title: Energetic adaptations persist after bariatric surgery in severely obese adolescents.
abstract: OBJECTIVE
  Energetic adaptations induced by bariatric surgery have not been studied in adolescents or for extended periods postsurgery. Energetic, metabolic, and neuroendocrine responses to Roux-en-Y gastric bypass (RYGB) surgery were investigated in extremely obese adolescents.
  
  
  METHODS
  At baseline and at 1.5, 6, and 12 months post-baseline, 24-h room calorimetry, body composition, and fasting blood biochemistries were measured in 11 obese adolescents relative to five matched controls.
  
  
  RESULTS
  In the RYGB group, mean weight loss was 44 ± 19 kg at 12 months. Total energy expenditure (TEE), activity EE, basal metabolic rate (BMR), sleep EE, and walking EE significantly declined by 1.5 months (P = 0.001) and remained suppressed at 6 and 12 months. Adjusted for age, sex, fat-free mass, and fat mass, EE was still lower than baseline (P = 0.001). Decreases in serum insulin, leptin, and triiodothyronine (T3), gut hormones, and urinary norepinephrine (NE) paralleled the decline in EE. Adjusted changes in TEE, BMR, and/or sleep EE were associated with decreases in insulin, homeostatic model assessment, leptin, thyroid stimulating hormone, total T3, peptide YY3-36, glucagon-like peptide-2, and urinary NE and epinephrine (P = 0.001-0.05).
  
  
  CONCLUSIONS
  Energetic adaptations in response to RYGB-induced weight loss are associated with changes in insulin, adipokines, thyroid hormones, gut hormones, and sympathetic nervous system activity and persists 12 months postsurgery.
authors.affiliation: USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Nancy F
authors.initials: NF
authors.lastname: Butte
authors.forename: Mary L
authors.initials: ML
authors.lastname: Brandt
authors.forename: William W
authors.initials: WW
authors.lastname: Wong
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.forename: Nitesh R
authors.initials: NR
authors.lastname: Mehta
authors.forename: Theresa A
authors.initials: TA
authors.lastname: Wilson
authors.forename: Anne L
authors.initials: AL
authors.lastname: Adolph
authors.forename: Maurice R
authors.initials: MR
authors.lastname: Puyau
authors.forename: Firoz A
authors.initials: FA
authors.lastname: Vohra
authors.forename: Roman J
authors.initials: RJ
authors.lastname: Shypailo
authors.forename: Issa F
authors.initials: IF
authors.lastname: Zakeri
mesh_terms: D000222:Adaptation, Physiological; D054392:Adipokines / Q000097:blood; D000293:Adolescent; D050110:Bariatric Surgery; D001481:Basal Metabolism; D001823:Body Composition; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D005768:Gastrointestinal Hormones / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D009767:Obesity, Morbid / Q000378:metabolism* / Q000601:surgery*; D063766:Pediatric Obesity / Q000378:metabolism* / Q000601:surgery*; D010446:Peptide Fragments / Q000097:blood; D019894:Peptide YY / Q000097:blood; D015431:Weight Loss / Q000502:physiology
chemical_list: D054392:Adipokines; D005768:Gastrointestinal Hormones; D007328:Insulin; D020738:Leptin; D010446:Peptide Fragments; D019894:Peptide YY; C061785:peptide YY (3-36)