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Bariatric Surgery Outcomes in Sarcopenic Obesity

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Abstract

Background

Sarcopenic obesity is the combination of low muscle mass and strength with increased fat mass. This condition is associated with negative health outcomes. We hypothesized that sarcopenia could be a pejorative factor on surgical weight loss.

Objective

The objectives of the study are to determine the influence of sarcopenic obesity on gastric bypass and sleeve gastrectomy results regarding weight loss and comorbidities resolution at 3, 6, and 12 months.

Setting

The study was conducted at the University Hospital.

Methods

Sixty-nine obese patients who benefited from bariatric surgery were included. Skeletal muscle mass was determined by the Janssen’s equation. Physical performance and muscle strength were determined using the 6-min walk test and the wall sit test. Obese subjects from the lowest tertile of the Skeletal Muscle mass Index (SMI) of Baumgartner were set as sarcopenic.

Results

Weight loss outcomes and rate of weight loss failure were not influenced by sarcopenia. At 1 year, mean EBMIL% was 75.4 % ± 5 in sarcopenic subjects vs 67.8 % ±4 in the non-sarcopenic subjects (p = 0.242). Improvement rates of co-morbidities were similar between groups. Skeletal muscle mass was no more different between groups at 1 year after surgery. There was no patient lost to follow-up.

Conclusions

Bariatric surgery remains effective in achieving weight loss target in sarcopenic patients, with similar remission rates of main comorbidities and similar safety profile than in the non-sarcopenic group. Whether bariatric surgery could result in improvement or deterioration of daily living activities disabilities and functional autonomy in sarcopenic obese patients still have to be evaluated.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolic disease, Institute of Internal Medicine, University of Cagliari, Monserrato, 09045, Cagliari, Italy

    Diego Mastino

  2. Department of Endocrinology Diabetology and Nutrition, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, F69495, Pierre Bénite, France

    Diego Mastino, Cecile Betry, Martine Laville & Emmanuel Disse

  3. Department of Digestive Surgery, Center of Bariatric Surgery, Hopital Edouard Herriot, Hospices Civils de Lyon, F69437, Lyon, France

    Maud Robert & Christian Gouillat

  4. Fédération Hospitalo-Universitaire DO-IT. Centre Intégré et Spécialisé de L’Obésité de Lyon. CRNH-RA, Hospices Civils de Lyon, Lyon, France

    Maud Robert, Cecile Betry, Martine Laville, Christian Gouillat & Emmanuel Disse

  5. University Claude Bernard Lyon 1, Lyon, France

    Maud Robert, Cecile Betry, Martine Laville, Christian Gouillat & Emmanuel Disse

Authors
  1. Diego Mastino
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  2. Maud Robert
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  3. Cecile Betry
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  4. Martine Laville
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  5. Christian Gouillat
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  6. Emmanuel Disse
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Corresponding author

Correspondence to Emmanuel Disse.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in that study were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent was not required.

Informed Consent

Informed consent does not apply in this study.

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Mastino, D., Robert, M., Betry, C. et al. Bariatric Surgery Outcomes in Sarcopenic Obesity. OBES SURG 26, 2355–2362 (2016). https://doi.org/10.1007/s11695-016-2102-7

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  • DOI: https://doi.org/10.1007/s11695-016-2102-7

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