Nicoletti Carolina Ferreira, de Oliveira Bruno Affonso Parenti, de Pinhel Marcela Augusta Souza, Donati Bruna, Marchini Julio Sergio, Salgado Junior Wilson, Nonino Carla Barbosa
Department of Internal Medicine, Faculty of Medicine of Ribeirao Preto, University of São Paulo, Avenida dos Bandeirantes, 3900, Ribeirao Preto, SP, 14049-900, Brazil,
Obes Surg. 2015 Feb;25(2):279-84. doi: 10.1007/s11695-014-1349-0.
Bariatric surgery produces a substantial weight loss and improves the comorbidities associated with obesity such as diabetes mellitus and dyslipidemia, although inability to lose weight or weight regain has been estimated to occur in 20 % of cases. The objective of the present study was to assess the influence of weight variations on biochemical indicators during a 4-year period after bariatric surgery.
A 4-year retrospective longitudinal study was conducted on 138 patients with grade III obesity submitted to Roux-en-Y gastric bypass, with the assessment of anthropometric measurements and biochemical indicators. The patients were divided into two groups according to percent excess weight loss (%EWL): %EWL > 50 % and %EWL < 50 %, and into two groups according to weight regain: <10 % and >10 %. The Student t test for independent samples was used to assess the differences in biochemical indicators between groups (p ≤ 0.05).
Four years after surgery, there was a weight loss of 49.4 ± 21.8 kg and %EWL of 61 ± 21.2 %, with 73.2 % (n = 101) of the patients showing %EWL of 50 % or more. Significant weight regain occurred in 24.6 % of the sample. There was a difference in weight, BMI, total cholesterol, LDL-cholesterol, triglycerides, and albumin between patients with different %EWL. No difference in biochemical indicators was observed between subjects with and without regain.
Four years after surgery, greater %EWL was associated with a better lipid profile. In addition, weight regain did not change the biochemical indicators of this patient series.
减肥手术能显著减轻体重，并改善与肥胖相关的合并症，如糖尿病和血脂异常，不过据估计，20%的病例会出现无法减重或体重反弹的情况。本研究的目的是评估减肥手术后4年期间体重变化对生化指标的影响。
对138例接受Roux-en-Y胃旁路手术的III级肥胖患者进行了为期4年的回顾性纵向研究，评估人体测量指标和生化指标。根据超重体重减轻百分比（%EWL）将患者分为两组：%EWL>50%和%EWL<50%，并根据体重反弹情况分为两组：<10%和>10%。采用独立样本的Student t检验评估组间生化指标的差异（p≤0.05）。
术后4年，体重减轻了49.4±21.8 kg，%EWL为61±21.2%，73.2%（n=101）的患者%EWL达到50%或更高。24.6%的样本出现了显著的体重反弹。不同%EWL的患者在体重、BMI、总胆固醇、低密度脂蛋白胆固醇、甘油三酯和白蛋白方面存在差异。有体重反弹和无体重反弹的受试者之间未观察到生化指标的差异。
术后4年，较高的%EWL与更好的血脂谱相关。此外，体重反弹并未改变该患者系列的生化指标。
