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Increased Resting Energy Expenditure/Body Weight and Decreased Respiratory Quotient Correlate with Satisfactory Weight Loss After Sleeve Gastrectomy: a 6-Month Follow-Up

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Abstract

Background

Although bariatric surgery can achieve sustained weight loss, there are major differences in the magnitude of weight change post-operatively. Reduced resting energy expenditure (REE) plays an important role in unsatisfactory weight loss effect by contributing to positive energy balance.

Objectives

To identify pre- and post-surgical predictors related to satisfactory percent of total weight loss (%TWL) in Chinese individuals with obesity after laparoscopic sleeve gastrectomy (LSG).

Methods

A retrospective cohort study was conducted in 97 ethnic Chinese with mean body mass index (BMI) of 37.2 kg/m2, focusing on body composition, anthropometric and metabolic energy expenditure parameters, and %TWL before and 6 months after LSG. Patients were divided post-operatively into those with or without satisfactory %TWL (%TWL ≥ 20%). Multiple stepwise logistic regression analysis was used to identify predictors.

Results

Satisfactory %TWL was achieved in 53 (54.6%) patients 6 months after surgery. The univariate analysis of post-operative variables showed that patients with satisfactory %TWL had significantly higher resting energy expenditure/body weight (REE/BW) and lower respiratory quotient (RQ) than those who did not (P < 0.001). Multiple stepwise logistic regression analysis indicated that REE/BW and RQ were closely associated with satisfactory %TWL (P = 0.004, P = 0.023, respectively). %TWL was positively correlated with changes in BMI, percent of fat-free mass (FFM%), REE/BW, and RQ.

Conclusions

Higher REE/BW and lower RQ resulting from LSG correlated with satisfactory %TWL in Chinese patients with obesity. The maintenance of FFM might be an important factor linking %TWL and REE/BW.

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Acknowledgments

My deepest gratitude goes to Professor Yousheng Li for his constant encouragement and guidance. Without his consistent and illuminating instruction, this study could not have reached its present form.

Funding

This study was supported by Fundamental Research Program Funding of Ninth People’s Hospital affiliated to Shanghai Jiao Tong University School of Medicine (JYZZ022), Ph.D. Innovation Program Funding of Shanghai Jiao Tong University School of Medicine (BXJ201934), Clinical Research Program of Ninth People’s Hospital affiliated to Shanghai Jiao Tong University School of Medicine (JYLJ0130, JYLJ022), Clinical Research Plan of SHDC (No.16CR2005A), Research Project of Pudong New Area Health and Family Planning Commission (PW2018D-01), and Clinical Research MDT Program of Ninth People’s Hospital affiliated to Shanghai Jiao Tong University School of Medicine (201701008).

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Author notes

  1. Kun Li and Lei Zheng contributed equally to this work.

Authors and Affiliations

  1. Department of General Surgery, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, No. 639 Zhizaoju Road, HuangPu District, Shanghai, 200011, China

    Kun Li, Lei Zheng, Feng Zhao, Chengcan Yang, Qiancheng Dai, Bing Wang & Yousheng Li

  2. Discipline Planning Department, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, No. 639 Zhizaoju Road, HuangPu District, Shanghai, 200011, China

    Jing Guo

  3. Clinical Research Center, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, No. 639 Zhizaoju Road, HuangPu District, Shanghai, 200011, China

    Wentao Shi

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  1. Kun Li
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  7. Qiancheng Dai
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  8. Bing Wang
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  9. Yousheng Li
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Correspondence to Bing Wang or Yousheng Li.

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For this type of study (retrospective study) formal consent is not required.

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Informed consent was obtained from all individual participants included in the study.

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Li, K., Zheng, L., Guo, J. et al. Increased Resting Energy Expenditure/Body Weight and Decreased Respiratory Quotient Correlate with Satisfactory Weight Loss After Sleeve Gastrectomy: a 6-Month Follow-Up. OBES SURG 30, 1410–1416 (2020). https://doi.org/10.1007/s11695-019-04308-2

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