Nutrients · 12 authors, 7 centres
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This longitudinal cohort study assessed body composition and metabolic changes in 83 patients for up to 24 months after sleeve gastrectomy, finding that fat mass loss was progressive over 12 months while lean tissue mass loss was concentrated in the first month. The study's main limitation is the high attrition rate, with only 60 of 83 patients completing the 24-month follow-up.
This longitudinal study investigated the kinetics of body composition and metabolic changes in obese patients following sleeve gastrectomy (SG). The background notes that while weight loss is a common metric, changes in fat mass (FM) and lean tissue mass (LTM) are more clinically relevant. The study followed 83 patients (mostly women) with measurements at baseline, 1, 12, and 24 months post-SG. Key results showed significant weight loss (~29% at 12 and 24 months). The change in body composition followed a biphasic pattern: an acute, concomitant loss of FM and LTM in the first month (both ~8-10% reduction), followed by a more sustained FM loss over 12 months (total ~42.7% reduction in whole-body FM) versus a lesser LTM loss (~19.4%). Visceral adipose tissue (VAT) decreased progressively. Biological markers improved, with reductions in CRP, HOMA-IR, and HbA1c. IGF-1 initially decreased but increased above baseline by 12 months, while IGFBP-3 remained lower. Resting energy expenditure (REE) decreased by 23.2% at 12 months and stabilized. Importantly, no significant further loss in FM, LTM, or metabolic parameters occurred between 12 and 24 months. A primary limitation is the high dropout rate, with only 60 patients completing the 24-month assessment. The study did not collect detailed data on diet or physical activity. The implications suggest that the first month post-surgery is critical for LTM loss, and strategies to preserve muscle mass during this period may be important for long-term metabolic health and weight maintenance.
