Comparative Study of Resting Metabolic Rate and Plasma Amino Acid Profile in Patients Who Underwent Laparoscopic Roux-en-Y Gastric Bypass and Laparoscopic Sleeve Gastrectomy: 6-Month Follow-up Study.

Abstract

Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are the most common techniques for treatment of morbid obesity. However, a few studies have compared the energy expenditure and plasma amino acid profile after LRYGB and LSG. The present study was conducted to assess the resting metabolic rate (RMR) and plasma amino acid profile in obese patients who underwent LRYGB and LSG before and 6months after the surgery in order to compare these changes from baseline between the two procedures. Forty-three adult obese patients participated in this study (LRYGB = 22 and LSG = 21) and were followed up for 6months. RMR was measured by indirect calorimetry. The plasma amino acid profile was determined using high-performance liquid chromatography (HPLC). Mean percent excess weight loss (%WL) were 22.8 ± 4.5% and 23.3 ± 5.7% in LRYGB and LSG, respectively. RMR reduced significantly from baseline by - 459 ± 202kcal/day in LRYGB and - 500 ± 262kcal/day in LSG. RMR reduced beyond the expected decrease in both procedures. A decreasing trend was observed in the plasma concentration of branched-chain amino acids (BCAA), aromatic amino acids (AAA), and amino acid index (AAI) in both techniques. There was no significant difference in weight, RMR analysis, and amino acid change from baseline between LRYGB and LSG. Our results showed that the effects of LRYGB and LSG on RMR and amino acid profile were comparable.