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. 2022 Jun:49:436-441.
doi: 10.1016/j.clnesp.2022.03.009. Epub 2022 Mar 17.

Prevalence of low skeletal muscle mass following bariatric surgery

Judith Molero  1 , Romina Olbeyra  2 , Lilliam Flores  3 , Amanda Jiménez  4 , Ana de Hollanda  4 , Alba Andreu  5 , Ainitze Ibarzabal  6 , Violeta Moizé  3 , Sílvia Cañizares  7 , José María Balibrea  6 , Amadeu Obach  7 , Josep Vidal  8
Affiliations

Prevalence of low skeletal muscle mass following bariatric surgery

Judith Molero et al. Clin Nutr ESPEN. 2022 Jun.

Abstract

Background and aims: Evidence on the occurrence of low skeletal muscle mass (low-SMM) following bariatric surgery (BS) as well as on the impact of low-SMM antedating BS on post-surgical body composition (BC) are scant. In this context, we aimed to prospectively evaluate the prevalence of low-SMM prior to and up to 5 years after BS, and to evaluate pre-surgical low-SMM as an independent risk factor for the presence of low-SMM after BS.

Methods: Retrospective analysis of prospectively collected database. BC was assessed by bioelectrical impedance analysis (BIA). A BIA-based formula was used to calculate skeletal muscle mass (SMM). Class I and class II low-SMM were defined respectively as a SMM index (SMMI = SMM/height2) value between -1 and -2, or > -2 standard deviations from the gender-specific regression line of the BMI versus the SMMI relationship in our reference group.

Results: A total 952 subjects were included, with BC being available for 877 (92%) subjects at 12 months and for 576 subjects (60%) at 60 months after BS. Prior to surgery, and at 12-, or at 60-months after surgery, class I and class II low-SMM was ascertained respectively in 15.6% and 4.6%, 5.3% and 1.4%, and 16.6% and 6.3% of the study participants. Logistic regression analysis showed that the occurrence of low-SMM at 12- and 60-months follow-up, was independently predicted not only by age at the time of surgery [respectively, HR: 1.052 (95% CI 1.020-1.084), p = 0.001; and 1.042 (95% CI 1.019-1.066); p < 0.001] but also by the presence of low-SMM prior to surgery [respectively, HR: 10.717 (95% CI 5.771-19.904), p < 0.001; and 5.718 (95% CI 3.572-9.153); p < 0.001].

Conclusions: Our data suggest that a low-SMM phenotype occurs not only in obesity surgery candidates but also after BS, and that low-SMM prior to surgery is an important risk factor for low-SMM throughout post-surgical follow-up.

Keywords: Gastric bypass; Inflammation; Obesity; Sarcopenia; Sleeve gastrectomy; Weight loss.

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Conflict of interest statement

Declaration of competing interest All authors report no biomedical financial interests or potential conflicts of interest related to this work.

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