比较两种减重手术在青少年肥胖人群中的效果：Roux-en-Y 胃旁路术与袖状胃切除术。
Comparing Outcomes of Two Types of Bariatric Surgery in an Adolescent Obese Population: Roux-en-Y Gastric Bypass vs. Sleeve Gastrectomy.
机构信息
Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School , Boston, MA , USA.
Pediatric Endocrine Unit, Massachusetts General Hospital for Children, Harvard Medical School, Boston, MA, USA; Weight Center, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine-Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
出版信息
Front Pediatr. 2016 Jul 26;4:78. doi: 10.3389/fped.2016.00078. eCollection 2016.
BACKGROUND
Obesity is prevalent among adolescents and is associated with serious health consequences. Roux-en-Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG) are bariatric procedures that cause significant weight loss in adults and are increasingly being performed in adolescents with morbid obesity. Data comparing outcomes of RYGB vs. SG in this age-group are scarce. This study aims to compare short-term (1-6 months) and longer-term (7-18 months) body mass index (BMI) and biochemical outcomes following RYGB and SG in adolescents/young adults.
METHODS
A retrospective study using data extracted from medical records of patients 16-21 years who underwent RYGB or SG between 2012 and 2014 at a tertiary care academic medical center.
RESULTS
Forty-six patients were included in this study: 24 underwent RYGB and 22 underwent SG. Groups did not differ for baseline age, sex, race, or BMI. BMI reductions were significant at 1-6 months and 7-18 months within groups (p < 0.0001), but did not differ by surgery type (p = 0.65 and 0.09, for 1-6 months and 7-18 months, respectively). Over 7-18 months, within-group improvement in low-density lipoprotein (LDL) (-24 ± 6 in RYGB, p = 0.003, vs. -7 ± 9 mg/dl in SG, p = 0.50) and non-high-density lipoprotein (non-HDL) cholesterol (-23 ± 8 in RYGB, p = 0.02, vs. -12 ± 7 in SG, p = 0.18) appeared to be of greater magnitude following RYGB. However, differences between groups did not reach statistical significance. When divided by non-alcoholic steatohepatitis stages (NASH), patients with Stage II-III NASH had greater reductions in alanine aminotransferase levels vs. those with Stage 0-I NASH (-45 ± 18 vs. -9 ± 3, p = 0.01) after 7-18 months. RYGB and SG groups did not differ for the magnitude of post-surgical changes in liver enzymes.
CONCLUSION
RYGB and SG did not differ for the magnitude of BMI reduction across groups, though changes trended higher following RYGB. Further prospective studies are needed to confirm these findings.
背景
肥胖在青少年中很普遍，与严重的健康后果有关。Roux-en-Y 胃旁路术（RYGB）和袖状胃切除术（SG）是两种减重手术，可使成年人显著减重，并且越来越多地用于患有病态肥胖的青少年。比较 RYGB 与 SG 在该年龄组的结果的数据很少。本研究旨在比较青少年/年轻成年人接受 RYGB 和 SG 后 1-6 个月和 7-18 个月的短期（1-6 个月）和长期（7-18 个月）体重指数（BMI）和生化结果。
方法
这是一项使用从 2012 年至 2014 年在一家三级保健学术医疗中心接受 RYGB 或 SG 的 16-21 岁患者病历中提取的数据进行的回顾性研究。
结果
本研究纳入了 46 名患者：24 名接受了 RYGB，22 名接受了 SG。两组在基线年龄、性别、种族和 BMI 方面没有差异。两组内 BMI 均在 1-6 个月和 7-18 个月时显著降低（p<0.0001），但与手术类型无关（p=0.65 和 0.09，分别为 1-6 个月和 7-18 个月）。在 7-18 个月期间，RYGB 组 LDL（-24±6，p=0.003，与 SG 组-7±9mg/dl，p=0.50）和非高密度脂蛋白（non-HDL）胆固醇（-23±8，p=0.02，与 SG 组-12±7，p=0.18）的改善幅度似乎更大。然而，两组之间的差异没有达到统计学意义。当按非酒精性脂肪性肝炎（NASH）阶段划分时，与 NASH 0-1 期相比，NASH II-III 期患者的丙氨酸氨基转移酶水平下降幅度更大（-45±18 与-9±3，p=0.01）在 7-18 个月后。RYGB 和 SG 组之间肝酶术后变化的幅度没有差异。
结论
RYGB 和 SG 在组间 BMI 降低的幅度上没有差异，尽管 RYGB 后变化趋势更高。需要进一步的前瞻性研究来证实这些发现。
Zotero 插件