Department of Surgery, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil.
Obes Surg. 2012 Oct;22(10):1580-5. doi: 10.1007/s11695-012-0731-z.
Obesity-related comorbidities are treated by Roux-en-Y gastric bypass (RYGB) due to weight loss and intestinal hormone changes. Few studies report the evolution of these comorbidities in a long-term follow-up, especially if weight regain is present. This study aims to analyze: (1) the resolution of obesity-related comorbidities after RYGB in a long-term follow-up and (2) its relationship to weight regain.
A retrospective study was conducted on 140 patients submitted to RYGB for morbid obesity for at least 5 years (mean follow-up 90 months). Mean body mass index (BMI) before operation was 52 kg/m(2), at nadir weight 29 kg/m(2), and at last follow-up 33 kg/m(2). The comorbidities diabetes, cardiovascular disease, arterial hypertension, dyslipidemia, sleep apnea, arthropathy, and infertility were classified as resolved, improved, unchanged, and worsened at nadir weight that happened between the first and second year and after five or more years of surgery. For each comorbidity, we compared the changes in the distribution of patients in the categories and the correlation of it with weight loss at the nadir and final weight.
BMI was significantly different in the three periods. Comorbidities resolution was sustained in a long-term follow-up for diabetes, hypertension, cardiovascular disease, and infertility. Comorbidities status was directly related to the weight loss for all comorbidities except infertility.
Our results show that comorbidities remission after RYGB is sustained in a long-term follow-up. Weight regain is linked to worse results for all comorbidities except infertility.
肥胖相关合并症通过 Roux-en-Y 胃旁路手术(RYGB)治疗,原因是体重减轻和肠道激素变化。很少有研究报告在长期随访中这些合并症的演变情况,尤其是在存在体重反弹的情况下。本研究旨在分析:(1)RYGB 后肥胖相关合并症在长期随访中的缓解情况,以及(2)其与体重反弹的关系。
对 140 例因病态肥胖接受 RYGB 手术至少 5 年(平均随访 90 个月)的患者进行回顾性研究。手术前平均体重指数(BMI)为 52kg/m²,体重最低点为 29kg/m²,最后一次随访时为 33kg/m²。糖尿病、心血管疾病、动脉高血压、血脂异常、睡眠呼吸暂停、关节病和不育等合并症在体重最低点(发生在手术第 1 年至第 2 年之间)和手术后 5 年或更长时间被归类为缓解、改善、不变和恶化。对于每种合并症,我们比较了患者在各分类中的分布变化,并比较了与体重最低点和最终体重的相关性。
BMI 在三个时期差异有统计学意义。糖尿病、高血压、心血管疾病和不育症在长期随访中,合并症缓解持续存在。除不育症外,所有合并症的状态都与体重减轻直接相关。
我们的结果表明,RYGB 后合并症的缓解在长期随访中是持续的。体重反弹与所有合并症(除不育症外)的结果恶化有关。