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Roux-en-Y胃旁路手术对饱腹感和食物偏好的影响:遗传学的作用。

Effect of Roux-en-Y gastric bypass on satiety and food likes: the role of genetics.

作者信息

Thirlby Richard C, Bahiraei Frohar, Randall Jim, Drewnoski Adam

机构信息

Department of Surgery, Virginia Mason Medical Center, 1100 Ninth Avenue, PO Box 900, Seattle, WA 98101-0900, USA.

出版信息

J Gastrointest Surg. 2006 Feb;10(2):270-7. doi: 10.1016/j.gassur.2005.06.012.

Abstract

Among factors influencing the outcome of bariatric surgery may be genetics and familial risk. The purpose of this study was to assess the etiology of obesity and its impact on hunger, satiety, and food likes in obese patients undergoing Roux-en-Y gastric bypass (RYGB). This study was based on 76 patients undergoing RYGB procedures performed by a single surgeon. A previously described 100-point obesity risk index (ORI) was used to assess familial obesity risk. Hunger and satiety were assessed using a standardized Visual Analog Scale "Snickers" test, and food preferences for regular vs. low-fat potato chips were measured preoperatively and postoperatively. Patients were stratified preoperatively into high ORI (n = 34) and low ORI (n = 42) groups. Before operation, high-ORI patients preferred high-fat (regular) potato chips to low-fat (baked) potato chips, whereas the low-ORI patients liked both food types equivalently (P < 0.05). After operation (n = 43), both groups showed lower preferences for high-fat potato chips (P < 0.05 for high-ORI group). As anticipated, hunger was dramatically suppressed after RYGB. However, there was more satiety in the high-ORI group (P < 0.05, ANOVA). Most patients undergoing bariatric surgery had a strong familial or genetic component to their disease. RYGB in high-ORI patients was associated with a significant decline in preference of fatty food and a significantly prolonged drop in hunger ratings after a fast and after a standard 282 kcal meal. The success of bariatric surgery may be influenced by the etiology of obesity.

摘要

影响减肥手术效果的因素可能包括遗传和家族风险。本研究的目的是评估肥胖的病因及其对接受Roux-en-Y胃旁路术(RYGB)的肥胖患者饥饿感、饱腹感和食物喜好的影响。本研究基于由一名外科医生实施RYGB手术的76例患者。使用先前描述的100分肥胖风险指数(ORI)评估家族性肥胖风险。使用标准化视觉模拟量表“士力架”测试评估饥饿感和饱腹感,并在术前和术后测量对普通薯片与低脂薯片的食物偏好。患者术前被分为高ORI组(n = 34)和低ORI组(n = 42)。术前,高ORI患者更喜欢高脂(普通)薯片而非低脂(烤制)薯片,而低ORI患者对两种食物的喜好程度相当(P < 0.05)。术后(n = 43),两组对高脂薯片的偏好均降低(高ORI组P < 0.05)。正如预期的那样,RYGB术后饥饿感大幅降低。然而,高ORI组的饱腹感更强(方差分析,P < 0.05)。大多数接受减肥手术的患者其疾病具有强烈的家族或遗传成分。高ORI患者接受RYGB手术后,对高脂肪食物的偏好显著下降,禁食后和进食标准282千卡餐后饥饿评分显著下降的持续时间延长。减肥手术的成功可能受肥胖病因的影响。

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