Department of Internal Medicine, Slotervaart Hospital, Louwesweg 6, 1066 EC, Amsterdam, The Netherlands.
Obes Surg. 2013 Mar;23(3):358-64. doi: 10.1007/s11695-012-0764-3.
Obesity is an independent risk factor for hypertension and chronic kidney disease. During the first months after bariatric surgery, an improvement of sodium excretion has been described. The aim of this work was to study the influence of bariatric surgery on sodium excretion at more than a year after the intervention.
Patients who have undergone Roux-en-Y gastric bypass (RYGB) and who had collected a 24-h urine sample before surgery more than 12 months ago were asked to participate. A second 24-h urine sample was collected. Blood pressure and weight were measured. The difference in sodium excretion before and after surgery was calculated, and the relationship with blood pressure and weight loss was investigated.
We included 33 patients; the median follow-up time was 21 months (range 14-41). Sodium excretion was high before surgery (median 195 mmol/day, IQR range 167-247) and decreased by 18 % after surgery (median 160 mmol/day, IQR range 118-205, p = 0.015), while there were significant improvements in body weight (% EWL 80.9 ± 21.8), systolic blood pressure (126 to 120 mmHg, p = 0.02), and diastolic blood pressure (84 to 77 mmHg, p = 0.002), even with a reduced number of antihypertensive drugs.
After RYGB and considerable weight loss, sodium excretion remains high in the longer term. The profound improvement in blood pressure cannot be explained by reductions in sodium excretion after RYGB.
肥胖是高血压和慢性肾脏病的独立危险因素。在减重手术后的头几个月，已描述了钠排泄的改善。本研究旨在探讨超过一年后减重手术对钠排泄的影响。
我们邀请了接受过 Roux-en-Y 胃旁路手术（RYGB）且在 12 个月前收集了 24 小时尿液样本的患者参与。收集第二次 24 小时尿液样本，测量血压和体重。计算手术前后钠排泄的差异，并研究其与血压和体重减轻的关系。
我们共纳入 33 名患者，中位随访时间为 21 个月（范围 14-41）。手术前钠排泄量较高（中位数 195mmol/天，IQR 范围 167-247），手术后减少 18%（中位数 160mmol/天，IQR 范围 118-205，p=0.015），而体重减轻（%EWL 80.9±21.8）、收缩压（从 126mmHg 降至 120mmHg，p=0.02）和舒张压（从 84mmHg 降至 77mmHg，p=0.002）均有显著改善，尽管降压药物的使用减少。
RYGB 术后和体重显著减轻后，钠排泄在较长时间内仍保持较高水平。RYGB 后血压的显著改善不能仅用钠排泄的减少来解释。
