Bencsath Kalman, Jammoul Adham, Aminian Ali, Shimizu Hideharu, Fisher Carolyn J, Schauer Philip R, Rae-Grant Alexander, Brethauer Stacy A
Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA; Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA.
Department of Neurology, Cleveland Clinic, Cleveland, OH, USA.
J Obes. 2017;2017:1935204. doi: 10.1155/2017/1935204. Epub 2017 Feb 19.
Obesity is common in patients with multiple sclerosis (MS); however, safety and efficacy of bariatric surgery in this population remain unclear. A database of 2,918 was retrospectively reviewed, yielding 22 (0.75%) severely obese patients with MS who underwent bariatric surgery. Sixteen surgical patients with complete follow-up data were matched to a nonsurgical control group of MS patients, based on age, BMI, MS subtype, and length of follow-up. MS relapse rates and trends in the timed twenty-five foot walk test (T25FW) were compared. In the surgical group (gastric bypass = 19, sleeve gastrectomy = 3), preoperative BMI was 46.5 ± 7.2 Kg/m and average excess weight was 60.4 kg. Follow-up data was collected at 59.0 ± 29.8 months. There were two major and four minor complications. Five patients required readmission and there were no mortalities. Percent excess weight loss was 75.5 ± 27.0%. In the 16 patients with follow-up data, patients who underwent bariatric surgery were significantly faster on the T25FW compared to the nonsurgical population. In conclusion, bariatric surgery is relatively safe and effective in achieving weight loss in patients with MS. In addition, surgery may help patients maintain ambulation. Findings support the need for further studies on bariatric surgery and disease-specific outcomes in this population.
肥胖在多发性硬化症（MS）患者中很常见；然而，减肥手术在这一人群中的安全性和有效性仍不明确。对一个包含2918例患者的数据库进行了回顾性分析，结果发现22例（0.75%）重度肥胖的MS患者接受了减肥手术。根据年龄、体重指数（BMI）、MS亚型和随访时长，将16例有完整随访数据的手术患者与一组非手术的MS患者对照组进行匹配。比较了MS复发率和25英尺计时步行试验（T25FW）的变化趋势。手术组（胃旁路手术 = 19例，袖状胃切除术 = 3例）术前BMI为46.5±7.2 kg/m²，平均超重60.4 kg。随访数据收集时间为59.0±29.8个月。发生了2例严重并发症和4例轻微并发症。5例患者需要再次入院治疗，无死亡病例。超重体重减轻百分比为75.5±27.0%。在有随访数据的16例患者中，接受减肥手术的患者在T25FW测试中的速度明显快于非手术人群。总之，减肥手术在MS患者中实现体重减轻方面相对安全有效。此外，手术可能有助于患者维持行走能力。研究结果支持对这一人群的减肥手术和疾病特异性结局进行进一步研究。
