Wang Xiaoqiang, Shu Xufeng, Pei Wenguang, Yuan Chendong, Su Xujie, Xiong Jianbo, Chen Wenzheng, Zhang Guoyang, Jie Zhigang, Liu Yi
Department of General Surgery, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330000, People's Republic of China.
Department of Abdominal Tumor Surgery, Jiangxi Cancer Hospital, Nanchang, 330000, People's Republic of China.
Diabetes Metab Syndr Obes. 2025 Aug 2;18:2655-2665. doi: 10.2147/DMSO.S511845. eCollection 2025.
Sarcopenic obesity (SO) presents a significant public health challenge. Although the prevalence of SO is on the rise, there is a notable paucity of research examining the impact of SO on weight loss efficacy following laparoscopic sleeve gastrectomy (LSG).
To investigate the impact of SO on weight loss outcomes and recurrent weight gain following LSG.
We retrospectively gathered clinical data of 104 patients with obesity who underwent LSG in our hospital between January 2020 and September 2023. The ratio of fat mass to lean mass ≥0.8 was calculated for SO. Among them, the SO group (n=34) and the non-sarcopenic obesity (NSO) group (n=70), and the effect of SO on weight loss outcomes and recurrent weight gain were comparatively analyzed.
Within one year after LSG, SO patients had an apparently higher average body mass index, excess body mass index, and lower average percentage of excess weight loss than NSO patients (P<0.05). Furthermore, NSO patients had a statistically striking optimal weight loss rate more than SO patients in the first year after surgery (58.6% vs 35.3%, P=0.026). Within two years after LSG, SO patients had a lower occurrence rate of recurrent weight gain than NSO patients. Nonetheless, this difference was not statistically significant (P=0.212). Additionally, diabetes was an independent risk factor for recurrent weight gain postoperatively in patients with obesity when both univariate and multivariate analyses were conducted (P<0.05).
SO adversely affects short-term weight loss outcomes after LSG. However, the effect of SO on postoperative recurrent weight gain was not statistically significant, indicating that further research is needed. Furthermore, diabetes is an independent risk factor for postoperative recurrent weight gain in patients with obesity.
肌少性肥胖(SO)是一项重大的公共卫生挑战。尽管SO的患病率呈上升趋势,但关于SO对腹腔镜袖状胃切除术(LSG)后体重减轻疗效影响的研究却明显匮乏。
探讨SO对LSG后体重减轻结果及体重反复增加的影响。
我们回顾性收集了2020年1月至2023年9月期间在我院接受LSG的104例肥胖患者的临床资料。计算脂肪量与瘦体量之比≥0.8以诊断SO。其中,SO组(n = 34)和非肌少性肥胖(NSO)组(n = 70),比较分析SO对体重减轻结果及体重反复增加的影响。
LSG后1年内,SO患者的平均体重指数、超重体重指数明显高于NSO患者,平均超重体重减轻百分比低于NSO患者(P<0.05)。此外,术后第一年NSO患者的最佳体重减轻率在统计学上显著高于SO患者(分别为58.6%和35.3%,P = 0.026)。LSG后2年内,SO患者体重反复增加的发生率低于NSO患者。然而,这种差异无统计学意义(P = 0.212)。此外,单因素和多因素分析均显示,糖尿病是肥胖患者术后体重反复增加的独立危险因素(P<0.05)。
SO对LSG后的短期体重减轻结果有不利影响。然而,SO对术后体重反复增加的影响无统计学意义,表明需要进一步研究。此外,糖尿病是肥胖患者术后体重反复增加的独立危险因素。