Akademik Veri Yönetim Sistemi
41. ESPEN Congress, Krakow, Polonya, 31 Ağustos - 03 Eylül 2019, ss.251-252
Rationale
The aim of this study
was to evaluate the energy expenditure, hormone levels and nutritional status
of the patients at the first, second and third months after laparoscopic sleeve
gastrectomy (LSG).
Methods
This research
performed on 20 female patients who had laparoscopic sleeve gastrectomy
operation in the medical faculty of Erciyes University. Before the surgery, information
about the demographic and health status of the individuals was obtained with
the help of a questionnaire form. Body analysis and anthropometric measurement of
these patients were performed. Mifflin-St Jeor equation is used for estimation
of resting metabolic rate (1), physical activity level (PAL) of patients indicated
with the usage of the 24-hour physical activity record. The biochemical data of
the patients recorded retrospectively from patient files. The Simplified
Nutritional Appetite Questionnaire (SNAQ) form was used to determine the
appetite score of the individuals. Three-day food consumption record of these
patients analyzed by BeBiS program. Plasma total ghrelin levels were performed
by immunoenzymatic (ELISA) method using a commercial ELISA kit. These process
repeated after the surgery following months of first, second and third. Post-surgical
complications were also evaluated in the postoperative term. The SPSS 25.0 used
for the analysis of the data.
Results
Body weight, BMI, body
fat percentage and amount, body lean tissue mass, total body water, waist, hip
and neck circumference measurements of the patients decreased in the
postoperative term (p<0,05). While
the resting metabolic rate (DMH) of the patients decreased; physical activity
level (PAL) and total energy expenditure (TEH) increased during the follow-up
period (p<0,05). The fasting blood glucose level decreased in the monitoring
term and this decreasing is correlated with the percentage of weight loss (r=-0,472; p<0,05). The level of serum
triglyceride, AST, ALT decreased despite serum albumin, vitamin B12, magnesium,
potassium, calcium and phosphor increased in the postoperative term (p<0,05). Serum TSH levels decreased in the first and
second months after surgery (p<0,05), there was an increase in the
postoperative third month, but this difference was not significant (p>0,05).
Plasma ghrelin hormone decreased during follow-up and there was a significant
and negative correlation between plasma ghrelin levels and total protein and
animal protein intake (r = -0.569; p <0.05). The patients' appetite score
decreased in the first postoperative month (p <0.05) and the increase after
the first month was not significant (p> 0.05). Total energy, dietary fiber,
carbohydrate and micronutrient intake decreased in the postoperative term (p<0,05).
Even protein and fat intake decreased with diet, the percentage of protein and
fat energy increased (p<0,05). In
the first postoperative month, 30% of the patients reported nausea, 10%
vomiting, 15% diarrhea, 70% constipation and 75% fatigue. At the third
postoperative month, 30% of the patients reported nausea, 15% vomiting, 10%
diarrhea, 45% constipation and 70% hair loss.
Conclusions
There were positive changes in anthropometric
measurements, biochemical parameters and activity levels of patients, however
food intakes decreased after LSG. Improvements in metabolic parameters have
been reported in patients with weight loss. In this study, only correlation
detected between ghrelin and protein intake. It was thought that the decrease
in the ghrelin level may be effective in weight loss by increasing protein
intake. After surgery individuals may have some complications. Therefore, these
individuals should be evaluated in terms of long-term complications of surgery.