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腹腔镜胃束带手术后病态肥胖患者肝脏脂肪含量变化的相关因素。

Associates of change in liver fat content in the morbidly obese after laparoscopic gastric banding surgery.

作者信息

Phillips M L, Boase S, Wahlroos S, Dugar M, Kow L, Stahl J, Slavotinek J P, Valentine R, Toouli J, Thompson C H

机构信息

Department of General Medicine, Flinders Medical Centre, Bedford Park, South Australia, Australia.

出版信息

Diabetes Obes Metab. 2008 Aug;10(8):661-7. doi: 10.1111/j.1463-1326.2007.00793.x. Epub 2007 Oct 17.

Abstract

AIM

Hepatic steatosis affects up to 30% of the population. After weight loss, monitoring of the change in hepatic steatosis is not routinely performed. This study aimed to define the closest associates of change in liver fat content in a population of obese females following laparoscopic gastric banding surgery.

METHODS

Before and 3 months after surgery, proton magnetic resonance spectroscopy and magnetic resonance imaging were used to estimate the amount of lipid contained within the liver and abdominal subcutaneous and visceral compartments of 29 obese [mean body mass index (BMI) 39 +/- 5 kg/m(2)], non-diabetic women aged between 20 and 62 years. Liver enzymes, fasting plasma glucose and insulin were also measured as well as body weight, BMI and waist circumference. Insulin sensitivity was estimated using homeostasis model assessment insulin resistance index.

RESULTS

Significant reductions occurred in body weight (p < 0.001), abdominal fat volumes (p < 0.001) and liver fat (p = 0.037) 3 months after surgery. Change in liver fat content more closely associated with change in serum gamma-glutamyl transferase (GGT; r = 0.71, p < 0.001) than with changes in weight (r = 0.10, p = 0.612) and waist circumference (r = 0.15, p = 0.468).

CONCLUSIONS

Our findings suggest that obese non-diabetic female patients who have undergone significant weight loss over 3 months can be better assessed for the regression of excess liver fat content by monitoring changes in serum GGT levels rather than changes in simple anthropometry.

摘要

目的

肝脂肪变性影响着高达30%的人群。体重减轻后,通常不会对肝脂肪变性的变化进行监测。本研究旨在确定接受腹腔镜胃束带手术的肥胖女性群体中,与肝脏脂肪含量变化关系最为密切的相关因素。

方法

在手术前及术后3个月,对29名年龄在20至62岁之间、肥胖[平均体重指数(BMI)为39±5kg/m²]、非糖尿病女性的肝脏、腹部皮下及内脏区域进行质子磁共振波谱分析和磁共振成像,以估算脂质含量。同时测量肝酶、空腹血糖和胰岛素水平,以及体重、BMI和腰围。使用稳态模型评估胰岛素抵抗指数估算胰岛素敏感性。

结果

术后3个月,体重(p<0.001)、腹部脂肪量(p<0.001)和肝脏脂肪(p=0.037)均显著降低。肝脏脂肪含量的变化与血清γ-谷氨酰转移酶(GGT)的变化相关性更强(r=0.71,p<0.001),而非与体重变化(r=0.10,p=0.612)和腰围变化(r=0.15,p=0.468)相关。

结论

我们的研究结果表明,对于在3个月内体重显著减轻的肥胖非糖尿病女性患者,通过监测血清GGT水平的变化而非简单人体测量学指标的变化,能更好地评估肝脏脂肪含量过多的消退情况。

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