Section of Minimally Invasive Surgery, Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida, USA.
Surg Obes Relat Dis. 2012 Jan-Feb;8(1):25-30. doi: 10.1016/j.soard.2011.08.012. Epub 2011 Aug 27.
Patients who are categorized with class I obesity have a body mass index (BMI) of 30-34.99 kg/m(2). This population of patients has a predisposition to diabetes, hypertension, and dyslipidemia. The aim of the present study was to investigate the improvements of these co-morbidities in a class I obese population that had undergone a bariatric procedure.
After internal review board approval and with adherence to the Health Insurance Portability and Accountability Act guidelines, a retrospective review was performed of a prospectively maintained database of 42 class I obese patients who underwent a bariatric procedure at our institution during a 10-year period, from February 2000 to May 2010. The fasting glucose level, glycosylated hemoglobin level, lipid profile, initial weight, and BMI were measured in the preoperative and postoperative periods.
Our patient population consisted of 30 women and 12 men, with a preoperative mean BMI of 33.9 kg/m(2). Laparoscopic sleeve gastrectomy was performed in 24 patients (57%), laparoscopic Roux-en-Y gastric bypass in 8 (19%), and laparoscopic adjustable gastric banding in 10 (24%). Of these 42 patients, 25 (60%) had type 2 diabetes, 1 patient was glucose intolerant, 27 (64%) had arterial hypertension, 25 (60%) had dyslipidemia, 17 (40%) had sleep apnea, and 8 (19%) had osteoarthritis. The postoperative findings included a mean BMI of 26.5 kg/m(2) and a mean weight loss of 41.4 lb. Of the 25 diabetic patients, 5 (20%) gained remission and 12 (48%) improvement of their diabetic status. The single patient with glucose intolerance showed improvement. Of the 27 patients with arterial hypertension, 9 (33%) showed remission and 13 (52%) improvement. Dyslipidemia resolved in 5 patients (20%) and improved in 13 (52%). Obstructive sleep apnea resolved in 10 (59%) and improvement was seen in 1 patient (6%). Finally, osteoarthritis resolved in 1 patient (12%) and improved in 5 (63%).
Bariatric surgery can significantly improve or resolve co-morbid metabolic conditions in patients with class I obesity.
体重指数（BMI）为 30-34.99kg/m²的患者被归类为 I 类肥胖症患者。此类患者易患糖尿病、高血压和血脂异常。本研究旨在探讨 I 类肥胖患者接受减重手术后这些合并症的改善情况。
经内部审查委员会批准并遵守《健康保险流通与责任法案》的规定，对我院在 10 年内（2000 年 2 月至 2010 年 5 月）接受减重手术的 42 名 I 类肥胖患者的前瞻性数据库进行回顾性分析。在术前和术后测量空腹血糖水平、糖化血红蛋白水平、血脂谱、初始体重和 BMI。
我们的患者人群由 30 名女性和 12 名男性组成，术前平均 BMI 为 33.9kg/m²。24 名患者（57%）接受腹腔镜袖状胃切除术，8 名患者（19%）接受腹腔镜 Roux-en-Y 胃旁路术，10 名患者（24%）接受腹腔镜可调节胃束带术。在这 42 名患者中，25 名（60%）患有 2 型糖尿病，1 名患者糖耐量异常，27 名（64%）患有动脉高血压，25 名（60%）患有血脂异常，17 名（40%）患有睡眠呼吸暂停，8 名（19%）患有骨关节炎。术后发现平均 BMI 为 26.5kg/m²，平均体重减轻 41.4 磅。在 25 名糖尿病患者中，5 名（20%）获得缓解，12 名（48%）糖尿病状态改善。唯一的糖耐量异常患者病情改善。在 27 名高血压患者中，9 名（33%）获得缓解，13 名（52%）得到改善。5 名（20%）患者血脂异常得到缓解，13 名（52%）患者血脂异常得到改善。10 名（59%）患者阻塞性睡眠呼吸暂停得到缓解，1 名（6%）患者睡眠呼吸暂停得到改善。最后，1 名（12%）患者骨关节炎得到缓解，5 名（63%）患者骨关节炎得到改善。
减重手术可显著改善 I 类肥胖患者的合并代谢疾病。
