Malin S K, Kaplan J L, Meng L, Garmey J C, Kirby J L, Taylor A M, Hallowell P T, McNamara C A
Department of Kinesiology University of Virginia Charlottesville USA.
Divison of Endocrinology and Metabolism University of Virginia Charlottesville USA.
Obes Sci Pract. 2017 Apr 26;3(2):193-200. doi: 10.1002/osp4.105. eCollection 2017 Jun.
Assess the role of inflammation on operating time in younger vs. older bariatric surgery patients.
Fifty-five younger (F: 46, Age: 34.9 ± 4.0 years, body mass index [BMI]: 48.2 ± 1.0 kg m) and 48 older (F: 34, Age: 57.0 ± 5.1 years, BMI: 46.8 ± 1.0 kg m) adults were studied prior to surgery. Blood pressure, glycaemic control (fasting glucose/insulin, HbA), lipids (high-density lipoprotein and triglycerides) and inflammation (monocyte chemoattractant protein-1 [MCP-1]) were assessed. Metabolic risk severity -scores were calculated from clinical outcomes. Omental adipose biopsies were collected at surgery for MCP-1 protein analysis. Operating time was used to characterize surgical difficulty.
Older vs. younger adults had higher HbA ( = 0.03). There was no difference in BMI, lipids, metabolic risk severity or insulin between groups, but operating time was longer in older vs. younger individuals ( = 0.04). Circulating MCP-1 was also elevated in older vs. younger adults ( = 0.04) independent of HbA, although this was not explained by omental fat. Nevertheless, serum MCP-1 was associated with increased metabolic risk severity ( = 0.27, = 0.01). In addition, operating time was linked to HbA ( = 0.30, = 0.01) and omental MCP-1 protein ( = 0.31, < 0.01).
MCP-1 is associated with longer operating time and increased metabolic risk severity in older bariatric patients independent of glycaemic control. Pre-operative treatment of inflammation may be required to enhance surgery effectiveness.
评估炎症在年轻与老年肥胖症手术患者手术时间方面所起的作用。
对55名年轻成年人（女性46名，年龄34.9±4.0岁，体重指数[BMI]：48.2±1.0kg/m²）和48名老年成年人（女性34名，年龄57.0±5.1岁，BMI：46.8±1.0kg/m²）在手术前进行研究。评估血压、血糖控制情况（空腹血糖/胰岛素、糖化血红蛋白）、血脂（高密度脂蛋白和甘油三酯）以及炎症指标（单核细胞趋化蛋白-1[MCP-1]）。根据临床结果计算代谢风险严重程度评分。在手术时采集网膜脂肪活检样本用于MCP-1蛋白分析。用手术时间来表征手术难度。
老年成年人的糖化血红蛋白高于年轻成年人（P=0.03）。两组在BMI、血脂、代谢风险严重程度或胰岛素方面无差异，但老年个体的手术时间比年轻个体更长（P=0.04）。与年轻成年人相比，老年成年人循环中的MCP-1也升高（P=0.04），且与糖化血红蛋白无关，尽管网膜脂肪并不能解释这一现象。然而，血清MCP-1与代谢风险严重程度增加相关（P=0.27，r=0.01）。此外，手术时间与糖化血红蛋白（P=0.30，r=0.01）和网膜MCP-1蛋白相关（P=0.31，P<0.01）。
在老年肥胖症患者中，MCP-1与更长的手术时间及代谢风险严重程度增加相关，且与血糖控制无关。可能需要在术前进行炎症治疗以提高手术效果。
