Energy Expenditure and Gastric-Bypass Surgery

能量消耗和胃绕道手术

• 批准号: 7102114
• 负责人: JAMES A LEVINE
• 金额: $ 54.52万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-06-01 至 2010-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7102114
• 关键词: bariatric surgery; basal metabolism; bioenergetics; body physical activity; caloric dietary content; clinical research; human subject; nutrition related tag; obesity; patient oriented research; stomach /intestine bypass; thermogenesis; weight gain; weight loss

DESCRIPTION (provided by applicant): Obesity is an epidemic with widereaching implications for health and society. Bariatric surgery is a successful therapy for achieving and maintaining weight loss and improving obesity comorbidiities. This study will explore the energetic mechanisms of weight loss in subjects undergoing gastric bypass bariatric surgery, which until now has not been clearly defined. In any scenario where there are substantial changes in energy stores, it is necessary to examine the role of changes in food intake and energy expenditure. After bariatric surgery, it is evident that energy intake declines. However, there is very little information as to how the components of energy expenditure, and in particular activity thermogenesis, change. This is not a trivial issue. In fact, changes in physical activity and activity thermogenesis could be crucial for understanding why some people lose more weight than others with bariatric surgery. Energy balance comprises energy intake and energy expenditure. Energy expenditure includes basal metabolic rate, thermic effect of food, and activity thermogenesis. Activity thermogenesis can be further divided into exercise activity thermogenesis and non-exercise activity thermogenesis (NEAT). The latter is even more difficult to measure than the former. Most Americans, and the vast majority of those with World Health Organization Class III obesity engage in relatively little purposeful exercise, and hence the majority of energy expended in physical activity is through NEAT. The aim of this study is to assess whether activity thermogenesis increases in patients undergoing bariatric surgery post-operatively compared to pre-operatively. We will assess non-exercise activity thermogenesis using a validated Physical Activity Monitoring System and doubly labeled water, immediately pre-operatively and again at 6 and 18 months post-operatively. PAMS has been validated in lean and obese individuals. This is to assess energy expenditure, activity thermogenesis and NEAT during the phase of greatest weight loss and once weight loss has plateaued. This will permit us to address our primary hypothesis that activity thermogenesis as a fraction of total daily energy expenditure increases in patients undergoing bariatric surgery 6 and 12 months post-operatively, compared to pre-operatively. Overall, obesity is a major personal health and health care burden. Bariatric surgery has been shown to be beneficial without a clear understanding of the mechanism. The scientific need exists and the technology is available to uncover the role of activity thermogenesis and energy expenditure in weight loss after bariatric surgery. This may have dramatic implications for bariatric surgery and obesity management in general.

描述（由申请人提供）：肥胖是一种流行病，对健康和社会具有广泛的影响。减肥手术是一种成功的疗法，可实现和维持体重减轻并改善肥胖合并症。这项研究将探讨接受胃旁路减肥手术受试者体重减轻的能量机制，到目前为止尚未明确定义。在能源商店发生实质性变化的任何情况下，都必须检查食物摄入和能量消耗的变化的作用。减肥手术后，很明显能量摄入量会下降。但是，关于能量消耗的组成部分，尤其是活性热发生的信息很少。这不是一个琐碎的问题。实际上，体育活动和活动生热发生的变化对于理解为什么有些人比减肥手术的其他人更大的体重可能至关重要。能源平衡包括能量摄入和能量消耗。能量消耗包括基础代谢率，食物的热效应和活性热发生。活性热发生可以进一步分为运动活性热发生和非运动活性热发生（NEAT）。后者比前者更难衡量。大多数美国人以及拥有世界卫生组织III级肥胖的绝大多数人从事相对较少的有目的的运动，因此在体育活动中花费的大多数能量都是通过整洁的。这项研究的目的是评估术后接受减肥手术的患者与术前相比，接受减肥手术的患者的活性生成是否增加。我们将使用经过验证的体育活动监测系统评估非运动活性的热发生，并在术后6和18个月时在术前和再次标记水。 PAM在精益和肥胖的个体中得到了证实。这是为了评估最大体重减轻阶段的能量消耗，活性热和整洁，并且一旦体重减轻了。这将使我们能够解决我们的主要假设，即在术前6个月和12个月接受减肥手术的患者与术前相比，接受活性的每日能量消耗的一小部分增加。总体而言，肥胖是主要的个人健康和医疗保健负担。减肥手术已被证明是有益的，没有清楚地了解该机制。存在科学需求，该技术可用于揭示活性热和能量消耗在减肥手术后体重减轻中的作用。这可能对减肥手术和肥胖管理具有巨大的影响。