The magnitude and progress of lean body mass, fat-free mass, and skeletal muscle mass loss following bariatric surgery: A systematic review and meta-analysis.
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ABSTRACT:
SUBMITTER: Nuijten MAH
PROVIDER: S-EPMC9285034 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:OBJECTIVE:This study investigated changes in fat-free mass (FFM) and skeletal muscle 5 years after surgery in participants from the Longitudinal Assessment of Bariatric Surgery-2 trial. METHODS:A three-compartment model assessed FFM, and whole-body magnetic resonance imaging (MRI) quantified skeletal muscle mass prior to surgery (T0) and 1 year (T1), 2 years (T2), and 5 years (T5) postoperatively in 93 patients (85% female; 68% Caucasian; age 44.2?±?11.6 years) who underwent gastric bypass (RYGB), sleeve gastrectomy, or adjustable gastric band. Repeated-measures mixed models were used to analyze the data. RESULTS:Significant weight loss occurred across all surgical groups in females from T0 to T1. FFM loss from T0 to T1 was greater after RYGB (mean?±?SE: -6.9?±?0.6 kg) than adjustable gastric band (-3.5?±?1.4 kg; P?<?0.05). Females with RYGB continued to lose FFM (-3.3?±?0.7 kg; P?<?0.001) from T1 to T5. A subset of males and females with RYGB and MRI-measured skeletal muscle showed similar initial FFM loss while maintaining FFM and skeletal muscle from T1 to T5. CONCLUSIONS:Between 1 and 5 years following common bariatric procedures, FFM and skeletal muscle are maintained or decrease minimally. The changes observed in FFM and muscle during the follow-up phase may be consistent with aging.
| S-EPMC6014876 | biostudies-literature
Project description:BackgroundLittle is known about the association of changes in two body components, muscle and fat mass, with the risk of cardiovascular disease (CVD) among young adults. We investigated the association of changes in predicted lean body mass index (LBMI), appendicular skeletal muscle mass index (ASMI), and body fat mass index (BFMI) with the development of CVD among young adults.MethodsThis nationwide, population-based cohort study included 3 727 738 young adults [2 406 046 (64.5%) men and 1 321 692 (35.5%) women] aged 20-39 years without a previous history of CVD who underwent two health screening examinations during 2009-2010 and 2011-2012. Using validated and robust prediction equations, we calculated the changes in predicted LBMI, ASMI, and BFMI from the first to the second examinations.ResultsThe mean (SD) age was 32.2 (4.9) years, and 2 406 046 (64.5%) of the participants were men. A total of 23 344 CVD events were detected during 22 257 632 person-years of follow-up. Each 1 kg/m2 increase in predicted LBMI and ASMI change was associated with a reduced risk of CVD among men [adjusted hazard ratio (aHR): 0.86, 95% confidence interval (CI) 0.82-0.91; aHR: 0.76, 95% CI 0.69-0.82, respectively] and women (aHR: 0.77, 95% CI 0.63-0.95; aHR: 0.75, 95% CI 0.59-0.96). Each 1 kg/m2 increase in predicted BFMI change was associated with an increased risk of CVD among men (aHR: 1.16, 95% CI 1.10-1.22) and women (aHR: 1.32, 95% CI 1.06-1.65). In both sexes, decreases in predicted LBMI and ASMI were associated with greater CVD risk, and decreased predicted BFMI was associated with a reduced CVD risk. Those who maintained their BMI between -1 and +1 kg/m2 also had a decreased risk of CVD per 1 kg/m2 increase in predicted LBMI and ASMI change among men (aHR: 0.86, 95% CI 0.80-0.92; aHR: 0.85, 95% CI 0.76-0.95) and women (aHR: 0.62, 95% CI 0.47-0.83; aHR: 0.59, 95% CI 0.44-0.80) and had a greater risk of CVD per 1 kg/m2 increase in predicted BFMI change among men (aHR: 1.17, 95% CI 1.10-1.25) and women (aHR: 1.64, 95% CI 1.20-2.23). Regardless of changes in weight, such as from normal to obese or vice versa, these results were consistent.ConclusionsAmong young adults, increased predicted muscle mass or decreased predicted fat mass were associated with a reduced risk of development of CVD. Decreased predicted muscle mass or increased predicted fat mass were associated with an elevated risk of development of CVD.
| S-EPMC8978024 | biostudies-literature
Project description:PURPOSE:Fat-free mass (FFM) loss is a concerning aspect of bariatric surgery, but little is known about its time-course and factors related with excessive FFM loss. This study examined (i) the progress of FFM loss up to 3 years post-bariatric surgery and (ii) the prevalence and determinants of excessive FFM loss. MATERIALS AND METHODS:A total of 3596 patients (20% males, 43.5?±?11.1 years old, BMI?=?44.2?±?5.5 kg/m2) underwent sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) surgery. Bioelectrical impedance analysis was performed preoperatively and 3, 6, 9, 12, 18, 24 and 36 months post-surgery. Changes in body composition were assessed by mixed model analysis. Prevalence of excessive FFM loss (based on three different cutoff values: ??25%, ??30% and ??35% FFM loss/weight loss (=?%FFML/WL)) was estimated and its determinants were assessed by linear regression analysis. RESULTS:Highest rates of FFM loss were found at 3 and 6 months post-surgery, reflecting 57% and 73% of peak FFM loss, respectively. Prevalence of excessive FFM loss ranged from 14 to 46% at 36 months post-surgery, with an older age (??=?0.14, 95%CI?=?0.10-0.18, P?<?.001), being male (??=?3.99, 95%CI?=?2.86-5.12, P?<?.001), higher BMI (??=?0.13, 95%CI?=?0.05-0.20, P?=?.002) and SG (??=?2.56, 95%CI?=?1.36-3.76, P?<?.001) as determinants for a greater %FFML/WL. CONCLUSION:Patients lost most FFM within 3 to 6 months post-surgery. Prevalence of excessive FFM loss was high, emphasizing the need for more vigorous approaches to counteract FFM loss. Furthermore, future studies should assess habitual physical activity and dietary intake shortly after surgery in relation to FFM loss.
| S-EPMC7305251 | biostudies-literature
Project description:It is recognized that higher height and weight are associated with higher risk of atrial fibrillation or flutter (AF) but it is unclear whether risk of AF is related to body fat, body fat location, or lean body mass.This article reports the Danish population-based prospective cohort Diet, Cancer and Health study conducted among 55,273 men and women 50-64 years of age at recruitment. The associations between bioelectrical impedance derived measures of body composition and combinations of anthropometric measures of body fat distribution and risk of an incident record of AF in the Danish Registry of Patients were investigated.During follow-up (median 13.5 years) AF developed in 1,669 men and 912 women. Higher body fat at any measured location was associated with higher risk of AF. The adjusted hazard ratio (HR) per 1 sex-specific standard deviation (SD) increment in body fat mass was 1.29 (95% confidence interval [CI], 1.24-1.33). Higher lean body mass was also associated with a higher risk of AF. The adjusted HR for 1 sex-specific SD increment was 1.40 (95% CI, 1.35-1.45).Higher body fat and higher lean body mass were both associated with higher risk of AF.
| S-EPMC4169701 | biostudies-literature
Project description:PURPOSE: The purpose of this study was to determine aerobic performance in men with an increased body mass due to (a) high body fat (>21.5%) but with a average (59.0-64.3 kg) lean body mass (HBF group) and (b) high lean body mass (>66.3 kg), but with average body fat (14.0-18.5%) (HLBM group). METHODS: The men in the HBF and HLBM had similar absolute body mass and body mass index (BMI). The aerobic performance was also determined in control group. Methods: Study participants comprised 39 men aged 21.3 ± 1.9 years who did not participate in competitive sports but were recreationally physically active. Participants were divided into three groups. Each group comprised 13 persons. The study involved anthropometric measurements, assessing aerobic performance (VO2max) using an incremental test on a mechanical treadmill. VO2max was expressed in absolute values, relative to body mass (VO2max ⋅ BM(-1)), relative to lean body mass (VO2max ⋅ LBM(-1)), and relative to BM raised by the exponents of 0.75 and 0.67. Body composition was measured using bioelectrical impedance analysis. RESULTS: No statistically significant differences in relative values of VO2max were found between the HBF and HLBM groups, in VO2max ⋅ BM(-1) (50.24 ± 4.56 vs. 53.11 ± 5.45 mL ⋅ kg(-1)), VO2max ⋅ LBM(-1) (65.33 ± 5.63 vs. 63.86 ± 7.13 mL ⋅ kgLBM(-1)), and VO2max ⋅ BM(-0.75) (150.29 ± 13.5 vs. 160.39 ± 16.15 mL ⋅ kg(-0.75)). Values of VO2max ⋅ BM(-1) were significantly lower in the HBF and HLBM groups than in the control group (58.23 ± 5.84 mL ⋅ kg(-1)). CONCLUSION: High body mass, regardless of the cause decreases VO2max ⋅ BM(-1).
| S-EPMC3994154 | biostudies-other
Project description:BackgroundLean / Fat Free Body Mass (LBM) is metabolically involved in active processes such as resting energy expenditure, glucose uptake, and myokine secretion. Nonetheless, its association with insulin sensitivity / resistance / glucose tolerance and metabolic syndrome remains unclear in childhood.MethodsThe current investigation aimed to examine the differences in fat-free mass /lean body mass according to the presence of insulin sensitivity/insulin resistance/glucose tolerance/metabolic syndrome in children. A systematic search was carried out in Medline/PubMed, Embase, Scopus, Web of Science, and SciELO, covering the period from each database's respective start to 21 June 2021. Two researchers evaluated 7111 studies according to the inclusion criteria: original human studies, written in English or Spanish, evaluating fat-free mass/lean body mass in children and adolescents including both with and without insulin sensitivity/insulin resistance /glucose tolerance and metabolic syndrome and reported the differences between them in terms of fat free mass/lean body mass. The results of the studies were combined with insulin sensitivity, insulin, resistance, glucose tolerance and metabolic syndrome. The standardized mean difference (SMD) in each study was calculated and combined using the random-effects model. Heterogeneity between studies was tested using the index of heterogeneity (I2), leave-one-out sensitivity analyses were performed, and publication bias was assessed using the Egger and Begg tests.ResultsFinally, 15 studies which compared groups defined according to different glucose homeostasis criteria or metabolic syndrome out of 103 eligible studies were included in this systematic review and 12 studies in the meta-analysis. Meta-analysis showed lower fat-free mass/lean body mass percentage in participants with insulin resistance/glucose tolerance/metabolic syndrome (SMD -0.47; 95% CI, - 0.62 to - 0.32) while in mass units (kg), higher values were found in the same group (SMD, 1.01; 95% CI, 0.43 to 1.60).ConclusionsOur results identified lower values of fat-free mass/lean body mass (%) in children and adolescents with insulin resistance/glucose tolerance/metabolic syndrome and higher values of fat-free mass/lean body mass when these are expressed in kg. The evidence of the impact of lean mass on children's glucose homeostasis or metabolic syndrome is limited, so future studies research should focus on explaining the effect of fat-free mass/lean body mass on different metabolic outcomes. Moreover, it may be interesting to evaluate the quality (muscle density) or functional (muscle strength) outcomes in addition to both absolute (kg) and relative (%) values in future studies. The systematic review was prospectively registered at PROSPERO (registration number CRD42019124734; available at: http://www.crd.york.ac.uk/prospero [accessed: 05 April 2019]).
| S-EPMC8783460 | biostudies-literature
Project description:An inverse association between body mass index (BMI) and risk of lung cancer has been reported. However, the association of body composition such as fat mass (FM) and lean body mass (LBM) with risk of lung cancer has not been fully investigated. Using two large prospective cohort studies (Nurses' Health Study, 1986-2014; Health Professionals Follow-up Study, 1987-2012) in the United States, we included 100,985 participants who were followed for occurrence of lung cancer. Predicted FM and LBM derived from validated anthropometric prediction equations were categorized by sex-specific deciles. During an average 22.3-year follow-up, 2615 incident lung cancer cases were identified. BMI showed an inverse association with lung cancer risk. Participants in the 10th decile of predicted FM and LBM had a lower risk of lung cancer compared with those in the 1st decile, but when mutually adjusted for each other, predicted FM was not associated with lung cancer risk (adjusted hazard ratio [aHR] = 0.98, 95% confidence interval [CI] 0.72-1.35; P(trend) = 0.97) whereas predicted LBM had an inverse association (aHR = 0.73, 95% CI 0.53-1.00; P(trend) = 0.03), especially among participants who were current smokers or had smoked in the previous 10 years (aHR = 0.55, 95% CI 0.36-0.84; P(trend) = 0.008). In conclusion, BMI was inversely associated with lung cancer risk. Based on anthropometric prediction equations, low LBM rather than low FM accounted for the inverse association between BMI and lung cancer risk.
| S-EPMC7504685 | biostudies-literature
Project description:Background:Severe weight loss through means of bariatric surgery has been associated with loss of muscle mass due to lack of absorption of protein. The aim of this RCT is to investigate the effectiveness of protein supplementation in reducing the risk of developing protein malnutrition and muscle wasting in post-bariatric surgery patients in Qatar. Methods and analysis:The study was based at the Department of bariatric and metabolic surgery, Doha metropolitan and regional areas. It is envisaged that approximately 160 post-bariatric surgery patients will be randomized and followed up for 6 months. These will be males and females obese (BMI >35) Qatari patients between the aged 18-60 years. Subjects with renal or liver disease and those with past history of bariatric surgery will be excluded. By the completion of the trial, patients who took less than 80% of the supplement will be further excluded from the final analysis. Protein supplement (Cubitan,Protein, Nutricia, Netherlands) that contain daily intake of 20 g of protein to be taken orally 3 times a day throughout the study period. The placebo group will receive identical ampule containing zero-protein with exact instructions as per the intervention group. Body weight, muscle and fat mass, total protein, albumin, vit B12, Magnesium and Zinc will be measured at baseline and every follow up/study visit. Study variables will be compared between the 2 groups at different stages of the trial, including baseline, using Sample T-test (paired and unpaired) and the significance level will be confirmed with the 95% confidence interval with alpha error set to 0.05. Ethics and dissemination:Protein supplementation for post-bariatric patients is not yet a standard procedure at Hamad Medical Corporation in Qatar and requires an RCT to establish evidence-based clinical practice guidelines. This study was approved by the Hamad Medical Corporation IRB and MRC committees (approval no. 16433/16). Trial registration:ClinicalTrials.gov NCT03147456 (registration date: 18 April 2017). Strengths and limitations of this study:One major strength of our study is that our population is a distinctive population (Qatari Obese patients) where results from international studies may not apply to the local and unique context. A local study like ours will provide healthcare providers in Qatar an opportunity to ensure good clinical practice and healthy and sustainable weight loss following bariatric surgery.The well-designed double-blinded RCT will almost certainly provide us with the evidence-based clinical practice guideline that we seek as health professionals.One limitation of our study is the slight discrepancy in caloric content of the intervention and the placebo (250 cal and 100 cal, respectively). However, it is the intervention that has the higher caloric content, in which case it may not influence the results in the direction of our hypothesis that protein supplementation leads to lower fat mass and higher muscle mass.Another limitation is that the use of the intervention and the placebo are not objectively measured. However, all efforts will be made to ensure compliance and reporting of consumption of products.A third limitation could be loss to follow up. Participants may cease to participate, particularly, once they have lost "sufficient' weight and gained the fitness to consume any type of foods they desire. This is common in late stages of post-bariatric surgery (beyond 3 months). We feel that this may be a challenge, particularly in reference to our specific population. However, such findings albeit negative, should serve in improving the clinical practice delivered by healthcare providers.
| S-EPMC5789587 | biostudies-literature
Project description:OBJECTIVES:Estimating body mass from skeletal dimensions is widely practiced, but methods for estimating its components (lean and fat mass) are poorly developed. The ability to estimate these characteristics would offer new insights into the evolution of body composition and its variation relative to past and present health. This study investigates the potential of long bone cross-sectional properties as predictors of body, lean, and fat mass. MATERIALS AND METHODS:Humerus, femur and tibia midshaft cross-sectional properties were measured by peripheral quantitative computed tomography in sample of young adult women (n?=?105) characterized by a range of activity levels. Body composition was estimated from bioimpedance analysis. RESULTS:Lean mass correlated most strongly with both upper and lower limb bone properties (r values up to 0.74), while fat mass showed weak correlations (r???0.29). Estimation equations generated from tibial midshaft properties indicated that lean mass could be estimated relatively reliably, with some improvement using logged data and including bone length in the models (minimum standard error of estimate?=?8.9%). Body mass prediction was less reliable and fat mass only poorly predicted (standard errors of estimate ?11.9% and >33%, respectively). DISCUSSION:Lean mass can be predicted more reliably than body mass from limb bone cross-sectional properties. The results highlight the potential for studying evolutionary trends in lean mass from skeletal remains, and have implications for understanding the relationship between bone morphology and body mass or composition.
| S-EPMC6178563 | biostudies-other
Project description:The interplay between fat mass and lean mass within human metabolism is not completely understood. We aimed to identify specific circulating metabolomic profiles associated with these body composition compartments. Cross-sectional analyses were conducted over 236 adults with overweight/obesity from the Satiety Innovation (SATIN) study. Body composition was assessed by dual-energy X-ray absorptiometry. A targeted multiplatform metabolite profiling approach was applied. Associations between 168 circulating metabolites and the body composition measures were assessed using elastic net regression analyses. The accuracy of the multimetabolite weighted models was evaluated using a 10-fold cross-validation approach and the Pearson's correlation coefficients between metabolomic profiles and body compartments were estimated. Two different profiles including 86 and 65 metabolites were selected for % body fat and lean mass. These metabolites mainly consisted of lipids (sphingomyelins, phosphatidylcholines, lysophosphatidylcholines), acylcarnitines, and amino acids. Several metabolites overlapped between these body composition measures but none of them towards the same direction. The Pearson correlation coefficients between the metabolomic profiles and % body fat or lean mass were 0.80 and 0.79, respectively. Our findings suggest alterations in lipid metabolism, fatty acid oxidation, and protein degradation with increased adiposity and decreased lean body mass. These findings could help us to better understand the interplay between body composition compartments with human metabolic processes.
| S-EPMC8153621 | biostudies-literature