Madan Atul K, Orth Whitney, Ternovits Craig A, Tichansky David S
Section of Minimally Invasive Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, 38163, USA.
Surg Obes Relat Dis. 2006 Jan-Feb;2(1):48-51; discussion 51. doi: 10.1016/j.soard.2005.09.014.
The metabolic syndrome is a group of risk factors predictive of cardiovascular diseases. The rising number of obese Americans has increased the prevalence of metabolic syndrome. This study investigated the hypothesis that the incidence of metabolic syndrome is decreased after laparoscopic gastric bypass surgery.
The charts of all patients who had undergone laparoscopic gastric bypass surgery during a 6-month period were reviewed for the presence of the diagnostic criteria for metabolic syndrome, both preoperatively and at least 1 year postoperatively. The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) criteria were used to define the metabolic syndrome. These criteria included elevated blood pressure, fasting blood glucose, triglycerides, high-density lipoprotein cholesterol, and waist circumference.
Data were available for 53 patients. Before laparoscopic gastric bypass surgery, 32 (60%) of the 53 patients had metabolic syndrome, as defined by the NCEP ATPIII criteria. No difference was found in the preoperative body mass index between patients who had metabolic syndrome (47.4 kg/m(2)) and those who did not (49.8 kg/m(2); P = NS). The percentage of excess body weight lost after at least 1 year was 78% in patients with metabolic syndrome. After surgery, only 1 (2%) of the 53 patients had metabolic syndrome (P <.0001).
Metabolic syndrome is quite common in patients undergoing bariatric surgery. The results of our study have shown that laparoscopic gastric bypass surgery resolves metabolic syndrome in most patients. Metabolic syndrome should be considered another co-morbidity that improves and is cured after gastric bypass surgery.
代谢综合征是一组可预测心血管疾病的危险因素。美国肥胖人数的增加导致了代谢综合征患病率的上升。本研究调查了腹腔镜胃旁路手术后代谢综合征发病率降低这一假说。
回顾了在6个月期间接受腹腔镜胃旁路手术的所有患者的病历，以了解术前和术后至少1年时代谢综合征诊断标准的存在情况。采用美国国家胆固醇教育计划成人治疗组第三次报告（NCEP ATPIII）标准来定义代谢综合征。这些标准包括血压升高、空腹血糖、甘油三酯、高密度脂蛋白胆固醇和腰围。
有53例患者的数据可用。根据NCEP ATPIII标准，在腹腔镜胃旁路手术前，53例患者中有32例（60%）患有代谢综合征。患有代谢综合征的患者（47.4kg/m²）与未患代谢综合征的患者（49.8kg/m²；P=无显著差异）术前体重指数无差异。代谢综合征患者至少1年后多余体重减轻的百分比为78%。手术后，53例患者中只有1例（2%）患有代谢综合征（P<.0001）。
代谢综合征在接受减肥手术的患者中相当常见。我们的研究结果表明，腹腔镜胃旁路手术可使大多数患者的代谢综合征得到缓解。代谢综合征应被视为胃旁路手术后得到改善并治愈的另一种合并症。
