Wang Yong, Zhang Cuihua
Departments of Internal Medicine, Medical Pharmacology & Physiology and Nutritional Sciences, Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65211.
Am J Biomed Sci. 2009 Jan 1;1(1):56-69. doi: 10.5099/aj090100056.
Morbid obesity, a physiological dysfunction in humans associated with environmental, genetic and endocrinological origins, has significantly increased in the past few decades in the USA. Many methods have emerged for treating morbid obesity, such as diets, exercise, behavior modification, liposuction, drugs, and surgery; among these, bariatric surgery reduces weight and appears to have other curative effects. Roux-en-Y gastric bypass is the principal form of bariatric surgery, followed by laparoscopic adjustable gastric banding, gastric sleeve operation, duodenojejunal bypass and biliopancreatic diversion. This weight-loss surgery may also affect comorbidities of morbid obesity, such as type 2 diabetes mellitus (T2D), atherosclerosis, hypertension and steatohepatitis. Weight-loss surgery, for example, is associated with a more than 80% diabetes (data indicates > 80%) remission rate in severely obese persons. Empirical evidence also suggests that the use of bariatric surgery reduces atherosclerosis, and may ameliorate other comorbities. This warrants closer examination.
病态肥胖是一种与环境、遗传和内分泌起源相关的人类生理功能障碍,在过去几十年中,美国的病态肥胖率显著上升。治疗病态肥胖的方法有很多,如节食、运动、行为矫正、抽脂、药物和手术;其中,减肥手术能减轻体重,且似乎还有其他治疗效果。胃旁路手术是减肥手术的主要形式,其次是腹腔镜可调节胃束带术、胃袖状切除术、十二指肠空肠旁路术和胆胰转流术。这种减肥手术也可能会影响病态肥胖的合并症,如2型糖尿病(T2D)、动脉粥样硬化、高血压和脂肪性肝炎。例如,减肥手术与重度肥胖者超过80%的糖尿病缓解率相关(数据表明>80%)。经验证据还表明,减肥手术的使用可减轻动脉粥样硬化,并可能改善其他合并症。这值得更深入的研究。