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

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/m 2 , 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/m 2), estimated visceral adipose area (235.8 ±70.0 vs. 126.5 ±50.4 cm 2), lean mass index (22.1 ±2.4 vs. 18.1 ±2.3 kg/m 2), appendage lean mass index (9.7 ±1.3 vs. 7.7 ±1.1 kg/m 2), 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.

Efficacy and safety of endoscopic sleeve gastroplasty and laparoscopic sleeve gastrectomy with 12+ months of adjuvant multidisciplinary support

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Obesity is Not Associated with Perioperative Adverse Events in Patients Undergoing Complex Revision Surgery for the Thoracolumbar Spine

“…Furthermore, studies have shown that although bariatric surgery is effective at lowering the BMI, this procedure may also induce sarcopenia post-operatively. 22,23 Thus, with the known risks of sarcopenia shown within our study, it may be inadvisable to recommend bariatric surgery to improve BMI prior to undergoing complex revision thoracolumbar spine surgery.…”

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“…The necessity of controlling diabetes treatment and dietary recommendations is widely known. However, it should not be forgotten that the consequences of the bariatric surgery bring the need to monitor a wide range of factors, such as the psychological aspect, the level of physical activity [ 10 ], and even the risk assessment of a planned pregnancy [ 11 ].…”