体重减轻与颈动脉内膜中层厚度：荟萃分析。
Weight loss and carotid intima-media thickness-a meta-analysis.
机构信息
The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, University of Sydney, Sydney, New South Wales, Australia.
Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
出版信息
Obesity (Silver Spring). 2017 Feb;25(2):357-362. doi: 10.1002/oby.21732. Epub 2016 Dec 27.
OBJECTIVE
Obesity is a risk factor for clinical cardiovascular disease, putatively via increased burden of atherosclerosis. It remains contentious as to whether weight loss in people with obesity is accompanied by a reduction in intima-media thickness, a noninvasive marker of subclinical atherosclerosis, consistent with a lowering of risk of cardiovascular events.
METHODS
A systematic literature search was performed to identify all surgical and nonsurgical weight loss interventions that reported intima-media thickness. A meta-analysis was undertaken to obtain pooled estimates for change in intima-media thickness.
RESULTS
From the 3,197 articles screened, 9 studies were included in the meta-analysis, with a total of 393 participants who lost an average of 16 kg (95% CI 9.4-22.5) of body weight over an average follow-up of 20 months. The pooled mean change in carotid intima-media thickness was -0.03 mm (95% CI -0.05 to -0.01), which was similar between surgical and nonsurgical interventions.
CONCLUSIONS
In people with obesity, weight loss was associated with a reduction in carotid intima-media thickness, consistent with a lowering in risk of cardiovascular events.
目的
肥胖是临床心血管疾病的一个风险因素，可能是通过增加动脉粥样硬化的负担。目前仍存在争议的是，肥胖人群的体重减轻是否伴随着内膜-中层厚度的减少，而内膜-中层厚度是亚临床动脉粥样硬化的一种非侵入性标志物，与心血管事件风险的降低一致。
方法
系统地检索了所有报告内膜-中层厚度的手术和非手术减肥干预措施的文献。进行了荟萃分析，以获得内膜-中层厚度变化的汇总估计值。
结果
从筛选出的 3197 篇文章中，有 9 项研究被纳入荟萃分析，共有 393 名参与者平均减轻了 16 公斤（95%置信区间 9.4-22.5）的体重，平均随访 20 个月。颈动脉内膜-中层厚度的平均变化为-0.03 毫米（95%置信区间-0.05 至-0.01），手术和非手术干预之间的差异无统计学意义。
结论
在肥胖人群中，体重减轻与颈动脉内膜-中层厚度的减少有关，这与心血管事件风险的降低一致。
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