Department of Nutrition, Pitié-Salpêtrière Hospital (AP-HP), University Pierre-et-Marie-Curie-Paris 6, Human Nutrition Research Center Île-de-France (CRNH IdF), 83, boulevard de l'Hôpital, 75013 Paris, France.
Diabetes Metab. 2013 Apr;39(2):148-54. doi: 10.1016/j.diabet.2012.10.008. Epub 2013 Jan 10.
Dynamics of improvement in health-related quality of life (QoL) after bariatric surgery have never been fully assessed, and neither has the potential influence of body mass index (BMI) and comorbidity modification. The objective of this study was to investigate early and medium-term changes in QoL following Roux-en-Y gastric bypass (RYGB), and their relationship to BMI and comorbidity variations.
A total of 71 obese subjects (80% women, mean age 42.1±11.2 years, mean baseline BMI 47.6±6.2kg/m(2)) undergoing RYGB filled in QoL questionnaires (SF-36) before and 3, 6 and 12 months after surgery. QoL was assessed using repeated-measures Anova, with associations between its changes and changes in BMI and comorbidities (diabetes, hypertension, dyslipidaemia, sleep apnoea, knee pain) assessed by mixed-effects models.
Physical QoL scales (physical component summary, PCS) significantly increased over time (from 38.9±9.3 to 52.6±7.9; P<0.001) as did other physical SF-36 scales (all P<0.001), whereas mental QoL summary scale did not vary significantly (from 45.7±9.5 to 48.6±11.5; P=0.072). Major changes in QoL occurred at 3 months after surgical intervention to reach values comparable to those in the general population. PCS was mostly associated with changes in either BMI or comorbidity status except for diabetes, dyslipidaemia and sleep apnoea.
Results show that improvements in physical QoL after RYGB are observed as early as 3 months after intervention, and are independently associated with weight loss and improvements in comorbidities.
减重手术后健康相关生活质量(QoL)的改善动态从未被全面评估过,体重指数(BMI)和合并症改善的潜在影响也没有被评估过。本研究的目的是调查 Roux-en-Y 胃旁路术(RYGB)后 QoL 的早期和中期变化,及其与 BMI 和合并症变化的关系。
共纳入 71 名肥胖患者(80%为女性,平均年龄 42.1±11.2 岁,平均基线 BMI 为 47.6±6.2kg/m²),在 RYGB 术前、术后 3、6 和 12 个月时填写 QoL 问卷(SF-36)。使用重复测量方差分析评估 QoL,使用混合效应模型评估其变化与 BMI 和合并症(糖尿病、高血压、血脂异常、睡眠呼吸暂停、膝关节疼痛)变化之间的关联。
身体 QoL 量表(身体成分综合评分,PCS)随时间显著增加(从 38.9±9.3 增加到 52.6±7.9;P<0.001),其他身体 SF-36 量表也是如此(均 P<0.001),而心理 QoL 综合评分没有显著变化(从 45.7±9.5 增加到 48.6±11.5;P=0.072)。在手术干预后 3 个月,QoL 发生重大变化,达到与普通人群相当的值。PCS 主要与 BMI 或合并症状态的变化相关,除了糖尿病、血脂异常和睡眠呼吸暂停。
结果表明,RYGB 后身体 QoL 的改善早在干预后 3 个月就出现了,并且与体重减轻和合并症改善独立相关。