| Abstrakt: |
Background: Weight regain that begins 12-18 months after laparoscopic gastric bypass has been attributed to changes in resting metabolic rate (RMR), which is largely determined by lean body mass (LBM). An oral supplement containing beta-hydroxy-beta-methylbutyrate, glutamine, and arginine (HMB/Glu/Arg) has helped to restore LBM in cachexia due to cancer and in critically ill trauma patients. The objective of this study was to evaluate the effect of oral HMB/Glu/Arg on LBM and RMR following laparoscopic gastric bypass (LGB). Methods: Patients who underwent LGB were randomized to receive 24 g of HMB/Glu/Arg dissolved in water twice daily for 8 weeks or to receive no supplement. Weight loss, LBM, and RMR were assessed preoperatively, 2 and 8 weeks postoperatively. LBM was determined by dual emission x-ray absorptiometry (DXA) and RMR was measured by indirect calorimetry. Results: Thirty patients were enrolled: 80% white; 20% African American; 96.7% women; mean age 46.9 ± 8.4 years; mean weight 113.4 ± 11.6 kg; and mean body mass index (BMI) 43.3 ± 4.1 kg/m. The experimental and control groups included 14 and 16 patients, respectively, and there was no difference in baseline demographics and characteristics between the two groups. At 8 weeks, weight, BMI, LBM, and RMR significantly decreased by 15.7 ± 2.5 kg, 6.0 ± 1.0 kg/m, 7.8 ± 4.0 kg, and 290.6 ± 234.9 kcal/day, respectively ( P < 0.0001 for each variable). However, when comparing these changes between the two groups, no statistical significance was observed. Conclusions: There is a significant decrease in weight, BMI, LBM, and RMR in all subjects after LGB, and these changes were not affected by the use of HMB/Glu/Arg. Potential preservation of LBM as a result of HMB/Glu/Arg requires further investigation. However, its consumption (78 calories per serving) did not adversely affect weight loss in the experimental group. [ABSTRACT FROM AUTHOR] |
