Espinós J C, Turró R, Moragas G, Bronstone A, Buchwald J N, Mearin F, Mata A, Uchima H, Turró J, Delgado-Aros S
Unidad de Endoscopia, Centro Médico Teknon, Barcelona, Catalonia, Spain.
CETIR Grup Médic Barcelona, Barcelona, Catalonia, Spain.
Obes Surg. 2016 May;26(5):1081-9. doi: 10.1007/s11695-015-1863-8.
Primary Obesity Surgery Endolumenal (POSE) is a novel bariatric endoscopic procedure that has been shown to reduce weight safely through 12 months. The study investigated potential mechanisms of weight loss following POSE.
Patients with class I-II obesity received transmural plications in the gastric fundus and distal gastric body. Patients were evaluated at baseline and at 2- and 6-month follow-up with gastric-emptying (GE) scintigraphy, a validated test of intake capacity (kcal) and plasma glucose homeostasis hormones/gastrointestinal peptides. Weight was recorded through 15 months. Mean data and 95% CIs are reported. Regression modeling assessed variables that influenced total weight loss (%TWL) and excess weight loss (%EWL).
POSE was performed on 18 patients (14 F/4 M); mean age 39 years (34-44), body mass index (BMI, kg/m(2)) 36 (95% CI, 35; 37). At 15 months (n = 15), mean TWL was 19.1 ± 6.6% (15.5; 22.8) and EWL was 63.7 ± 25.1% (49.8; 77.6). At 2 and 6 months (n = 18), intake capacity decreased significantly from 901 (685; 1117) to 473 (345; 600) and 574 kcal (418; 730), respectively (p < 0.001). At 2 months, GE was delayed but returned to baseline levels at 6 months (n = 18). Glucose/insulin ratio improved (p < 0.05). Postprandial decrease in ghrelin was enhanced (p = 0.03) as well as postprandial increase in PYY (p = 0.001). The best model for EWL prediction 15 months after POSE (R (2): 66%, p = 0.006) included pre-POSE BMI, post-POSE GE, and postprandial PYY increase.
The POSE procedure was followed by significant sustained weight loss and improved glucose homeostasis and satiation peptide responses. Weight loss following POSE may be mediated through changes in gastrointestinal neuro-endocrine physiology.
原发性肥胖症手术内镜治疗（POSE）是一种新型的减肥内镜手术，已被证明可在12个月内安全减重。本研究调查了POSE术后体重减轻的潜在机制。
I-II级肥胖患者在胃底和胃体远端接受经壁折叠术。在基线以及术后2个月和6个月随访时，对患者进行胃排空（GE）闪烁扫描、摄入量（千卡）验证测试以及血浆葡萄糖稳态激素/胃肠肽评估。记录15个月内的体重。报告均值数据和95%置信区间。回归模型评估影响总体重减轻（%TWL）和超重减轻（%EWL）的变量。
对18例患者（14例女性/4例男性）实施了POSE手术；平均年龄39岁（34-44岁），体重指数（BMI，kg/m²）为36（95%置信区间，35；37）。在15个月时（n = 15），平均TWL为19.1±6.6%（15.5；22.8），EWL为63.7±25.1%（49.8；77.6）。在2个月和6个月时（n = 18），摄入量分别从901（685；1117）显著降至473（345；600）和574千卡（418；730）（p < 0.001）。在2个月时，GE延迟，但在6个月时恢复到基线水平（n = 18）。葡萄糖/胰岛素比值改善（p < 0.05）。餐后胃饥饿素的降低增强（p = 0.03），餐后肽YY的增加也增强（p = 0.
