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Associação entre alterações da composição corporal e o perfil cardiometabólico após cirurgia metabólica e bariátrica
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Resumo(s)
Background: Some evidence suggests that different changes in body composition after
Metabolic and Bariatric Surgery (MBS) may be distinctly associated with specific cardiometabolic
outcomes. However, evidence is scarce and longitudinal studies describing body composition
changes and their association with cardiometabolic markers are warranted.
Objective: To evaluate the association of weight and body composition changes with the
cardiometabolic profile, after MBS, considering a possible heterogeneity between Roux-en-Y
Gastric Bypass (Bypass) and Sleeve Gastrectomy (Sleeve).
Methodology: Longitudinal retrospective study in patients undergoing MBS at CUF Tejo Hospital,
between September 2018 and March 2021.Anthropometric and body composition assessment
data [weight, BMI, Fat Mass (FM) and Skeletal Muscle Mass (SMM)],as well as cardiometabolic
markers [Total Cholesterol (TC), LDL, HDL and VLDL, Triacylglycerols, Fasting Glucose (FG) and
Glycated Haemoglobin A1c], were collected in the electronic medical record from the
preoperative evaluation until the follow-up of 6 months post-surgery, at four time points (pre surgery, 1, 3, and 6 months after surgery). Associations of anthropometric and body composition
changes with cardiometabolic outcomes were estimated by regression coefficients (ẞ) and
respective 95% confidence intervals (95%CI) by separate linear regression models for each marker.
Results: No significant heterogeneity was observed between Bypass and Sleeve on the
association with cardiometabolic markers. One month after surgery, we observed that decreased
weight and BMI were significantly associated with lower HDL cholesterol levels at 3 months (ß=-
2,118 mg/dL; 95%CI: -2,970; -1,267; ß=-7,192 mg/dL; 95%CI: -9,485 ; -4,900, respectively).A decreased
in SMM at 3 months after MBS, was associated with lower HDL cholesterol and TC at 6 months
(ß=-9,612 mg/dL; 95%CI: -13,583; -5,640; ß=-16;296 mg/dL; 95%CI: -29,243; -3,349, respectively). After
adjustment for sociodemographic characteristics, no significant associations were observed with
the remaining cardiometabolic markers.
Conclusion: Weight loss and the corresponding decrease in BMI are associated with a decrease
in HDL cholesterol at 3 and 6 months of follow-up, with loss of SMM being the factor most strongly
associated with this decrease.
Descrição
Palavras-chave
Metabolic and Bariatric Surgery Sleeve Gastrectomy Roux-en-Y Bypass Cardiometabolic Markers Body Composition