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Role of nutritional ketosis in the improvement of metabolic parameters following bariatric surgery

World Journal of Diabetes 2022年第1期13卷 54-64页

作者： Fioralba Pindozzi Carlo Socci Massimiliano Bissolati monica marchi Elisabetta Devecchi Alessandro Saibene Caterina Conte Unitàdi Chirurgia Generale Provinciale Ospedale del DeltaLagosanto(FE)44023Italy Transplant and Metabolic/Bariatric Surgery Unit IRCCS Ospedale San RaffaeleMilan 20132Italy Department of General Medicine Diabetes and EndocrinologyIRCCS Ospedale San RaffaeleMilan 20132Italy Department of Human Sciences and Promotion of the Quality of Life San Raffaele Open UniversityRome 00166Italy Department of Endocrinology Nutrition and Metabolic DiseasesIRCCS MultiMedicaMilan 20099Italy

BACKGROUND Ketone bodies(KB)might act as potential metabolic modulators besides serving as energy *** metabolic surgery(BMS)offers a unique opportunity to study nutritional ketosis,as acute postoperative caloric restriction leads to increased lipolysis and circulating free fatty *** To characterize the relationship between KB production,weight loss(WL)and metabolic changes following *** For this retrospective study we enrolled male and female subjects aged 18-65 years who underwent BMS at a single *** on demographics,anthropometrics,body composition,laboratory values and urinary KB were *** Thirty-nine patients had data available for analyses[74.4%women,mean age 46.5±9.0 years,median body mass index 41.0(38.5;45.4)kg/m^(2),fat mass 45.2%±6.2%,23.1%had diabetes,43.6%arterial hypertension and 74.4%liver steatosis].At 46.0±13.6 d post-surgery,subjects had lost 12.0%±3.6%of pre-operative ***-nine percent developed *** with nutritional ketosis were significantly younger[42.9(37.6;50.7)years vs 51.9(48.3;59.9)years,P=0.018],and had significantly lower fasting glucose[89.5(82.5;96.3)mg/dL vs 96.0(91.0;105.3)mg/dL,P=0.025]and triglyceride levels[108.0(84.5;152.5)mg/dL vs 152.0(124.0;186.0)mg/dL,P=0.045]vs those with *** 6 mo,percent WL was greater in those with postoperative ketosis(-27.5%±5.1%vs 23.8%±4.3%,P=0.035).Urinary KBs correlated with percent WL at 6 and 12 *** metabolic changes were *** Our data support the hypothesis that subjects with worse metabolic status have reduced ketogenic capacity and,thereby,exhibit a lower WL following BMS.

关键词： Obesity Ketone bodies Bariatric surgery Weight loss Glucose metabolism Lipid metabolism

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