The University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE 68198, USA.
Nutrients. 2012 Sep 26;4(10):1358-66. doi: 10.3390/nu4101358.
Patients developing the short bowel syndrome (SBS) are at risk for hepatobiliary disease, as are morbidly obese individuals. We hypothesized that morbidly obese SBS individuals would be at increased risk for developing hepatobiliary complications. We reviewed 79 patients with SBS, 53 patients with initial body mass index (BMI) < 35 were controls. Twenty-six patients with initial BMI > 35 were the obese group. Obese patients were more likely to be weaned off parenteral nutrition (PN) (58% vs. 21%). Pre-resection BMI was significantly lower in controls (26 vs. 41). BMI at 1, 2, and 5 years was decreased in controls but persistently increased in obese patients. Obese patients were more likely to undergo cholecystectomy prior to SBS (42% vs. 32%) and after SBS (80% vs. 39%, p < 0.05). Fatty liver was more frequent in the obese group prior to SBS (23% vs. 0%, p < 0.05) but was similar to controls after SBS (23% vs. 15%). Fibrosis (8% vs. 13%) and cirrhosis/portal hypertension (19% vs. 21%) were similar in obese and control groups. Overall, end stage liver disease (ESLD) was similar in obese and control groups (19% vs. 11%) but was significantly higher in obese patients receiving PN (45% vs. 14%, p < 0.05). Obese patients developing SBS are at increased risk of developing hepatobiliary complications. ESLD was similar in the two groups overall but occurs more frequently in obese patients maintained on chronic PN.
患有短肠综合征（SBS）的患者存在发生肝胆疾病的风险，病态肥胖患者也是如此。我们假设病态肥胖的 SBS 患者发生肝胆并发症的风险会增加。我们回顾了 79 例 SBS 患者，其中 53 例患者的初始体重指数（BMI）<35，作为对照组。26 例初始 BMI > 35 的患者为肥胖组。肥胖患者更有可能停止接受肠外营养（PN）（58% vs. 21%）。对照组术前 BMI 明显较低（26 与 41）。1、2 和 5 年时，对照组 BMI 降低，但肥胖组 BMI 持续增加。肥胖患者更有可能在 SBS 之前（42% vs. 32%）和之后（80% vs. 39%，p < 0.05）进行胆囊切除术。SBS 之前肥胖组脂肪肝更常见（23% vs. 0%，p < 0.05），但 SBS 后与对照组相似（23% vs. 15%）。纤维化（8% vs. 13%）和肝硬化/门静脉高压（19% vs. 21%）在肥胖组和对照组中相似。总体而言，肥胖组和对照组的终末期肝病（ESLD）相似（19% vs. 11%），但接受慢性 PN 的肥胖患者 ESLD 发生率显著更高（45% vs. 14%，p < 0.05）。患有 SBS 的肥胖患者发生肝胆并发症的风险增加。两组总体 ESLD 相似，但在接受慢性 PN 的肥胖患者中更为常见。
