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

Matej Pekař, Anna Pekařová, Marek Bužga, Pavol Holéczy, Marek Soltes, Matej Pekař, Anna Pekařová, Marek Bužga, Pavol Holéczy, Marek Soltes

Abstract

Introduction: Bariatric procedures lead to changes in body composition. Desired fat loss may be accompanied by decrease of muscle mass, thus raising the risk of sarcopenia.

Aim: To detect the risk of sarcopenia in patients 24 months after different bariatric/metabolic (B/M) procedures by DEXA.

Material and methods: Consecutive patients scheduled for a B/M procedure underwent DEXA scan and anthropometric assessment before and 24 months after surgery in a prospective manner. Obtained data were tested for significant differences (p < 0.05) to detect body composition changes and occurrence of sarcopenia. The International Physical Activity Questionnaire (IPAQ) was answered at 24 months to assess physical activity.

Results: Nineteen patients were enrolled, with no drop-off at follow-up. Body mass index dropped from 42.4 ±6.3 to 30.3 ±4.9 kg/m2, with excess weight loss of 72 ±25% and substantial improvement of all relevant anthropometric measurements (p < 0.001). Significant changes in DEXA parameters were observed: fat mass index (19.5 ±4.7 vs. 12.1 ±3.7 kg/m2), estimated visceral adipose area (235.8 ±70.0 vs. 126.5 ±50.4 cm2), lean mass index (22.1 ±2.4 vs. 18.1 ±2.3 kg/m2), appendage lean mass index (9.7 ±1.3 vs. 7.7 ±1.1 kg/m2), bone mineral content (1.22 ±0.1 vs. 1.12 ±0.1 kg), Z score (2.32 vs. 0.96) and T score (0.58 vs. -0.58). A low level of physical activity was recorded at 24 months.

Conclusions: B/M procedures lead to significant changes in body composition at 24 months after surgery. DEXA detects these changes effectively. Desired fat loss is associated with significant reduction of skeletal muscle and bone mineral mass. As such, patients after B/M surgery are at risk of sarcopenia. A low level of physical activity may also play a negative role.

Keywords: bariatric surgery; dual-energy X-ray absorptiometry; laparoscopy; metabolic surgery; obesity; sarcopenia.

Conflict of interest statement

The authors declare no conflict of interest.

Copyright: © 2020 Fundacja Videochirurgii.

Figures

Figure 1
Figure 1
Fat mass index (FMI), lean mass index (LMI) and appendage lean mass index (ALMI) at baseline and after 24 months *P-value

References

    1. IFSO Obesity consequences | obesity problems [Internet] Available from:
    1. Kuno T, Tanimoto E, Morita S, et al. Effects of bariatric surgery on cardiovascular disease: a concise update of recent advances. Front Cardiovasc Med. 2019;6:94.
    1. WHO Obesity and overweight. Available from: .
    1. Moya-Ramón M, Picó-Sirvent I, Aracil-Marco A. Effects of physical activity programmes in severe obesity before and after bariatric surgery: a current framework. Eur J Hum Mov. 2018;41:103–23.
    1. Spaniolas K, Kasten KR, Celio A, et al. Postoperative follow-up after bariatric surgery: effect on weight loss. Obes Surg. 2016;26:900–3.
    1. Buzgova R, Buzga M, Holeczy P, et al. Evaluation of quality of life, clinical parameters, and psychological distress after bariatric surgery: comparison of the laparoscopic sleeve gastrectomy and laparoscopic greater curvature plication. Bariatr Surg Pract. 2016;11:169–76.
    1. Reoch J, Motillo S, Shimony A, et al. Safety of laparoscopic vs open bariatric surgery: a systematic review and meta-analysis. Arch Surg. 2011;146:1314–22.
    1. Voican CS, Lebrun A, Maitre S, et al. Predictive score of sarcopenia occurrence one year after bariatric surgery in severely obese patients. PLoS One. 2018;13:e0197248.
    1. Tallroth K, Kettunen JA, Kujala UM. Reproducibility of regional DEXA examinations of abdominal fat and lean tissue. Obes Facts. 2013;6:203–10.
    1. Lohman M, Tallroth K, Kettunen JA, et al. Reproducibility of dual-energy X-ray absorptiometry total and regional body composition measurements using different scanning positions and definitions of regions. Metabolism. 2009;58:1663–8.
    1. Barazzoni R, Bischoff S, Boirie Y, et al. Sarcopenic obesity: time to meet the challenge. Obes Facts. 2018;11:294–305.
    1. Dieli-Conwright CM, Courneya KS, Demark-Wahnefried W, et al. Effects of aerobic and resistance exercise on metabolic syndrome, sarcopenic obesity, and circulating biomarkers in overweight or obese survivors of breast cancer: a randomized controlled trial. J Clin Oncol. 2018;36:875–83.
    1. Park J, Kwon Y, Park H. Effects of 24-week aerobic and resistance training on carotid artery intima-media thickness and flow velocity in elderly women with sarcopenic obesity. J Atheroscler Thromb. 2017;24:1117–24.
    1. Gando Y. Carotid artery parameters after combined exercise training in women with sarcopenic obesity. J Atheroscler Thromb. 2017;24:1090–1.
    1. IFSO Body Mass Index. Available from:
    1. Bužga M, Holéczy P, Švagera Z, et al. Laparoscopic gastric plication and its effect on saccharide and lipid metabolism: a 12-month prospective study. Videosurgery Miniinv. 2015;10:398–405.
    1. Bužga M, Holéczy P, Švagera Z, et al. Effects of sleeve gastrectomy on parameters of lipid and glucose metabolism in obese women – 6 months after operation. Videosurgery Miniinv. 2013;8:22–8.
    1. Pluskiewicz W, Buzga M, Holeczy P, et al. A comment on “Changes in bone mineral density in women following 1-year gastric bypass surgery” published by Casagrande DS et al. Obes Surg. 2013;23:1885.
    1. Adamczyk P, Buzga M, Holeczy P, et al. Body size, bone mineral density and body composition in obese women after laparoscopic sleeve gastrectomy: a 1-year longitudinal study. Horm Metab Res. 2015;47:873–9.
    1. 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.
    1. IPAQ The IPAQ Group. Guidelines for Data Processing and Analysis of the International Physical Activity Questionnaire. Available from: .
    1. Bužga M, Marešová P, Petřeková K, et al. The efficacy of selected bariatric surgery methods on lipid and glucose metabolism: a retrospective 12-month study. Cent Eur J Public Health. 2018;26:49–53.
    1. Kasalický M, Bařinka A, Čierny M, et al. 10 years of sleeve gastrectomy in the Czech Republic in terms of the surgical procedure. Rozhl Chir. 2016;95:425–31.
    1. Bužga M, Hauptman K, Švagera Z, et al. Metabolic effects of sleeve gastrectomy and laparoscopic greater curvature plication: an 18-month prospective, observational, open-label study. Obes Surg. 2017;27:3258–66.
    1. Nicklas BJ, Penninx BWJH, Ryan A, et al. Visceral adipose tissue cutoffs associated with metabolic risk factors for coronary heart disease in women. Diabetes Care. 2003;26:1413–20.
    1. Brown JC, Harhay MO, Harhay MN. Anthropometrically-predicted visceral adipose tissue and mortality among men and women in the third national health and nutrition examination survey (NHANES III) Am J Hum Biol Off J Hum Biol Counc. 2017;29 doi: 10.1002/ajhb.22898.
    1. Baumgartner R. Body composition in healthy aging. Ann N Y Acad Sci. 2000;904:437–48.

Source: PubMed

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