一名完全性 MC4R 缺乏症患者的减重手术。
Bariatric surgery in a patient with complete MC4R deficiency.
机构信息
Division of Endocrinology, Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA.
出版信息
Int J Obes (Lond). 2011 Mar;35(3):457-61. doi: 10.1038/ijo.2010.168. Epub 2010 Aug 24.
Abstract
Bariatric surgery is often successful for treatment of severe obesity. The mechanisms of weight loss after bariatric surgery and the role of central energy homeostatic pathways in this weight loss process are not well understood. The study of individuals with complete loss of function of genes important in the leptin-melanocortin system may help establish the significance of these pathways for weight loss after bariatric surgery. We describe the outcome of bariatric surgery in an adolescent with compound heterozygosity and complete functional loss of both alleles of the melanocortin 4 receptor (MC4R). The patient underwent laparoscopic adjustable gastric banding and truncal vagotomy at years of age, which resulted in initial, but not long-term weight loss. Our experience with this patient suggests that complete MC4R deficiency impairs response to gastric banding and results in poor weight loss after this surgery.
摘要
减重手术通常是治疗重度肥胖症的有效方法。然而，减重手术后体重减轻的机制以及中枢能量稳态途径在这一过程中的作用尚未完全明了。研究瘦素-黑皮质素系统中重要基因完全失活的个体，可能有助于确定这些途径在减重手术后体重减轻中的重要性。我们描述了一名青少年复合杂合子和黑皮质素 4 受体 (MC4R) 两个等位基因完全功能性丧失的患者的减重手术结果。该患者在岁时接受了腹腔镜可调胃束带术和胃短路手术，但仅获得了初始减重，而没有长期减重效果。我们对该患者的经验表明，MC4R 完全缺乏会损害对胃束带术的反应，并导致该手术后体重减轻效果不佳。
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