Predictors of fat-free mass loss 1 year after laparoscopic sleeve gastrectomy

  • B. Guida
  • M. Cataldi
  • L. Busetto
  • M. L. Aiello
  • M. Musella
  • D. Capone
  • S. Parolisi
  • V. Policastro
  • G. Ragozini
  • A. Belfiore
Original Article



Laparoscopic sleeve gastrectomy (LSG) is one of the most frequently performed bariatric surgery interventions because of its safety and efficacy. Nevertheless, concerns have been raised on its detrimental effect on patient nutritional state that can ultimately lead to the loss of fat-free mass (FFM). There is interest in identifying predictors for the early identification of patients at risk of this highly unwanted adverse because they could benefit of nutritional preventive interventions. Therefore, we investigated whether anthropometric parameters, body composition or resting energy expenditure (REE) measured before surgery could predict FFM loss 1 year after LSG.


Study design was retrospective observational. We retrieved data on body weight, BMI, body composition and REE before and 1 year after LSG from the medical files of 36 patients operated on by LSG at our institutions. Simple regression, the Oldham’s method and multilevel analysis were used to identify predictors of FFM loss.


Averaged percentage FFM loss 1 year after LSG was 17.0 ± 7.7% with significant differences between sexes (20.8 ± 6.6 in males and 12.2 ± 6.1% in females, p < 0.001). FFM loss was strongly predicted by pre-surgery FFM and this effect persisted also after correcting for the contribution of sex.


High FFM values before surgery predict a more severe FFM loss after LSG. This factor could also account for the higher FFM loss in men than in women. Our finding could help in the early identification of patient requiring a nutritional support after LSG.


Laparoscopic sleeve gastrectomy Fat-free mass Resting energy expenditure BIA Gender difference 


Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

For this type of study formal consent is not required.

Informed consent

No informed consent.


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Copyright information

© Italian Society of Endocrinology (SIE) 2018

Authors and Affiliations

  • B. Guida
    • 1
    • 2
  • M. Cataldi
    • 2
    • 3
  • L. Busetto
    • 4
  • M. L. Aiello
    • 1
  • M. Musella
    • 2
    • 5
  • D. Capone
    • 2
  • S. Parolisi
    • 1
  • V. Policastro
    • 6
  • G. Ragozini
    • 6
  • A. Belfiore
    • 1
    • 2
  1. 1.Division of Physiology, Department of Clinical Medicine and SurgeryFederico II University of NaplesNaplesItaly
  2. 2.Federico II University HospitalNaplesItaly
  3. 3.Division of Pharmacology, Department of Neuroscience, Reproductive Sciences and DentistryFederico II University of NaplesNaplesItaly
  4. 4.Department of MedicineUniversity of PadovaPaduaItaly
  5. 5.Division of Surgery, Department of Advanced Biomedical SciencesFederico II University of NaplesNaplesItaly
  6. 6.Division of Statistics, Department of Political ScienceFederico II University of NaplesNaplesItaly

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