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Abstract(s)
Introdução: A obesidade associa-se a um risco acrescido de desenvolver múltiplas patologias. OAGB é um procedimento misto, pois envolve um componente restritivo e um componente mal absortivo. As técnicas cirúrgicas com componente mal absortivo estão associadas a um aumento do risco de carências nutricionais. Objetivos: Avaliar o estado nutricional e metabólico de pacientes submetidos a OAGB, comparando os momentos pré e pós cirurgia; avaliar a remissão de comorbilidades associadas à obesidade e analisar, os efeitos do procedimento nos défices nutricionais e na perda de peso. Metodologia: Foi realizado um estudo coorte retrospetivo n=43, constituído por ambos os géneros, com idades superiores a 18 anos, que recorreram às consultas de um centro multidisciplinar da doença metabólica, na região de Lisboa e Vale do Tejo entre setembro de 2018 a setembro de 2019, e foram submetidos a OAGB. Tendo sido analisado os parâmetros antropométricos, bioquímicos, metabólicos e a redução da morbilidade associada à obesidade, em 4 momentos de avaliação distintos pré e pós-operatório, aos 3, 6 e 12 meses. Resultados: A amostra foi constituída por 81,4% mulheres e 18,6% homens, com IMC inicial de 41,43 e final de 27,16, e massa gorda inicial 41,10% e final 32,20%. Observou-se uma diminuição na prevalência das comorbilidades associadas à obesidade, HTA, hipercolesterolemia e HDL. Relativamente à prevalência de DM, pré DM2 e TG observou-se uma redução. Os défices de micronutrientes como ácido fólico, ferro e vitamina D apresentaram uma redução ao longo do primeiro ano, contrariamente o défice de cálcio aumentou. 93,3% da amostra teve sucesso cirúrgico. Discussão/Conclusão: O OAGB induz uma perda de peso significativa, originando uma melhoria da morbilidade associada à obesidade. Após cirurgia bariátrica os indivíduos apresentaram uma diminuição na prevalência da maioria dos défices nutricionais à exceção do cálcio. Os pacientes bariátricos devem manter acompanhamento por equipa multidisciplinar especializada a longo prazo de forma a prevenir complicações.
ABSTRACT - Introduction: Obesity is associated with an increased risk of developing multiple pathologies. OAGB is a mixed procedure as it involves a restrictive effect and a malabsorptive effect. Surgical techniques with malabsorptive effects are associated with an increased risk of nutritional deficiencies. Objectives: To evaluate the nutritional and metabolic status of patients undergoing OAGB, comparing pre and post-surgery; evaluate the remission of comorbidities associated with obesity and analyze the effects of the procedure on nutritional deficits and weight loss. Methodology: A retrospective cohort study was carried out (n=43), consisting of both genders, aged over 18 years, who attended the consultations of a multidisciplinary center for metabolic disease, in the region of Lisbon and Vale do Tejo September from 2018 to September 2019, and were submitted to OAGB. Anthropometric, biochemical, and metabolic parameters and the reduction of obesity-associated morbidity were analyzed at 4 different pre and postoperative assessment moments, at 3, 6, and 12 months. Results: The sample consisted of 81.4% women and 18.6% men, with an initial BMI of 41.43 and a final BMI of 27.16, an initial fat mass of 41.10%, and a final 32.20%. There was a decrease in the prevalence of comorbidities associated with obesity, hypertension, hypercholesterolemia, and HDL. Regarding the prevalence of DM, pre-DM2, and TG, remission occurred. Deficits of micronutrients such as folic acid, iron, and vitamin D showed a reduction over the first year, only the calcium deficit increased. 93.3% of the sample had surgical success. Discussion/Conclusion: The OAGB induces significant weight loss, leading to an improvement or remission of the obesity parameters. After bariatric surgery, patients showed a decrease in the prevalence of most nutritional deficits with the exception of calcium. Bariatric patients should maintain long-term follow-up by a specialized multidisciplinary team in order to prevent complications.
ABSTRACT - Introduction: Obesity is associated with an increased risk of developing multiple pathologies. OAGB is a mixed procedure as it involves a restrictive effect and a malabsorptive effect. Surgical techniques with malabsorptive effects are associated with an increased risk of nutritional deficiencies. Objectives: To evaluate the nutritional and metabolic status of patients undergoing OAGB, comparing pre and post-surgery; evaluate the remission of comorbidities associated with obesity and analyze the effects of the procedure on nutritional deficits and weight loss. Methodology: A retrospective cohort study was carried out (n=43), consisting of both genders, aged over 18 years, who attended the consultations of a multidisciplinary center for metabolic disease, in the region of Lisbon and Vale do Tejo September from 2018 to September 2019, and were submitted to OAGB. Anthropometric, biochemical, and metabolic parameters and the reduction of obesity-associated morbidity were analyzed at 4 different pre and postoperative assessment moments, at 3, 6, and 12 months. Results: The sample consisted of 81.4% women and 18.6% men, with an initial BMI of 41.43 and a final BMI of 27.16, an initial fat mass of 41.10%, and a final 32.20%. There was a decrease in the prevalence of comorbidities associated with obesity, hypertension, hypercholesterolemia, and HDL. Regarding the prevalence of DM, pre-DM2, and TG, remission occurred. Deficits of micronutrients such as folic acid, iron, and vitamin D showed a reduction over the first year, only the calcium deficit increased. 93.3% of the sample had surgical success. Discussion/Conclusion: The OAGB induces significant weight loss, leading to an improvement or remission of the obesity parameters. After bariatric surgery, patients showed a decrease in the prevalence of most nutritional deficits with the exception of calcium. Bariatric patients should maintain long-term follow-up by a specialized multidisciplinary team in order to prevent complications.
Description
Mestrado em Nutrição Clínica
Keywords
Nutrição Obesidade Síndroma metabólica Cirurgia bariátrica One Anastomosis Gastric Bypass OAGB Défice nutricional Nutrition Obesity Metabolic syndrome Bariatric surgery Nutritional deficits
Citation
Rodrigues SF. Caracterização da avaliação do estado nutricional e metabólico pré e pós mini bypass gástrico OAGB-MGB [dissertation]. Lisboa: Faculdade de Medicina da Universidade de Lisboa; Escola Superior de Tecnologia da Saúde de Lisboa/Instituto Politécnico de Lisboa; 2021.