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A multifaceted and inclusive methodology for the detection of sarcopenia in patients undergoing bariatric surgery: an in-depth analysis of current evidence

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Abstract

Bariatric surgery is widely recognized as the most effective intervention for obesity and offers benefits beyond weight loss. However, not all patients achieve satisfactory weight loss, balanced changes in body composition, and resolution of comorbidities. Therefore, thorough pre- and postoperative evaluations are important to predict success and minimize adverse effects. More comprehensive assessments require broadening the focus beyond body weight and fat measurements to consider quantitative and qualitative evaluations of muscles. Introducing the concept of sarcopenia is useful for assessing the degradative and pathological changes in muscles associated with cardiometabolic function, physical performance, and other obesity-related comorbidities in patients undergoing bariatric surgery. However, there is currently no consensus or definition regarding the research and clinical use of sarcopenia in patients undergoing bariatric surgery. Therefore, this review aimed to define the concept of sarcopenia applicable to patients undergoing bariatric surgery, based on the consensus reached for sarcopenia in the general population. We also discuss the methods and significance of measuring muscle mass, quality, and strength, which are key variables requiring a comprehensive assessment.

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Abbreviations

ALM:

Appendicular lean mass

BIA:

Bioimpedance analysis

BMI:

Body mass index

CT:

Computed tomography

DXA:

Dual-energy X-ray absorptiometry

EASO:

European Association for the Study of Obesity

ESPEN:

European Society for Clinical Nutrition and Metabolism

EWGSOP:

European Working Group on Sarcopenia in Older People

EWGSOP2:

European Working Group on Sarcopenia in Older People, revised in 2018

FNIH:

Foundation for the National Institutes of Health

HU:

Hounsfield units

MRI:

Magnetic resonance imaging

SMI:

Skeletal muscle index

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Funding

Open access funding provided by a grant of Korea University and Yungjin Pharm. Co., Ltd.

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Author notes

  1. Eunhye Seo and Yeongkeun Kwon contributed equally to this study as co-first authors.

Authors and Affiliations

  1. Keimyung University College of Nursing, Daegu, Republic of Korea

    Eunhye Seo

  2. Division of Foregut Surgery, Korea University College of Medicine, 73 Goryeodae- ro, Seongbuk-gu, 02841, Seoul, Republic of Korea

    Yeongkeun Kwon & Sungsoo Park

  3. Center for Obesity and Metabolic Diseases, Korea University Anam Hospital, Seoul, Republic of Korea

    Yeongkeun Kwon & Sungsoo Park

  4. Ministry of Health Jordan, General surgery affiliationision, prince Hamzah hospital, Amman, Jordan

    Ahmad ALRomi

  5. Taif Armed Forces Hospital, Nasr City, Egypt

    Mohannad Eledreesi

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  1. Eunhye Seo
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  3. Ahmad ALRomi
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  4. Mohannad Eledreesi
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  5. Sungsoo Park
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Contributions

All authors contributed to the study conception. The original draft of the manuscript was written by E.S. and Y.K. and the review of the manuscript and supervision were performed by S.P. All authors read and approved the final manuscript.

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Correspondence to Sungsoo Park.

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Seo, E., Kwon, Y., ALRomi, A. et al. A multifaceted and inclusive methodology for the detection of sarcopenia in patients undergoing bariatric surgery: an in-depth analysis of current evidence. Rev Endocr Metab Disord (2024). https://doi.org/10.1007/s11154-023-09864-8

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