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Aspectos nutricionais em obesos antes e após a cirurgia bariátrica Nutrition aspects in obese before and after bariatric surgery

By Isabella Valois Pedrosa, Maria Goretti Pessoa de Araújo Burgos, Niedja Cristina Souza and Caroline Neves de Morais

Abstract

OBJETIVO: Determinar perfil clínico-nutricional de pacientes obesos submetidos à cirurgia bariátrica, no HC/UFPE. MÉTODOS: Foram avaliados retrospectivamente, 205 pacientes, no período 2002/2006. A análise considerou história clínica para diabetes tipo 2 (DM 2), hipertensão arterial (HA) e síndrome metabólica (SM). O estado nutricional pré-operatório foi avaliado pelo IMC e bioquímica (hemoglobina, hematócrito, albumina, proteínas totais, triglicérides (TG), colesterol associado à lipoproteína de alta (HDLc) e baixa (LDLc) densidade e glicemia de jejum (GJ). Nos períodos pós-operatórios (6, 12, 18, 24 meses) a avaliação nutricional foi feita pelas medidas de peso, perda ponderal, percentual de perda de peso (%PP), IMC e bioquímica incluindo ferro, ferritina e transferrina. RESULTADOS: 71,2% eram do sexo feminino, idade de 38,4 ± 9,96 anos, 129,66±27,40 Kg e IMC 48,6 ± 8,9 Kg/m², no pré-operatório. Receberam o diagnóstico de SM 26,8%, HA 52,7% e DM 2 11,7%. A bioquímica revelou TG, LDLc, GJ elevados, estando normais os demais parâmetros. Evolução antropométrica demonstrou perda ponderal progressiva, atingindo aos 24 meses IMC 31,7±5,82 Kg/m² (p< 0,001) e maior %PP (36,05%). Valores de TG, LDLc e GJ atingiram a normalidade a partir do 6° mês pós-operatório: 104,4mg/dL(p=0,018), 95,5mg/dL(p=0,263) e 84,8g/dL(p=0,004), respectivamente; transferrina apresentou valores reduzidos aos 6 meses. Prevalência maior dos sintomas ocorreu no 6° mês: alopécia (19%), vômitos (18%), intolerância alimentar (12,2%). CONCLUSÃO: A Cirurgia bariátrica foi um procedimento eficaz para promover perda ponderal e sua manutenção por dois anos, assim como melhora de parâmetros bioquímicos e co-morbidades, com sintomas clínico-nutricionais reduzidos e/ou evitados por monitorização nutricional.<br>OBJECTIVE: To determine the physical-nutritional profile of obese patients submitted to bariatric surgery at the HC/UFPE. MEHTODS: Two-hundred-and-five patients were evaluated retrospectively during the period of 2002 through 2006. Analysis considered clinical history for diabetes type 2 (DM 2), high blood pressure (HBP) and metabolic syndrome (MS). The preoperative nutritional status was evaluated by MBI and the biochemistry (hemoglobin, hematocrit, albumin, total proteins, triglycerides (TG), cholesterol associated with the lipoprotein of high (HDLc) and low (LDLc) density and fasting glycemia (FG). During the postoperative periods (6, 12, 18, 24 months), we evaluated the nutritional status through measures of weight, weight loss, weight loss percentage (%WL), MBI and biochemistry including iron, ferritin, transferrin. RESULTS: Seventy-one and two-tenth percent were female, age was 38.4 ± 9.96 years, and MBI preoperative was 48.6 ± 8.9 Kg /m2. MS diagnosis was present in 26.8%, HBP was present in 52.7% and DM 2 was detected in 11.7%. The biochemistry disclosed TG, it raised LDLc, and FG, and all other parameters were normal. The anthropometrical evolution demonstrated gradual loss, reaching at the 24 months, MBI 31.7±5.82 Kg/m2 (p< 0.001) and greater %WL, 36%. Values of TG, LDLc and FG reached normality at the 6th postoperative month: 104.4mg/dL(p=0.018), 95.5mg/dL(p=0.263) and 84.8g/dL(p=0.004) respectively; the transferrin showed reduced values at the 6th month. A larger prevalence of the symptoms occurred in 6th month: hair loss (19%), vomiting (18%), and food intolerances (12.2%). CONLCUSION: The bariatric surgery was an efficient procedure to promote weight loss and its maintenance in two years, as well as improvement of biochemical parameters and comorbidities, with reduced clinical-nutritional symptoms and/or prevented by nutritional monitoring

Topics: Cirurgia bariátrica, Obesidade, Obesidade mórbida, Transtornos da alimentação, Síndrome metabólica, Nutrição, Cuidados pré-operatórios, Cuidados pós-operatórios, Bariatric surgery, Obesity, Obesity, morbid, Eating disorders, Metabolic syndrome, Nutrition, Preoperative care, Postoperative care, LCC:Surgery, LCC:RD1-811, LCC:Medicine, LCC:R, DOAJ:Surgery, DOAJ:Medicine (General), DOAJ:Health Sciences
Publisher: Colégio Brasileiro de Cirurgiões
Year: 2009
DOI identifier: 10.1590/S0100-69912009000400008
OAI identifier: oai:doaj.org/article:f50c21ca14ca4076a30bf73696b5cfc8
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