on kidney function in a multiethnic Asian population. Surg Obes Relat Dis; 2016;12(3):600–5.CrossRefPubMed Ngoh CLY, So JBY, Tiong HY, Shabbir A, Teo BW. Effect of weight loss after bariatric surgery on kidney function in a multiethnic Asian population. Surg Obes Relat Dis; 2016;12(3):600–5.CrossRefPubMed
20.
go back to reference Cheng I-C, Wei S-C, Yeh S-L, Wang W. Comparison of Weight Loss and Body Composition Changes in Morbidly Obese Taiwanese Patients with Different Bariatric Surgeries: A 1-Year Follow-up Study. Obes Surg. 2014;24(4):572–7.CrossRefPubMed Cheng I-C, Wei S-C, Yeh S-L, Wang W. Comparison of Weight Loss and Body Composition Changes in Morbidly Obese Taiwanese Patients with Different Bariatric Surgeries: A 1-Year Follow-up Study. Obes Surg. 2014;24(4):572–7.CrossRefPubMed
21.
go back to reference Wells JCK. Sexual dimorphism of body composition. Best Pract Res Clin Endocrinol Metab. 2007;21(3):415–30.CrossRefPubMed Wells JCK. Sexual dimorphism of body composition. Best Pract Res Clin Endocrinol Metab. 2007;21(3):415–30.CrossRefPubMed
23.
go back to reference Peterli R, Steinert RE, Woelnerhanssen B, et al. Metabolic and hormonal changes after laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: A randomized, prospective trial. Obes Surg. 2012;22(5):740–8.CrossRefPubMedPubMedCentral Peterli R, Steinert RE, Woelnerhanssen B, et al. Metabolic and hormonal changes after laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: A randomized, prospective trial. Obes Surg. 2012;22(5):740–8.CrossRefPubMedPubMedCentral
24.
go back to reference Tymitz K, Engel A, McDonough S, Hendy MP, Kerlakian G. Changes in ghrelin levels following bariatric surgery: Review of the literature. Obes Surg. 2011;21(1):125–30.CrossRefPubMed Tymitz K, Engel A, McDonough S, Hendy MP, Kerlakian G. Changes in ghrelin levels following bariatric surgery: Review of the literature. Obes Surg. 2011;21(1):125–30.CrossRefPubMed
25.
go back to reference Takiguchi S, Murakami K, Yanagimoto Y, et al. Clinical application of ghrelin in the field of surgery. Surg Today; 2015;45(7):801–7.CrossRefPubMed Takiguchi S, Murakami K, Yanagimoto Y, et al. Clinical application of ghrelin in the field of surgery. Surg Today; 2015;45(7):801–7.CrossRefPubMed
Metadata
Title
Sleeve Gastrectomy and Roux-En-Y Gastric Bypass Lead to Comparable Changes in Body Composition in a Multiethnic Asian Population
Authors
Guowei Kim
Chuen Seng Tan
Kah Wei Tan
Serene P. Y. Lim
Jimmy B. Y. So
Asim Shabbir
Publication date
01-03-2019
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 3/2019
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-018-3920-9

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