Gibbons Emma, Casey Amanda Faith, Brewster Keith Z
Department of Human Kinetics, St. Francis Xavier University, Antigonish, NS, Canada.
Department of Human Kinetics, St. Francis Xavier University, Antigonish, NS, Canada.
Disabil Health J. 2017 Jan;10(1):3-10. doi: 10.1016/j.dhjo.2016.09.005. Epub 2016 Sep 16.
Rates of morbid obesity are higher for individuals with intellectual disability (ID). Individuals with ID may find nutritional guidelines difficult to follow and many face personal and environmental barriers for physical activity. Bariatric surgery may reduce obesity related health comorbidities while promoting sustained weight loss in diverse populations. Yet no study has reviewed the feasibility of conducting bariatric surgery on individuals with ID.
To conduct a scoping review of literature on bariatric procedures performed on individuals with ID.
Authors searched electronic database via PubMED, Science Direct, Wiley and Medline (1975-2014). Extracted articles were evaluated independently following scoping reviews guidelines.
Reviewers included sixteen studies. Nine surgical interventions were reported on 49 patients with ID. Studies followed either case report or case series design. The most common procedure patients received was biliopancreatic diversion (n = 24) followed by Roux-en-Y Gastric Bypass (n = 12). Degree of weight loss was the primary outcome in each study. Excess weight loss (%EWL) ranged from 12% to 86%. Further benefits included improved quality of life, decreased psychological tension within family and resolution of sleep apnea, hypertension, respiratory distress and type II diabetes. Six studies included a post-operative follow-up period below two years.
Bariatric surgery may be a viable option to treat obesity in individuals with ID but there is no consensus which procedure is preferred and which associated interventions should be in place to warrant long lasting results. Further research featuring randomized control trials may be beneficial.
智障人士的病态肥胖率更高。智障人士可能觉得营养指南难以遵循，许多人在进行体育活动时面临个人和环境障碍。减肥手术可能会减少与肥胖相关的健康合并症，同时促进不同人群持续减重。然而，尚无研究评估对智障人士实施减肥手术的可行性。
对针对智障人士实施的减肥手术相关文献进行范围综述。
作者通过PubMed、Science Direct、Wiley和Medline（1975 - 2014年）检索电子数据库。按照范围综述指南对提取的文章进行独立评估。
综述纳入16项研究。报告了对49例智障患者实施的9种手术干预。研究采用病例报告或病例系列设计。患者接受的最常见手术是胆胰转流术（n = 24），其次是Roux - en - Y胃旁路术（n = 12）。体重减轻程度是每项研究的主要结局。超重减轻百分比（%EWL）范围为12%至86%。其他益处包括生活质量改善、家庭中心理压力减轻以及睡眠呼吸暂停、高血压、呼吸窘迫和II型糖尿病得到缓解。6项研究的术后随访期不足两年。
减肥手术可能是治疗智障人士肥胖的一个可行选择，但对于哪种手术更优以及应采取哪些相关干预措施以确保长期效果尚无共识。开展随机对照试验的进一步研究可能有益。
