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里程碑多中心随机对照试验:与药物治疗相比,姿势治疗12个月后的体重减轻和饱腹感结果。

MILEPOST Multicenter Randomized Controlled Trial: 12-Month Weight Loss and Satiety Outcomes After pose vs. Medical Therapy.

作者信息

Miller Karl, Turró R, Greve J W, Bakker C M, Buchwald J N, Espinós J C

机构信息

Bariatric Medical Unit, Wehrle Diakonissen Private Clinic, Salzburg, Austria.

Unidad de Endoscopia, Centro Médico Teknon, Barcelona, Catalonia, Spain.

出版信息

Obes Surg. 2017 Feb;27(2):310-322. doi: 10.1007/s11695-016-2295-9.

Abstract

BACKGROUND

Pose is an endolumenal weight-loss intervention in which suture anchors are placed endoscopically in the gastric fundus/distal gastric body. Observational studies of pose have shown safe, effective weight loss. Twelve-month results of a randomized controlled trial comparing weight loss and satiety after pose vs. conventional medical therapy are reported.

METHODS

Subjects with classes I-II obesity were randomized in a 3:1 ratio to pose or diet/exercise guidance only (control). Pose subjects received gastric fundus and distal body suture-anchor plications with diet/exercise counseling. Total body (%TBWL) and excess weight loss (%EWL) were assessed at 6 and 12 months. Analysis of covariance (ANCOVA) was used to analyze 12-month %TBWL. Satiety changes were assessed at 6 and 12 months.

RESULTS

From November 2013 to July 2014, 44 subjects were randomized (34, 77.3 % female; mean age, 38.3 ± 10.7 years; body mass index, 36.5 ± 3.4 kg/m) to pose (n = 34) or control (n = 10) groups in three centers. Mean pose procedure time was 51.8 ± 14.5 min; pose subjects received a mean 8.8 ± 1.3 fundal and 4.2 ± 0.7 distal body plications. Twelve-month TBWL: pose, 13.0 % (EWL, 45.0 %), n = 30 vs. control group, 5.3 % (18.1 %), n = 9; significant mean difference, 7.7 % (95 % CI 2.2, 13.2; p < 0.01). Pose subjects showed significant reductions in satiety parameters (p < 0.001); controls experienced reduced caloric intake and satiety volume (p < 0.05). No serious device- or procedure-related adverse events occurred.

CONCLUSIONS

In a randomized controlled trial at 12 months, pose-treated subjects had significantly greater weight loss than those treated with diet/exercise guidance alone. At 6 and 12 months, pose subjects showed significant reduction in satiety parameters.

STUDY REGISTRATION

clinicaltrials.gov identifier # NCT01843231.

摘要

背景

Pose是一种腔内减肥干预措施,通过内镜将缝合锚钉置于胃底/胃体远端。对Pose的观察性研究表明其减肥效果安全有效。本文报告了一项随机对照试验的12个月结果,该试验比较了Pose与传统药物治疗后的体重减轻和饱腹感情况。

方法

将I-II级肥胖受试者按3:1的比例随机分为Pose组或仅接受饮食/运动指导的对照组。Pose组受试者接受胃底和胃体远端缝合锚钉折叠术并接受饮食/运动咨询。在6个月和12个月时评估总体重减轻百分比(%TBWL)和超重减轻百分比(%EWL)。采用协方差分析(ANCOVA)分析12个月时的%TBWL。在6个月和12个月时评估饱腹感变化。

结果

2013年11月至2014年7月,在三个中心将44名受试者(34名,77.3%为女性;平均年龄38.3±10.7岁;体重指数36.5±3.4kg/m²)随机分为Pose组(n = 34)或对照组(n = 10)。Pose手术平均时间为51.8±14.5分钟;Pose组受试者平均接受8.8±1.3次胃底折叠术和4.2±0.7次胃体远端折叠术。12个月时的总体重减轻情况:Pose组为13.0%(超重减轻45.0%),n = 30;对照组为5.3%(18.1%),n = 9;平均差异显著,为7.7%(95%CI 2.2, 13.2;p < 0.01)。Pose组受试者的饱腹感参数显著降低(p < 0.001);对照组的热量摄入和饱腹感容积降低(p < 0.05)。未发生与器械或手术相关的严重不良事件。

结论

在一项为期12个月的随机对照试验中,接受Pose治疗的受试者体重减轻显著大于仅接受饮食/运动指导的受试者。在6个月和12个月时,Pose组受试者的饱腹感参数显著降低。

研究注册

clinicaltrials.gov标识符#NCT

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