Raoux Loïc, Moszkowicz David, Vychnevskaia Karina, Poghosyan Tigran, Beauchet Alain, Clauser Sylvain, Bretault Marion, Czernichow Sébastien, Carette Claire, Bouillot Jean-Luc
Department of Digestive, Oncologic and Metabolic Surgery, Ambroise Paré Hospital, Boulogne-Billancourt, France.
Service de Chirurgie Digestive, Oncologique et Métabolique, Hôpital Ambroise Paré, 9 avenue Charles de Gaulle, 92100, Boulogne-Billancourt, France.
Obes Surg. 2017 Feb;27(2):387-393. doi: 10.1007/s11695-016-2292-z.
Abdominal obesity is strongly correlated with cardiovascular risk and associated with platelet hyperactivity. This hyperactivity is associated with an increase in mean platelet volume (MPV). Few data are available about changes in platelet counts and MPV in obese patients after bariatric surgery (BS). The purpose of this study was to describe quantitative and qualitative changes in the platelet lineage after BS.
One hundred twenty-eight consecutive patients were included. The mean age was 43 ± 12 years, 77 % of patients were female, and the mean preoperative BMI was 44 ± 6 kg/m. Ninety patients (71 %) had a Roux-en-Y gastric bypass (RYGBP), and 38 (29 %) had a sleeve gastrectomy (SG). Patients were evaluated preoperatively, and postoperative follow-up was performed at 3, 6, and 12 months. The postoperative evaluation included blood samples for full blood count (FBC), including measure of mean platelet volume (MPV).
At the 12-month follow-up, the reduction in preoperative weight was 29 ± 9 %. We showed a significant decrease in platelet count (245 ± 62 vs. 234 ± 54 G/L; p = 0.0015) found in parallel with a non-significant decrease in MPV (9.27 ± 1.1 vs. 9.22 ± 1.05; p = 0.34). With regard to the intervention type, SG caused a more significant decrease in platelet count than RYGBP (p = 0.02). There was no significant difference in MPV variations between the two groups (p = 0.08).
Our results suggest that BS has a positive impact on platelet metabolism, possibly mediated by weight loss. These data need to be confirmed to understand the multifactorial benefits of BS on cardiovascular risk in obese patients.
腹部肥胖与心血管风险密切相关，并与血小板活性亢进有关。这种活性亢进与平均血小板体积（MPV）增加有关。关于肥胖患者在减肥手术后（BS）血小板计数和MPV的变化，相关数据较少。本研究的目的是描述减肥手术后血小板系的定量和定性变化。
纳入128例连续患者。平均年龄为43±12岁，77%的患者为女性，术前平均BMI为44±6kg/m²。90例（71%）患者接受了Roux-en-Y胃旁路术（RYGBP），38例（29%）接受了袖状胃切除术（SG）。术前对患者进行评估，并在术后3、6和12个月进行随访。术后评估包括采集全血细胞计数（FBC）血样，包括平均血小板体积（MPV）测量。
在12个月的随访中，术前体重减轻了29±9%。我们发现血小板计数显著下降（245±62 vs. 234±54G/L；p = 0.0015），同时MPV有非显著性下降（9.27±1.1 vs. 9.22±1.05；p = 0.34）。关于干预类型，SG导致的血小板计数下降比RYGBP更显著（p = 0.02）。两组之间MPV变化无显著差异（p = 0.08）。
我们的结果表明，减肥手术对血小板代谢有积极影响，可能是由体重减轻介导的。这些数据需要得到证实，以了解减肥手术对肥胖患者心血管风险的多因素益处。
