20-45 岁女性在接受减重手术后短期体重下降幅度大于 55-65 岁女性。
Greater short-term weight loss in women 20-45 versus 55-65 years of age following bariatric surgery.
机构信息
Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA,
出版信息
Obes Surg. 2013 Oct;23(10):1650-4. doi: 10.1007/s11695-013-0984-1.
BACKGROUND
Whether and how sex and age affect bariatric-surgery outcome is poorly understood. Estrogens regulate body composition in women and animals, and increase weight loss in a rodent model of gastric bypass, suggesting that premenopausal women may lose more weight following bariatric surgery.
METHODS
One thousand three hundred fifty-six female gastric-bypass or gastric-banding patients were retrospectively grouped as 20-45 years old (presumptively premenopausal; n = 1,199) and 55-65 years old (presumptively postmenopausal; n = 157). Mixed-model ANCOVA followed by Bonferroni-corrected t tests were used to categorically test the effect of age on percent excess body weight loss (%EBWL) at 1 and 2 years post-surgery, controlling for preoperative EBW and surgery type. Age effects were also tested dimensionally in all women and in 289 male patients.
RESULTS
Twenty- to forty-five-year-old women showed greater %EBWL 1 and 2 years post-surgery than 55-65-year-old women (p's < 0.0005). No age effect was detected in 20-25- vs. 30-35-, 30-35- vs. 40-45-, or 20-25- vs. 40-45-year-old women (p's > 0.2) This age effect was detected only after gastric banding, with 20-45-year-old women losing ∼7 kg more than 55-65-year-old women after 2 years. Dimensional analysis confirmed a significant inverse effect of age on bariatric surgery outcome in women, but did not detect any effect in men.
CONCLUSIONS
Results indicate that 55-65-year-old women lose less weight than 20-45-year-old women in the initial 2 years after bariatric surgery, especially gastric banding; this may be mediated by age- or menopause-associated changes in physical activity, energy expenditure, or energy intake.
背景
性别和年龄是否以及如何影响减重手术的结果尚不清楚。雌激素调节女性和动物的身体成分，并增加胃旁路动物模型的体重减轻，这表明绝经前女性在接受减重手术后可能会减轻更多体重。
方法
对 1356 名接受胃旁路或胃束带手术的女性患者进行回顾性分组，年龄为 20-45 岁（假定为绝经前；n=1199）和 55-65 岁（假定为绝经后；n=157）。使用混合模型 ANCOVA 并结合 Bonferroni 校正的 t 检验，在控制术前 EBW 和手术类型的情况下，对年龄对术后 1 年和 2 年的超额体重减轻百分比（%EBWL）的影响进行分类测试。还在所有女性和 289 名男性患者中对年龄影响进行了维度测试。
结果
20-45 岁的女性在术后 1 年和 2 年的 EBWL 百分比高于 55-65 岁的女性（p<0.0005）。在 20-25 岁与 30-35 岁、30-35 岁与 40-45 岁或 20-25 岁与 40-45 岁的女性之间未检测到年龄影响（p>0.2）。仅在胃束带手术后才发现这种年龄影响，20-45 岁的女性在 2 年后比 55-65 岁的女性多减轻约 7kg。维度分析证实，年龄对女性减重手术结果有显著的负向影响，但在男性中未检测到任何影响。
结论
结果表明，55-65 岁的女性在减重手术后的最初 2 年中比 20-45 岁的女性体重减轻更少，尤其是胃束带手术后；这可能是由于年龄或绝经相关的体力活动、能量消耗或能量摄入变化所致。
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