Lean mass and strength profile of women submitted to bariatric surgery: comparison of the EWGSOP2 and FNIH classification for sarcopenia – ASBS program phase II

Abstract

Aim: To assess the effect of bariatric surgery on the lean mass of women after one year of the procedure, comparing its outcomes upon the classification from both the Foundation of the National Institutes of Health (FNIH) and the European Working Group on Sarcopenia in the Elderly People (EWGSOP). Material and methods: Twenty-eight obese women aged 40.5 ± 9.8 yrs who underwent Roux-en-Y gastric bypass (RYGB) were included. 27 of them were reassessed after 6 months of surgery, and 16 completed the one-year follow-up. Pre-sarcopenia condition was assessed through a handgrip strength test and body composition by dual-energy X-ray absorptiometry (DXA). Total body mass, body mass index, and lean mass (LM) were collected prior to, 6 and 12 months after RYGB surgery. Results: All subjects reassessed after 12 months were diagnosed with pre-sarcopenia according to the FNIH classification criteria, while according to the EWGSOP2 Consensus they presented normal values. LM represented 14% of the influence on handgrip strength (p = .049) after 6 months of surgery; however, its influence on strength after 12 months increased to 30% (p = .028). Conclusion: The FNIH classification is the most effective criteria since it uses LM content as the first test, considering that strength capacity needs more time to be affected by the surgical procedure. On the other hand, the EWGSOP2 classification should not be applied to determine the loss of LM in younger populations regardless of what may have caused such changes.

摘要

目的

通过比较美国国家卫生研究院基金会（FNIH）和欧洲老年人肌肉减少症工作组（EWGSOP）的分类结果, 评估减肥手术对手术一年后女性瘦体重的影响。

材料和方法

28名接受Roux-en-Y胃旁路术（RYGB）的肥胖女性, 年龄40.5±9.8岁。其中27例在手术6个月后重新评估, 16例完成了一年的随访。通过握力测试和双能X射线吸收测定法（DXA）评估肌少症前的情况。在RYGB手术前、术后6个月和12个月收集总体重、体重指数和瘦体重（LM）。

结果

根据FNIH分类标准, 12个月后重新评估的所有受试者均被诊断为前肌减少症, 而根据EWGSOP2共识, 他们表现出正常值。手术6个月后, LM对握力的影响占14%（p=0.049）；然而, 12个月后其对强度的影响增加到30%（p=0.028）。

结论

FNIH分类以LM含量为首要指标, 考虑到强度能力受手术过程的影响需要较长的时间, 是最有效的分型标准。另一方面, 无论是什么原因导致了这种变化, EWGSOP2分类不应用于确定年轻人群中LM的损失。

Keywords:

• Sarcopenia
• bariatric surgery
• obesity
• muscle strength
• lean mass

关键词:

• 肌少症
• 减肥手术
• 肥胖
• 肌肉力量
• 瘦体重

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was funded by CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior).