EVALUATION OF ENERGY EXPENDİTURE, HORMONE LEVELS AND NUTRITIONAL STATUS OF PATIENTS WITH SLEEVE GASTRECTOMY


Çalapkorur S., Köksal E., Şahin H., Şentürk M.

41. ESPEN Congress, Krakow, Poland, 31 August - 03 September 2019, pp.251-252

  • Publication Type: Conference Paper / Summary Text
  • City: Krakow
  • Country: Poland
  • Page Numbers: pp.251-252
  • Erciyes University Affiliated: Yes

Abstract

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.