Long-term changes in the metabolic and nutritional parameters after gastrectomy in early gastric cancer patients with overweight

Asian J Surg. 2019 Jan;42(1):386-393. doi: 10.1016/j.asjsur.2018.06.011. Epub 2018 Aug 7.

Abstract

Background: With the increase in the prevalence of overweight, percentage of overweight patients with gastric cancer has also increased. This 5-year retrospective cohort study was performed to investigate long-term changes in the metabolic and nutritional parameters of early gastric cancer (EGC) patients with overweight after gastrectomy.

Methods: EGC patients who underwent gastrectomy were followed up over a 5-year period. We included 393 patients (261 men, 132 women) who had an initial body mass index (BMI) of ≥23 kg/m2, and analyzed the longitudinal changes in the metabolic and nutritional parameters.

Results: Body weight and random glucose, alanine aminotransferase (ALT), hemoglobin, and serum calcium levels significantly decreased, while serum protein and albumin levels increased in both men and women after gastrectomy. The odds ratios (ORs) for BMI ≥ 25 kg/m2 (P < 0.001 for men and women), random glucose ≥ 126 mg/dL (men; P = 0.001, women; P < 0.001), and ALT > 40 IU/dL (men; P < 0.001, women; P = 0.018) were lower in both men and women after 5 years. The ORs for low protein and albumin levels decreased, although the ORs for anemia and hypocalcemia increased in both sexes at 5 years after gastrectomy.

Conclusion: Gastrectomy in overweight patients followed up over 5-year could lead to approximately 10% weight loss and favorable changes in the metabolic parameters in both men and women. The risk of anemia and hypocalcemia increased, and the risk of low protein and albumin levels decreased in both sexes.

Keywords: Early gastric cancer; Gastrectomy; Metabolic parameters; Nutritional state; Overweight.

MeSH terms

  • Adult
  • Anemia
  • Blood Proteins
  • Body Mass Index
  • Body Weight
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Gastrectomy*
  • Humans
  • Hypocalcemia
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Nutritional Status*
  • Overweight / complications*
  • Overweight / metabolism*
  • Retrospective Studies
  • Risk
  • Stomach Neoplasms / complications
  • Stomach Neoplasms / metabolism*
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*
  • Time Factors

Substances

  • Blood Proteins