Department of Surgery, University of California, Davis, 2221 Stockton Boulevard, Sacramento, CA, 95817, USA.
Surg Endosc. 2013 Dec;27(12):4556-63. doi: 10.1007/s00464-013-3122-1. Epub 2013 Aug 16.
Despite similar rates of obesity among American men and women, population-based studies suggest that bariatric surgery patients are disproportionately female. We sought to assess this observation quantitatively.
Data were prospectively collected from 1,368 consecutive patients evaluated for bariatric surgery over a 4-year period. The prevalence of diabetes mellitus (DM), hypertension (HTN), dyslipidemia (DYS), obstructive sleep apnea (OSA), gastroesophageal reflux disease, depression, back pain (BKP), and musculoskeletal peripheral disease was assessed. A severity score from 1 to 5 had been assigned to each comorbidity based on the Assessment of Obesity Related Comorbidities Scale (AORC). Metabolic syndrome (MetS) was defined as the concurrent presence of DM, HTN, and DYS.
The majority of patients were female (n = 1,115, 81.5%). Male patients were older (44.5 ± 9.5 vs. 42.6 ± 9.6 years, p = 0.0044) and had higher body mass index (48.7 ± 7.8 vs. 46.6 ± 7.4 kg/m(2), p < 0.0001). On average, men presented with 4.54 serious comorbidities and 3.7 complicated comorbidities (AORC score ≥3), whereas women presented with 4.15 serious comorbidities and 3.08 complicated comorbidities. More men presented with DM (36.4 vs. 28.9%, p = 0.0154), HTN (68.8 vs. 55.3%, p = 0.0001), OSA (71.9 vs. 45.7%, p < 0.0001), and MetS (20.9 vs. 15.2%, p = 0.0301). Men also presented with more complicated DM (33.2 vs. 23.9%, p = 0.0031), DYS (36.8 vs. 23.5%, p < 0.0001), HTN (58.9 vs. 44.6%, p < 0.0001), BKP (25.3 vs. 19.3%, p = 0.0378), OSA (56.9 vs. 30.1%, p < 0.0001), and MetS (17.8 vs. 10.0%, p = 0.001).
Although men typically comprise less than 20% of bariatric surgery patients, they potentially have more to gain from these operations. Men present later in life, with more advanced obesity, and with more complicated comorbidities. Such findings mandate more research and resources to investigate this barrier to treatment and to provide the morbidly obese male with the surgical care he clearly needs.
尽管美国男性和女性的肥胖率相似，但基于人群的研究表明，接受减肥手术的患者中女性比例过高。我们试图对此进行定量评估。
在 4 年期间，前瞻性收集了 1368 例接受减肥手术评估的连续患者的数据。评估了糖尿病（DM）、高血压（HTN）、血脂异常（DYS）、阻塞性睡眠呼吸暂停（OSA）、胃食管反流病、抑郁、背痛（BKP）和肌肉骨骼外周疾病的患病率。根据肥胖相关并发症评估量表（AORC），对每种合并症的严重程度从 1 到 5 进行评分。代谢综合征（MetS）定义为同时存在 DM、HTN 和 DYS。
大多数患者为女性（n=1115，81.5%）。男性患者年龄较大（44.5±9.5 vs. 42.6±9.6 岁，p=0.0044），体重指数（BMI）较高（48.7±7.8 vs. 46.6±7.4 kg/m²，p<0.0001）。平均而言，男性患者有 4.54 种严重合并症和 3.7 种复杂合并症（AORC 评分≥3），而女性患者有 4.15 种严重合并症和 3.08 种复杂合并症。更多的男性患者患有糖尿病（36.4%比 28.9%，p=0.0154）、高血压（68.8%比 55.3%，p=0.0001）、阻塞性睡眠呼吸暂停（71.9%比 45.7%，p<0.0001）和代谢综合征（20.9%比 15.2%，p=0.0301）。男性还患有更复杂的糖尿病（33.2%比 23.9%，p=0.0031）、血脂异常（36.8%比 23.5%，p<0.0001）、高血压（58.9%比 44.6%，p<0.0001）、背痛（25.3%比 19.3%，p=0.0378）、阻塞性睡眠呼吸暂停（56.9%比 30.1%，p<0.0001）和代谢综合征（17.8%比 10.0%，p=0.001）。
尽管男性通常不到减肥手术患者的 20%，但他们可能从这些手术中获益更多。男性患者的发病年龄较大，肥胖程度较重，且合并症更为复杂。这些发现需要更多的研究和资源来调查这一治疗障碍，并为病态肥胖的男性提供他显然需要的手术护理。
