FATORES ASSOCIADOS À EVOLUÇÃO DA FORÇA MUSCULAR NO PRÉ E PÓS-OPERATÓRIO DE CIRURGIA BARIÁTRICA E EFETIVIDADE CIRÚRGICA
DOI:
https://doi.org/10.66104/0p39n076Palabras clave:
sarcopenia, cirurgia bariátrica, força muscular, obesidadeResumen
Introdução: A obesidade é uma condição crônica e multifatorial associada a alterações metabólicas e funcionais. A cirurgia bariátrica é uma estratégia eficaz para o controle do peso e das comorbidades, porém ainda existem lacunas quanto às alterações precoces da força muscular após o procedimento, aspecto relevante para a funcionalidade e efetividade cirúrgica. Objetivo: Avaliar fatores associados à evolução da força de preensão manual e à efetividade cirúrgica no pós-operatório de cirurgia bariátrica. Métodos: Este é um estudo do tipo coorte prospectiva com pacientes submetidos à cirurgia bariátrica em hospital público. Foram avaliados força de preensão manual, peso, índice de massa corporal (IMC), nível de atividade física, uso de suplementos proteicos e prática de exercícios de força no período pré-operatório e aos 1 e 3 meses pós-operatórios. A efetividade cirúrgica foi avaliada aos 1 e 3 meses. Resultados: Foram avaliados 52 pacientes. Observou-se redução significativa do peso corporal e do IMC (p<0,001), além de aumento da adesão à suplementação proteica e da prática de exercícios de força ao longo do seguimento. A efetividade cirúrgica foi majoritariamente classificada como boa. Embora as análises pareadas não tenham identificado diferenças significativas nos valores médios da força de preensão manual, os modelos de regressão demonstraram redução significativa da força no pós-operatório em comparação ao período pré-operatório. A efetividade cirúrgica demonstrou uma tendência de redução ao longo do período de seguimento. Conclusão: A CMB promoveu redução significativa do peso e do IMC nos primeiros três meses, sem melhora da força de preensão manual, que apresentou declínio no pós-operatório, independente da idade, suplementação proteica, exercícios de força, do tipo de cirurgia e do IMC pré-operatório. A efetividade cirúrgica não apresentou melhora significativa ao longo do seguimento.
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ALBA, D. L. et al. Changes in Lean Mass, Absolute and Relative Muscle Strength, and Physical Performance After Gastric Bypass Surgery. The Journal of Clinical Endocrinology & Metabolism, v. 104, n. 3, p. 711–720, 16 jan. 2019. DOI: https://doi.org/10.1210/jc.2018-00952
ARTERBURN, D. E. et al. Benefits and Risks of Bariatric Surgery in Adults. JAMA, v. 324, n. 9, p. 879, 1 set. 2020. DOI: https://doi.org/10.1001/jama.2020.12567
Associação Brasileira para o Estudo da Obesidade e da Síndrome Metabólica (ABESO). Diretrizes brasileiras de obesidade 2016. São Paulo: ABESO, 2016.
ATKINS, J. L. et al. Sarcopenic Obesity and Risk of Cardiovascular Disease and Mortality: A Population-Based Cohort Study of Older Men. Journal of the American Geriatrics Society, v. 62, n. 2, p. 253–260, 15 jan. 2014. DOI: https://doi.org/10.1111/jgs.12652
BLÜHER, M. Obesity: global epidemiology and pathogenesis. Nature Reviews Endocrinology, v. 15, n. 5, p. 288–298, 27 fev. 2019. DOI: https://doi.org/10.1038/s41574-019-0176-8
CARVALHO, A. DA S.; ROSA, R. DOS S. Cirurgias bariátricas realizadas pelo Sistema Único de Saúde no período 2010-2016: estudo descritivo das hospitalizações no Brasil*. Epidemiologia e Serviços de Saúde, v. 28, n. 1, abr. 2019. DOI: https://doi.org/10.5123/S1679-49742019000100023
CRUZ-JENTOFT, A. J. et al. Sarcopenia: Revised European Consensus on Definition and Diagnosis. Age and Ageing, v. 48, n. 1, p. 16–31, 1 jan. 2019.
CURRIER, B. S. et al. Resistance training prescription for muscle strength and hypertrophy in healthy adults: a systematic review and Bayesian network meta-analysis. British Journal of Sports Medicine, v. 57, n. 18, 6 jul. 2023. DOI: https://doi.org/10.1136/bjsports-2023-106807
HAN NA JUNG et al. Preserved Muscle Strength Despite Muscle Mass Loss After Bariatric Metabolic Surgery: a Systematic Review and Meta-analysis. Obesity Surgery, v. 33, n. 11, p. 3422–3430, 20 set. 2023. DOI: https://doi.org/10.1007/s11695-023-06796-9
HERRING, L. Y. et al. Changes in physical activity behaviour and physical function after bariatric surgery: a systematic review and meta-analysis. Obesity Reviews, v. 17, n. 3, p. 250–261, 18 jan. 2016. DOI: https://doi.org/10.1111/obr.12361
JUNQUERA BAÑARES, S. et al. Evaluation of quality of life, weight loss and evolution of comorbidities at 6 years after bariatric surgery. Endocrinologia, Diabetes Y Nutricion, v. 68, n. 7, p. 501–508, 1 ago. 2021. DOI: https://doi.org/10.1016/j.endien.2021.11.010
LAURETANI, F. et al. Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. Journal of Applied Physiology, v. 95, n. 5, p. 1851–1860, nov. 2003. DOI: https://doi.org/10.1152/japplphysiol.00246.2003
LEONG, D. P. et al. Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. The Lancet, v. 386, n. 9990, p. 266–273, jul. 2015. DOI: https://doi.org/10.1016/S0140-6736(14)62000-6
LIM, S. et al. Sarcopenic Obesity: Prevalence and Association With Metabolic Syndrome in the Korean Longitudinal Study on Health and Aging (KLoSHA). Diabetes Care, v. 33, n. 7, p. 1652–1654, 11 maio 2010. DOI: https://doi.org/10.2337/dc10-0107
LUZ, E. R. Nível habitual de atividade física em indivíduos após cirurgia bariátrica na cidade de Vitória da Conquista-BA. Revista Brasileira de Obesidade, Nutrição e Emagrecimento, v. 5, n. 29, set. 2012.
MARTÍNEZ, M. C. et al. The Impact of Bariatric Surgery on the Muscle Mass in Patients with Obesity: 2-Year Follow-up. Obesity Surgery, v. 32, n. 3, p. 625–633, 30 nov. 2021. DOI: https://doi.org/10.1007/s11695-021-05815-x
MARTÍNEZ, M. C. et al. The Impact of Bariatric Surgery on the Muscle Mass in Patients with Obesity: 2-Year Follow-up. Obesity Surgery, v. 32, n. 3, p. 625–633, 30 nov. 2021. DOI: https://doi.org/10.1007/s11695-021-05815-x
MATSUDO, S. et al. QUESTIONÁRIO INTERNACIONAL DE ATIVIDADE FÍSICA (IPAQ): ESTUDO DE VALIDADE E REPRODUTIBILIDADE NO BRASIL. Revista Brasileira de Atividade Física & Saúde, v. 6, n. 2, p. 5–18, 2001.
MECHANICK, J. I. et al. CLINICAL PRACTICE GUIDELINES FOR THE PERIOPERATIVE NUTRITION, METABOLIC, AND NONSURGICAL SUPPORT OF PATIENTS UNDERGOING BARIATRIC PROCEDURES – 2019 UPDATE: COSPONSORED BY AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS/AMERICAN COLLEGE OF ENDOCRINOLOGY, THE OBESITY SOCIETY, AMERICAN SOCIETY FOR METABOLIC & BARIATRIC SURGERY, OBESITY MEDICINE ASSOCIATION, AND AMERICAN SOCIETY OF ANESTHESIOLOGISTS. Endocrine Practice, v. 25, n. 12, 4 nov. 2019. DOI: https://doi.org/10.4158/GL-2019-0406
MENDES, C. et al. How Weight Loss After Bariatric Surgery Affects Sarcopenia Parameters and Diagnosis. Surgeries, v. 6, n. 2, p. 31, 7 abr. 2025. DOI: https://doi.org/10.3390/surgeries6020031
MOHAPATRA, S.; GANGADHARAN, K.; PITCHUMONI, C. S. Malnutrition in obesity before and after bariatric surgery. Disease-a-Month, v. 66, n. 2, p. 100866, fev. 2020. DOI: https://doi.org/10.1016/j.disamonth.2019.06.008
MORALES-MARROQUIN, E. et al. Resistance Training in Post-Metabolic and Bariatric Surgery Patients: a Systematic Review. Obesity Surgery, v. 30, n. 10, p. 4071–4080, 16 jul. 2020. DOI: https://doi.org/10.1007/s11695-020-04837-1
NUIJTEN, M. A. H. et al. The magnitude and progress of lean body mass, fat‐free mass, and skeletal muscle mass loss following bariatric surgery: A systematic review and meta‐analysis. Obesity Reviews, 19 out. 2021. DOI: https://doi.org/10.1111/obr.13370
OKUNOGBE, A. et al. Economic impacts of overweight and obesity: current and future estimates for 161 countries. BMJ Global Health, v. 7, n. 9, set. 2022. DOI: https://doi.org/10.1136/bmjgh-2022-009773
OLIVEIRA, V. D. S. et al. Tendências das cirurgias bariátricas nas Unidades Federativas brasileiras, 2009-2019: um estudo descritivo. Revista do Colégio Brasileiro de Cirurgiões, v. 49, p. e20223335, 4 nov. 2022. DOI: https://doi.org/10.1590/0100-6991e-20223335
ORIA, H. E.; MOOREHEAD, M. K. Bariatric Analysis and Reporting Outcome System (BAROS). Obesity Surgery, v. 8, n. 5, p. 487–499, 1 out. 1998. DOI: https://doi.org/10.1381/096089298765554043
PHELPS, N. H. et al. Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. The Lancet, v. 403, n. 10431, 1 fev. 2024.
RIBEIRO, E. F. et al. Impacto da Cirurgia Bariátrica em Pacientes de Goiás, Brasil, Usando Metodologia BAROS: Um Estudo Preliminar. GE-Portuguese Journal of Gastroenterology, v. 22, n. 3, p. 93–102, 1 jun. 2015. DOI: https://doi.org/10.1016/j.jpge.2015.03.003
ROBERTS, H. C. et al. A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approach. Age and Ageing, v. 40, n. 4, p. 423–429, jul. 2011. DOI: https://doi.org/10.1093/ageing/afr051
SOYSAL, P. et al. Handgrip strength and health outcomes: Umbrella review of systematic reviews with meta-analyses of observational studies. Journal of Sport and Health Science, v. 10, n. 3, jun. 2020. DOI: https://doi.org/10.1016/j.jshs.2020.06.009
SRIKANTHAN, P.; HEVENER, A. L.; KARLAMANGLA, A. S. Sarcopenia Exacerbates Obesity-Associated Insulin Resistance and Dysglycemia: Findings from the National Health and Nutrition Examination Survey III. PLoS ONE, v. 5, n. 5, p. e10805, 26 maio 2010. DOI: https://doi.org/10.1371/journal.pone.0010805
TOMKINSON, G. R. et al. International norms for adult handgrip strength: A systematic review of data on 2.4 million adults aged 20 to 100+ years from 69 countries and regions. Journal of Sport and Health Science, v. 14, p. 101014, 6 dez. 2024. DOI: https://doi.org/10.1016/j.jshs.2025.101042
TURICCHI, J. et al. Associations between the proportion of fat-free mass loss during weight loss, changes in appetite, and subsequent weight change: results from a randomized 2-stage dietary intervention trial. The American Journal of Clinical Nutrition, v. 111, n. 3, p. 536–544, 17 jan. 2020. DOI: https://doi.org/10.1093/ajcn/nqz331
VOICAN, C. S. et al. Predictive score of sarcopenia occurrence one year after bariatric surgery in severely obese patients. PLOS ONE, v. 13, n. 5, p. e0197248, 14 maio 2018. DOI: https://doi.org/10.1371/journal.pone.0197248
WHITE, T. A.; LEBRASSEUR, N. K. Myostatin and Sarcopenia: Opportunities and Challenges - A Mini-Review. Gerontology, v. 60, n. 4, p. 289–293, 2014. DOI: https://doi.org/10.1159/000356740
WIND, A. E. et al. Is grip strength a predictor for total muscle strength in healthy children, adolescents, and young adults? European journal of pediatrics, v. 169, n. 3, p. 281–7, 2010. DOI: https://doi.org/10.1007/s00431-009-1010-4
World Health Organization. Obesity: preventing and managing the global epidemic. Geneva: WHO, 2000. (WHO Technical Report Series, n. 894).
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Derechos de autor 2026 Isadora Almeida Faria, Daianna Lima da Mata, Ana Carolina da Silva Lima, Maria Clara Nunes e Belo , Graziela Campos de Almeida, Andréia Rodrigues do Carmo Brasil
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