The main objective of the study is to evaluate the protein requirement associated with postoperative weight loss caused by by-pass (shunt which leads to a certain degree of malabsorption) or sleeve gastrectomy (more technically conservative with less malabsorption), through the study of nitrogen balance. The benefit of protein supply easily absorbed and with high essential amino acids content (proteins "fast" soluble milk) on protein metabolism and muscle function will also be studied. Endotoxemia and intestinal flora variations were measured before and after bariatric surgery.
This is a prospective longitudinal study of the effect of bariatric surgery on protein requirements and protein metabolism, and protein supplementation interest, appropriate to the digestive tract changes, for the mass and muscle function. Three groups of patients will be studied: One group undergoing sleeve gastrectomy in Clermont-Ferrand (group 1: n = 20) will be followed by current recommendations. A second group undergoing sleeve gastrectomy in Clermont-Ferrand (group 2: n = 20) will receive during three months, protein supplement (powder whey protein ("fast")) at dose of 40g / day. 10 patients in group 1 and 10 patients in group 2 will participate in protein metabolism study. The third group undergoing gastric bypass in Lyon (group 3: n = 20) will be followed by the current recommendations and will participate in study of endotoxemia.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
25
This is a prospective longitudinal study of the effect of bariatric surgery on protein requirements and protein metabolism, and protein supplementation interest, appropriate to the digestive tract changes, for the mass and muscle function
CHU Clermont-Ferrand
Clermont-Ferrand, France
to measure the nitrogen balance and its variation during weight loss
Time frame: before, after 3 months and 1 year after the operation
Protein metabolism of body and muscle will be assessed
Time frame: before and 3 months after surgery
- Body composition will be assessed using deuterated water (2H2O) ingested and by BIA (Bioelectrical Impedance Analysis )
Time frame: before, after 3 months and 1 year after surgery
Changes of endotoxemia will be assessed by measuring blood levels of endotoxin, their carriers, inflammatory cytokines, and protein transfer fasting and after a high fat breakfast test
Time frame: before and 3 months after surgery
The voluntary muscular force and muscular weariness will be assessed in Clermont-Ferrand and Lyon by Dynatrac measurement apparatus
Time frame: before, after 3 months and 1 year after the operation
Muscle mass will be estimated by urinary creatinine measurements
Time frame: before, after 3 months and 1 year after the operation).
Intestinal flora microbiology analysis will be performed
Time frame: 3 months and 1 year after bariatric surgery
Daily physical activity will be measured by an Acti-Heart apparatus
Time frame: before, after 3 months and 1 year after surgery
- Insulino-resistance will be measured by the HOMA test( test aHomeostatic Model Assessment)and the DISSE index ((Disse E, Diabetes & Metabolism, 2008).
Time frame: before, after 3 months and 1 year after surgery)
Inflammatory, hormonal, metabolic parameters' variation will be assessed by blood biological and urinary parameters measurement
Time frame: before, after 3 months and 1 year after surgery).
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