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肥胖青少年的减重手术可改善多种主要合并症,包括高尿酸血症。

Bariatric surgery in severely obese adolescents improves major comorbidities including hyperuricemia.

机构信息

Department of Cardiac Surgery, University of Leipzig, Heart Center Leipzig, Leipzig, Germany; University of Dresden, Department of Health Sciences/Public Health, Dresden, Germany.

Department of Urology, University of Leipzig, Leipzig, Germany.

出版信息

Metabolism. 2014 Feb;63(2):242-9. doi: 10.1016/j.metabol.2013.11.012. Epub 2013 Nov 22.

Abstract

OBJECTIVE

Serum uric acid (sUA) is believed to contribute to the pathogenesis of metabolic comorbidities like hypertension, insulin-resistance (IR) and endothelial dysfunction (EDF) in obese children. The present pilot study investigated the association between sUA concentrations and loss of body weight following laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y-gastric bypass (RYGB) in severely obese adolescents.

MATERIALS/METHODS: 10 severely obese adolescents underwent either LSG (n=5) or RYGB (n=5). 17 normal weight, healthy, age- and gender-matched adolescents served as a normal weight peer group (NWPG). Pre- and 12 months postoperatively, sUA and relevant metabolic parameters (glucose homeostasis, transaminases, lipids) were compared.

RESULTS

Preoperatively, sUA was significantly elevated in patients with severe obesity compared to NWPG. Twelve months after LSG and RYGB, a significant decrease in sUA, BMI, CVD risk factors, hepatic transaminases, and HOMA-IR was observed. Reduction in SDS-BMI significantly correlated with changes in sUA.

CONCLUSIONS

sUA levels and metabolic comorbidities improved following bariatric surgery in severely obese adolescents. The impact of changes in sUA on long-term clinical complications of childhood obesity deserves further study.

摘要

目的

尿酸(sUA)被认为有助于肥胖儿童的代谢合并症的发病机制,如高血压、胰岛素抵抗(IR)和内皮功能障碍(EDF)。本初步研究调查了腹腔镜袖状胃切除术(LSG)或腹腔镜 Roux-en-Y 胃旁路术(RYGB)后 sUA 浓度与肥胖青少年体重减轻之间的关系。

材料/方法:10 名严重肥胖的青少年接受了 LSG(n=5)或 RYGB(n=5)。17 名体重正常、健康、年龄和性别匹配的青少年作为体重正常对照组(NWPG)。术前和术后 12 个月,比较 sUA 和相关代谢参数(葡萄糖稳态、转氨酶、脂质)。

结果

与 NWPG 相比,严重肥胖患者的 sUA 术前显著升高。LSG 和 RYGB 术后 12 个月,sUA、BMI、心血管疾病风险因素、肝转氨酶和 HOMA-IR 显著降低。SDS-BMI 的减少与 sUA 的变化显著相关。

结论

肥胖青少年进行减重手术后,sUA 水平和代谢合并症得到改善。sUA 变化对儿童肥胖长期临床并发症的影响值得进一步研究。

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