Body Composition & REE Responses to Bariatric Surgeries

身体构成

• 批准号: 6987504
• 负责人: DYMPNA GALLAGHER
• 金额: $ 62.48万
• 依托单位: ST. LUKE'S-ROOSEVELT INST FOR HLTH SCIS
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-30 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6987504
• 关键词: African American; adipose tissue; bioenergetics; body composition; body weight; bone density; caucasian American; clinical research; heart function; hormone regulation /control mechanism; human subject; longitudinal human study; magnetic resonance imaging; obesity; postoperative state; stomach /intestine bypass; striated muscles; thermogenesis; weight loss

DESCRIPTION (provided by applicant): Important unanswered questions surround the nature of body composition and resting energy expenditure (REE) after substantial and sustained weight loss by severely obese persons. The LABS population is well suited for the study of these questions in that: they are of a degree of fatness rarely studied, which allows us to test and extend the range of applicability of current knowledge; they will undergo massive weight loss; the weight loss is likely to be sustained over a long period of time thereby allowing for adaptations of organ and tissue mass and fat redistribution to occur; the surgical interventions achieve their effects by different degrees of restriction and malabsorption, providing an opportunity to determine whether and how this dimension affects body composition and thermogenesis. The composition of weight loss under usual negative energy balance conditions in overweight and moderately obese persons is typically 70-80% fat and 20-30% lean tissues, however it is likely that the composition of weight loss in extremely obese persons may be different. We will analyze the composition of body weight in LABS patients undergoing rapid and large changes in weight using advanced body composition models and measurement methods. Using MRI, we will describe body composition changes at the tissue and organ level and adipose tissue distribution allowing us to address questions of biological and clinical importance including the body composition changes influences on REE. The Specific Aims are to: 1) identify the clinically important components of weight change in persons undergoing different types of bariatric surgery on fat mass and its distribution, and on fat-free mass (FFM); including bone mineral density (BMD), skeletal muscle, and specific organs at baseline and two time-points post surgery, and whether these are related to the type of surgery; 2) measure the change in REE following surgery induced weight loss and determine its relation to type of surgery, to changes in body composition compartments, and its duration over the follow-up. Secondary research questions relate to changes in cardiac structure and function, psychological functioning, and hormonal (ghrelin, leptin, insulin) levels associated with massive weight loss. Consenting, eligible LABS patients from Columbia University-Weill Cornell and the University of Pittsburgh will undergo some combination of the following measures: total body water by deuterium dilution (fat and FFM), extracellular water by sodium bromide tracer, body density by the BodPod, whole-body MRI (adipose tissue and its distribution; skeletal muscle mass; mass of liver, kidneys, heart, and brain), dual energy-X-ray absorptiometry (hip BMD, total body fat, FFM, and bone mineral content), and REE. Subjects will be African-American and Caucasian women and men (n=106; 50 percent (35>BMI kg/m2<45) will undergo MRI studies before surgery and one and two years later; 50 percent (45>BMI kg/m2<60) will have MRI only post surgery) equally distributed between the New York and Pittsburgh sites, and equally distributed across 3 surgical procedures: gastric banding; biliary pancreatic diversion and duodenal switch; and Roux-en-Y gastric bypass.

描述（由申请人提供）： 重要的未解决的问题围绕着身体成分和静止能量消耗（REE）的性质，这是在严重肥胖的人严重减轻体重之后。实验室人群非常适合研究这些问题：他们的肥胖程度很少，这使我们能够测试和扩展当前知识的适用性范围；他们将承受大量的体重减轻；体重减轻可能会在很长一段时间内持续，从而使器官和组织质量和脂肪重新分布的适应。手术干预措施通过不同程度的限制和吸收不良来实现其作用，提供了确定该维度是否影响身体组成和热生成的机会。在超重和中度肥胖者中通常的负能量平衡条件下，体重减轻的组成通常为70-80％的脂肪和20-30％的瘦肉组织，但是极度肥胖者的体重减轻的组成可能会有所不同。我们将使用先进的身体组成模型和测量方法分析实验室患者的体重组成。使用MRI，我们将描述组织和器官水平的身体组成变化以及脂肪组织分布，从而使我们能够解决生物学和临床重要性问题，包括人体成分变化对REE的影响。具体目的是：1）确定接受不同类型的减肥手术对脂肪质量及其分布以及无脂肪质量（FFM）的体重变化的临床重要组成部分；包括骨矿物质密度（BMD），基线和手术后两个时间点时的骨骼肌和特定器官，以及这些是否与手术类型有关； 2）衡量手术后REE的变化引起的体重减轻，并确定其与手术类型的关系，与身体组成室的变化以及随访的持续时间。二级研究问题与心脏结构和功能，心理功能的变化以及与大规模体重减轻相关的激素（生长素蛋白，瘦素，胰岛素）水平有关。 Consenting, eligible LABS patients from Columbia University-Weill Cornell and the University of Pittsburgh will undergo some combination of the following measures: total body water by deuterium dilution (fat and FFM), extracellular water by sodium bromide tracer, body density by the BodPod, whole-body MRI (adipose tissue and its distribution; skeletal muscle mass; mass of liver, kidneys, heart, and大脑），双能X射线吸收法（髋关节BMD，全身脂肪，FFM和骨矿物质含量）和REE。受试者将是非裔美国人和高加索的女性（n = 106; 50％; 50％（35> BMI kg/m2 <45）将在手术前接受MRI研究，一年和两年后； 50％（45> bmi kg/m2 <60）将在纽约和皮特斯堡（pittsburger）之间均等分配MRI在手术后同等分布。乐队胆道胰腺转移和十二指肠开关；和roux-en-y胃旁路。