Factors Affecting Muscle Mass Loss Following Laparoscopic Sleeve Gastrectomy and Laparoscopic Mini Gastric Bypass Surgeries

Abstract

Excessive muscle mass loss is common following bariatric surgery due to decreased protein intake. Therefore, this study aimed to examine factors associated with muscle mass loss after three months in patients who underwent Laparoscopic Sleeve Gastrectomy (LSG) and Mini-gastric bypass (MGB) in a bariatric surgery centre in Alexandria, Egypt. An observational study was performed on 50 patients, 25 of whom underwent LSG, whereas 25 underwent MGB. At baseline and after three months, physical activity level, energy and protein intake were assessed. Bioelectric impedance analysis assessed the body composition preoperatively and after three months. The current study's demonstrated that LSG and MGB three months postoperatively lost -17.3 ± 2.8 % and -18.5 ± 3.1 %, respectively, of their weight. Nevertheless, in MGB, patients lost more muscle mass (-17.2±12.4 %) compared to LSG (-11.5 ± 5.6 %) (p=0.063). In MGB, females lost -23.5 ± 11.6 % of their muscle mass compared to -7.9 ± 6.6 % in males (p<0.05). Muscle mass loss in < 60 g protein eaters was higher in MGB than LSG (M ± SD= 20.3 ± 12.5 % vs -13.0 ± 5.3 %, p=0.033). While muscle mass loss in ≥ 60 g protein eaters was -5.6± 1.5 % in LSG and 7.4± 5.9 % in MGB. In conclusion, females in MGB lost more muscle mass than males after three months. Protein intake ≥ 60 g/day during the first three months postoperative is associated with low muscle mass loss. High preoperative HbA1c correlates with muscle mass loss in MGB especially in females . High preoperative Hba1c and protein intake of < 60 g/d are associated with muscle mass loss in LSG.