Department of Morbid Obesity and Bariatric Surgery, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
Department of Morbid Obesity and Bariatric Surgery, Oslo University Hospital, Oslo, Norway.
Surg Obes Relat Dis. 2014 Jan-Feb;10(1):71-8. doi: 10.1016/j.soard.2013.05.003. Epub 2013 May 25.
Few long-term reports with high rates of follow-up are available after gastric bypass. We report changes in weight, co-morbidity, cardiovascular risk, and health-related quality of life (HRQoL) 5 years after gastric bypass.
Patients who had gastric bypass (2004-2006) were included. Prospective data were reviewed. Long-term complications, cardiovascular risk factors, and HRQoL were evaluated, and the 10-year risk for coronary heart disease was estimated (Framingham risk score). Outcomes were compared in patients with body mass index (BMI)<50 and ≥50 kg/m(2).
A total of 184 of 203 patients (91%) met to follow-up. The mean ± SD preoperative BMI was 46 ± 5 kg/m(2), and the mean ± SD age was 38 ± 9 years; 75% were women. Thirty-two percent of the patients had a BMI ≥50 kg/m(2), and 30% had type 2 diabetes. Follow-up was 63 ± 5 months. After 5 years, total weight loss was 27% ± 11%. Remission of type 2 diabetes had occurred in 67%. The prevalence of hypertension, dyslipidemia, sleep apnea, and metabolic syndrome had decreased. HRQoL was improved. The Framingham risk score was reduced (5.6% versus 4.6%; P = .021). Sixty-one patients (33%) had long-term complications, most commonly chronic abdominal pain (10%). BMI was 33 ± 5 and 37 ± 7 kg/m(2) in patients with preoperative BMI<50 and ≥50 kg/m(2), but changes in metabolic, cardiovascular risk profile and HRQoL were broadly similar.
Beneficial effects on weight loss, cardiovascular risk, and HRQoL were documented 5 years after gastric bypass in morbidly and super-obese patients.
胃旁路手术后,仅有少数长期、高随访率的报道。我们报告了胃旁路手术后 5 年体重、合并症、心血管风险和健康相关生活质量(HRQoL)的变化。
纳入 2004-2006 年接受胃旁路手术的患者。回顾前瞻性数据。评估长期并发症、心血管危险因素和 HRQoL,并估计 10 年冠心病风险(弗雷明汉风险评分)。比较 BMI<50 和≥50kg/m²的患者的结局。
共有 203 例患者中的 184 例(91%)符合随访要求。术前 BMI 的平均值±标准差为 46±5kg/m²,平均年龄±标准差为 38±9 岁;75%为女性。32%的患者 BMI≥50kg/m²,30%患有 2 型糖尿病。随访时间为 63±5 个月。5 年后,体重总减轻 27%±11%。2 型糖尿病缓解率为 67%。高血压、血脂异常、睡眠呼吸暂停和代谢综合征的患病率降低。HRQoL 得到改善。弗雷明汉风险评分降低(5.6%对 4.6%;P=0.021)。61 例(33%)患者出现长期并发症,最常见的是慢性腹痛(10%)。术前 BMI<50 和≥50kg/m²的患者 BMI 分别为 33±5 和 37±7kg/m²,但代谢、心血管风险状况和 HRQoL 的变化大致相似。
在肥胖和超级肥胖患者中,胃旁路手术后 5 年体重减轻、心血管风险和 HRQoL 均有获益。