Min Thinzar, Prior Sarah L, Caplin Scott, Barry Jonathan D, Stephens Jeffrey W
1 Diabetes Research Group, College of Medicine, Swansea University , Swansea, United Kingdom .
2 Department of Diabetes and Endocrinology, Morriston Hospital , ABMU Health Board, Swansea, United Kingdom .
Metab Syndr Relat Disord. 2017 Apr;15(3):130-136. doi: 10.1089/met.2016.0112. Epub 2017 Jan 5.
Cardiovascular (CV) risk equations are routinely used to predict risk in nonbariatric populations, but have not been studied in depth in patients undergoing bariatric surgery and specifically those with impaired glucose regulation. The aim of this pilot study was to investigate changes in the 10-year and lifetime predicted CV risk in subjects with impaired glucose regulation before, 1 month, 6 months, and 5 years after bariatric surgery.
A nonrandomized prospective study was conducted of 45 participants with impaired glucose regulation undergoing temporal assessments during follow-up. Body weight, body mass index (BMI), blood pressure, lipid profile, and HbA1c were recorded preoperatively, 1 month, 6 months, and 5 years postoperatively. Preoperative and postoperative predicted CV risk was calculated using the QRISK2, QRISK lifetime, and JBS3 calculators. Follow-up rates were 93%, 91%, and 71% at 1 month, 6 months, and 5 years, respectively. The sample had a mean age of 48.8 ± 7.0 years, a mean BMI of 53.9 ± 11.1 kg/m, and a mean HbA1c of 7.5% ± 1.7%. The predicted 10-year QRISK2 score decreased by 35%, 54%, and 24% at 1 month, 6 months, and 5 years, respectively (P < 0.001). The predicted lifetime risk also decreased with the greatest reduction (24.5% with QRISK lifetime and 26.7% with JBS3 lifetime score) observed at 5 years even though the subjects were 5 years older.
Bariatric surgery in patients with impaired glucose regulation is associated with a significant reduction in predicted 10-year and lifetime CV risk in a population that was 5 years older compared to baseline.
心血管（CV）风险方程常用于预测非肥胖人群的风险，但在接受减肥手术的患者，尤其是血糖调节受损的患者中尚未进行深入研究。这项初步研究的目的是调查减肥手术前、术后1个月、6个月和5年时血糖调节受损受试者的10年和终生预测心血管风险的变化。
对45名血糖调节受损的参与者进行了一项非随机前瞻性研究，在随访期间进行了定期评估。记录术前、术后1个月、6个月和5年时的体重、体重指数（BMI）、血压、血脂谱和糖化血红蛋白（HbA1c）。使用QRISK2、QRISK终生风险计算器和JBS3计算器计算术前和术后预测的心血管风险。1个月、6个月和5年时的随访率分别为93%、91%和71%。样本的平均年龄为48.8±7.0岁，平均BMI为53.9±11.1kg/m，平均HbA1c为7.5%±1.7%。预测的10年QRISK2评分在术后1个月、6个月和5年分别下降了35%、54%和24%（P<0.001）。预测的终生风险也有所下降，5年时下降幅度最大（QRISK终生风险计算器下降24.5%，JBS3终生风险评分下降26.7%），尽管受试者年龄增加了5岁。
与基线相比，血糖调节受损患者接受减肥手术与预测的10年和终生心血管风险显著降低相关，该人群年龄比基线时大5岁。
