Influência do nível de atividade física na composição corporal e gasto energético em pacientes submetidos à cirurgia bariátrica

• Ano de defesa: 2012
• Autor(a) principal: Hintze, Luzia Jaeger
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Estadual de Maringá; Brasil; Programa de Pós-Graduação Associado em Educação Física - UEM/UEL; UEM; Maringá, PR; Centro de Ciências da Saúde
• Palavras-chave em Português: Obesidade; Cirurgia gástrica; Sarcopenia; Obesidade sarcopênica; Gordura abdominal; Taxa metabólica basal; Ciências da Saúde; Educação Física
• Link de acesso: http://repositorio.uem.br:8080/jspui/handle/1/2229

Bariatric surgery (BS) is a method of treatment of severe obesity that has received attention in recent years mainly by two factors: increasing incidence of obesity and extreme obesity and the good results, especially for patients requiring great weight loss. One of the main advantages of this method is the marked weight loss and the long term maintenance related to resolution of comorbidities. However, in Brazil, there are few studies on the effects of this procedure on body composition and resting metabolic rate of these patients. Moreover, little is known about the influence of physical activity level (PAL) in reducing visceral adipose tissue (VAT), prevalence of sarcopenic obesity and energy expenditure in patients undergoing BS. In this sense the study aimed to: analyze the influence of the PAL in VAT, prevalence of sarcopenic obesity and energy expenditure in BS patients and in one equivalent group not operated. Methods: 91 subjects, divided in two groups: G1 - operated group (n = 50) and G2 - Non-operated group (n = 41). The first group consisted of BS patients underwent to mixed techniques (Fobi-Capella and Gastric Bypass) and the second group was selected by convenience following the search for equivalence considering gender, age and current BMI range. In order to analyze the effects of time after BS the subject operated were categorized into two groups: a) BS between 36 and 96 months, b) BS for more than 97 months. Anthropometric variables were measured (weight, height, waist and hip circumference), body composition by DXA, the PAL at work and at leisure (questionnaire proposed by Larsson et al., 2004 - validated for individuals with different BMI ranges) and by the RMR metabolic gas analyzer VO2000. With the results of the assessment of body composition from DXA were calculated: the prevalence of sarcopenia among the obese subjects using the criteria proposed by Oliveira et al. (2011) and the estimation of visceral abdominal fat was done as proposed by Kaul et al. (2012). All evaluations were performed at the Multidisciplinary Center for the Study of Obesity (NEMO) from the State University of Maringa. Statistical analyzes involving measures of central tendency and dispersion. The inferential was performed by normality testing, from which were defined the parametric or nonparametric appropriate procedures. We applied the Student t test for independent samples and nonparametric Mann-Whitney tests for testing the null hypothesis (H0) that there was no significant difference between groups in demographics, body composition, ventilatory and energy expenditure. It was also used the chi-square and Fisher's exact test to verify whether there was association between categorical variables of the study and to analyze the magnitude of these associations, we used Poisson regression with robust adjustment of variance. Statistical significance was set at p <0.05 for all tests. There were no significant differences in anthropometric variables, body composition and energy expenditure when compared to G1 and G2. Comparing the groups operated between 36 and 96 months and 97 months or more, there were differences in anthropometric variables, body fat and sarcopenic obesity. It was found that patients operated over 97 months were 1.28 (95% CI 1.08 to 1.51, SD 0.108) likely to have sarcopenic obesity in relation to the BS patients with shorter interval after the operation. There were no associations between PAL and sarcopenic obesity and PAL and classification of fat%. However, there were differences in anthropometric and body composition of the active group compared with the group not active. The study results support the BS as an important strategy for morbidly obesity people since the body composition did not differ among BS patients from a matched group not operated. Our data suggest that factors other than age should interfere in the loss of lean tissue and the appearance of sarcopenic obesity, as the BS and the time since BS. Moreover, the results indicate that BS was not enough to change the PAL in patients.