Lins Daniel C, Campos Josemberg M, de Paula Patrícia S, Galvão-Neto Manoel, Pachu Eduardo, Cavalcanti Ney, Ferraz Álvaro A B
Oswaldo Cruz Hospital, Faculty of Medical Sciences of Pernambuco, Brazil.
Federal University of Pernambuco, Recife, PE, Brazil.
Arq Bras Cir Dig. 2015;28 Suppl 1(Suppl 1):11-4. doi: 10.1590/S0102-6720201500S100005.
Obesity and type 2 diabetes mellitus are associated to inflammatory state, which can be set off by the adipose tissue, once it is a metabolically active organ that can cause a chronic mild inflammatory state.
To evaluate the correlation between preoperative C-reactive protein and postoperative complications risk in obese patients (grades II and III) after Roux-en-Y gastric bypass, with and without type 2 diabetes mellitus.
Between 2008 and 2013 were analysed 209 patients (107 with diabetes), presenting body mass index >40 kg/m2 or >35 kg/m2 with comorbidities. During the postoperative period, two groups were evaluated: with and without complications. Preoperative ultra-sensitive C-reactive protein was measured by immunonephelometry method.
Complications occurred in seven patients (pulmonary thromboembolism, fistula, two cases of suture leak, pancreatitis, evisceration and upper digestive hemorrhage). No statistical significance was found regarding lipid profile and C-reactive protein between patients with and without type 2 diabetes mellitus. When compared to each other, both groups (with and without complications) presented with statistical significance regarding C-reactive protein level (7,2 mg/dl vs 3,7 mg/dl, p=0,016) and had similar weight loss percentage after 3, 6 and 12 months follow-up.
Preoperative C-reactive protein serum level was higher in the group which presented complications after Roux-en-Y gastric bypass when compared to the group without postoperative complications.
肥胖和2型糖尿病与炎症状态相关，脂肪组织可引发这种炎症状态，因为它是一个具有代谢活性的器官，能够导致慢性轻度炎症状态。
评估接受Roux-en-Y胃旁路手术的肥胖患者（II级和III级），无论有无2型糖尿病，术前C反应蛋白与术后并发症风险之间的相关性。
分析2008年至2013年间的209例患者（107例患有糖尿病），这些患者体重指数>40kg/m2或>35kg/m2且伴有合并症。在术后期间，对两组进行评估：有并发症组和无并发症组。术前超敏C反应蛋白采用免疫比浊法测量。
7例患者出现并发症（肺血栓栓塞、瘘管、2例缝合口漏、胰腺炎、脏器脱出和上消化道出血）。2型糖尿病患者和非2型糖尿病患者之间在血脂谱和C反应蛋白方面未发现统计学意义。两组（有并发症组和无并发症组）相互比较时，在C反应蛋白水平方面具有统计学意义（7.2mg/dl对3.7mg/dl，p=0.016），并且在3、6和12个月随访后体重减轻百分比相似。
与无术后并发症的组相比，接受Roux-en-Y胃旁路手术后出现并发症的组术前血清C反应蛋白水平更高。
