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术前血清维生素D水平对胃旁路术后并发症及体重过度减轻的影响

Impact of Preoperative Serum Vitamin D Level on Postoperative Complications and Excess Weight Loss After Gastric Bypass.

作者信息

Schaaf Caroline, Gugenheim Jean

机构信息

Service de Chirurgie Digestive et Transplantation Hépatique, Hôpital Archet 2, Centre Hospitalo Universitaire, Université de Nice Sophia Antipolis, Nice, France.

出版信息

Obes Surg. 2017 Aug;27(8):1982-1985. doi: 10.1007/s11695-017-2600-2.

Abstract

INTRODUCTION

The aim of this study was to determine the impact of hypovitaminosis D on Gastric Bypass outcomes.

METHODS

We retrospectively reviewed all patients who underwent primary intention Gastric Bypass in our center between January 2012 and December 2013. Postoperative complications, 1 and 2-year excess weight loss were compared between patients with and without hypovitaminosis D.

RESULTS

Among 258 patients who met inclusion criteria, 56 (21.7%) presented with vitamin D deficiency. Mean age was 41.73 ± 12.95 years. Mean BMI was 40.90 kg/m (34-58 kg/m). No statistically significant difference in postoperative complication rate was found between patients with and without hypovitaminosis D. Mean 1-year excess weight loss was 75.24%. In patients with vitamin D deficiency mean 1-year excess weight loss was 71.90 versus 76.15% in patients with optimal serum vitamin D level (p = 0.17). No significant difference was found after a 2-year follow-up. In patients presenting with vitamin D insufficiency, 1-year excess weight loss was 75.64 versus 79.34% in patients with optimal serum vitamin D level (p = 0.53). After a 2-year follow-up, there was a significant difference between patients presenting with and without vitamin D insufficiency (79.45 versus 91.71%; p = 0.01) and between patients presenting with and without hypovitaminosis D (80.50 versus 91.71%; p = 0.01).

CONCLUSION

In our study, hypovitaminosis D seemed to have a negative impact on long term excess weight loss, but not on short-term outcome or postoperative complications. The role of systematic supplementation before bariatric surgery has to be explored in prospective studies.

摘要

引言

本研究的目的是确定维生素D缺乏对胃旁路手术结果的影响。

方法

我们回顾性分析了2012年1月至2013年12月在本中心接受初次胃旁路手术的所有患者。比较了维生素D缺乏和不缺乏患者的术后并发症、1年和2年的超重减轻情况。

结果

在258例符合纳入标准的患者中,56例(21.7%)存在维生素D缺乏。平均年龄为41.73±12.95岁。平均体重指数为40.90kg/m²(34-58kg/m²)。维生素D缺乏和不缺乏患者的术后并发症发生率无统计学显著差异。平均1年超重减轻率为75.24%。维生素D缺乏患者的平均1年超重减轻率为71.90%,而血清维生素D水平最佳的患者为76.15%(p=0.17)。2年随访后未发现显著差异。维生素D不足的患者,1年超重减轻率为75.64%,而血清维生素D水平最佳的患者为79.34%(p=0.53)。2年随访后,维生素D不足和不不足的患者之间存在显著差异(79.45%对91.71%;p=0.01),维生素D缺乏和不缺乏的患者之间也存在显著差异(80.50%对91.71%;p=0.01)。

结论

在我们的研究中,维生素D缺乏似乎对长期超重减轻有负面影响,但对短期结果或术后并发症没有影响。必须在前瞻性研究中探讨减肥手术前系统补充维生素D的作用。

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