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胃癌患者的心血管危险因素在胃切除术后1年降低。

Cardiovascular Risk Factors in Gastric Cancer Patients Decrease 1 Year After Gastrectomy.

作者信息

Ha Tae Kyung, Seo Youn Kyoung, Kang Bo Kyeong, Shin Jinho, Ha Eunyoung

机构信息

Department of Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea.

Department of Anatomy and Cell Biology, College of Medicine, Hanyang University, Seoul, Republic of Korea.

出版信息

Obes Surg. 2016 Oct;26(10):2340-7. doi: 10.1007/s11695-016-2085-4.

Abstract

BACKGROUND

Due to the high 5-year overall survival rate (>95 %) for early gastric cancer (EGC), patients now face risks of developing comorbidities. Cardiovascular disease (CVD) is one of the most common causes of death not only in the general population and but also in cancer patients. Thus, we determined the effect of gastrectomy on cardiovascular risk factors by analyzing changes in lipid profiles of patients who underwent curative gastrectomy for EGC.

METHODS

Seventy-three patients who received curative gastrectomy for EGC were included and divided into gastroduodenostomy (GD) and duodenal bypass (DB) groups according to the anastomosis. Changes in visceral fat area (VFA), subcutaneous fat area (SFA), and lipid profiles [total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C)] were evaluated in both groups 1 year after gastrectomy.

RESULTS

Body weight, VFA, SFA, TG, LDL-C, and TC decreased significantly while HDL-C increased (p < 0.001) after the surgery. We observed a weak negative correlation between percent change of VFA and HDL-C (r = -0.245, p = 0.036). When compared with the GD group, the DB group lost more SFA (p < 0.001), body weight (p = 0.008), and TC (p = 0.031). We also found that the degree of BMI change (∆BMI) was greater in the obese patients than in the non-obese patients (p < 0.001).

CONCLUSIONS

Curative gastrectomy reduces VFA, SFA, and body weight and improves lipid profiles in patients with EGC, all of which indicates reduced cardiovascular risk. Therefore, prospective studies are required to verify whether gastrectomy in EGC patients has favorable effects on future CVD mortality.

摘要

背景

由于早期胃癌(EGC)的5年总生存率较高(>95%),患者现在面临发生合并症的风险。心血管疾病(CVD)不仅是普通人群,也是癌症患者最常见的死亡原因之一。因此,我们通过分析接受EGC根治性胃切除术患者血脂谱的变化,确定胃切除术对心血管危险因素的影响。

方法

纳入73例接受EGC根治性胃切除术的患者,并根据吻合方式分为胃十二指肠吻合术(GD)组和十二指肠旁路术(DB)组。在胃切除术后1年评估两组患者的内脏脂肪面积(VFA)、皮下脂肪面积(SFA)和血脂谱[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)]的变化。

结果

术后体重、VFA、SFA、TG、LDL-C和TC显著下降,而HDL-C升高(p<0.001)。我们观察到VFA变化百分比与HDL-C之间存在弱负相关(r=-0.245,p=0.036)。与GD组相比,DB组的SFA(p<0.001)、体重(p=0.008)和TC(p=0.031)下降更多。我们还发现肥胖患者的体重指数变化程度(∆BMI)大于非肥胖患者(p<0.001)。

结论

根治性胃切除术可减少EGC患者的VFA、SFA和体重,并改善血脂谱,所有这些均表明心血管风险降低。因此,需要进行前瞻性研究以验证EGC患者的胃切除术对未来CVD死亡率是否有有利影响。

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