Department of Surgery, Weill Cornell College of Medicine, New York, NY, USA.
Obesity and Quality of Life Consulting, and Duke University School of Medicine, Durham, NC, USA.
Nutr Diabetes. 2014 Sep 1;4(9):e132. doi: 10.1038/nutd.2014.29.
In severe obesity, impairments in health-related quality of life (HRQoL) and dysphoric mood are reported. This is a post-surgery analysis of the relationship between HRQoL and depressive symptoms, and weight change after four different types of bariatric procedures.
A total of 105 consented patients completed the Short-Form-36 Health Survey (SF-36), the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) and the Beck Depression Inventory (BDI) before and 25 months after surgery. Analysis of variance or Kruskal-Wallis test evaluated changes.
Patients with Roux-en Y gastric bypass (46 patients), decreased body mass indexes (BMIs; kg m(-)(2)) 47-31 kg m(-)(2) (P<0.0001); biliopancreatic diversion with duodenal switch (18 patients), decreased BMIs 57-30 kg m(-)(2) (P<0.0001); adjustable gastric banding (18 patients), decreased BMIs 45-38 kg m(-)(2) (P<0.0001); and sleeve gastrectomies (23 patients), decreased BMIs 58 42 kg m(-)(2) (P<0.0001). The excess percentage BMI loss was 69, 89, 36 and 53 kg m(-)(2), respectively (P<0.0001). Before surgery, the SF-36 differences were significant regarding bodily pain (P=0.008) and social functioning (P=0.01). After surgery, physical function (P=0.03), general health (P=0.05) and physical component (P=0.03) were different. IWQOL-Lite recorded no differences until after surgery: physical function (P=0.003), sexual life (P=0.04) and public distress (P=0.003). BDI scores were not different for the four groups at baseline. All improved with surgery, 10.6-4.4 (P=0.0001).
HRQoL and depressive symptoms significantly improvement after surgery. These improvements do not have a differential effect over the wide range of weight change.Nutrition & Diabetes (2014) 4, e132; doi:10.1038/nutd.2014.29; published online 1 September 2014.
在严重肥胖症患者中,生活质量(HRQoL)受损和情绪抑郁被报道。这是手术后对四种不同减重手术类型后的 HRQoL 和抑郁症状与体重变化之间关系的分析。
共有 105 名同意参与的患者在手术前和手术后 25 个月完成了简明 36 健康调查(SF-36)、体重对生活质量影响简短版(IWQOL-Lite)和贝克抑郁量表(BDI)。方差分析或 Kruskal-Wallis 检验评估变化。
Roux-en Y 胃旁路术(46 例)患者体重指数(BMI;kg/m2)降低 47-31kg/m2(P<0.0001);胆胰分流加十二指肠转位术(18 例)患者 BMI 降低 57-30kg/m2(P<0.0001);可调胃束带术(18 例)患者 BMI 降低 45-38kg/m2(P<0.0001);袖状胃切除术(23 例)患者 BMI 降低 58-42kg/m2(P<0.0001)。BMI 过量损失百分比分别为 69、89、36 和 53kg/m2(P<0.0001)。手术前,SF-36 在身体疼痛(P=0.008)和社会功能(P=0.01)方面存在显著差异。手术后,生理功能(P=0.03)、一般健康(P=0.05)和生理成分(P=0.03)有所不同。IWQOL-Lite 直到手术后才记录到差异:生理功能(P=0.003)、性生活(P=0.04)和公众困扰(P=0.003)。BDI 评分在基线时在四组之间没有差异。所有组在手术后都有改善,10.6-4.4(P=0.0001)。
手术治疗后 HRQoL 和抑郁症状明显改善。这些改善在广泛的体重变化范围内没有差异。