Department of General Surgery and The Bariatric and Metabolic Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA.
Surg Endosc. 2018 Mar;32(3):1248-1254. doi: 10.1007/s00464-017-5799-z. Epub 2017 Aug 25.
There is vast evidence that supports the importance of obesity in the pathogenesis and progression of cardiovascular disease. Rapid weight loss induced by laparoscopic Roux-en-Y gastric bypass (RYGB) and adjustable gastric banding (LAGB) has proven beneficial. The aim of this study is to evaluate laparoscopic sleeve gastrectomy (LSG) as an alternative treatment modality and its impact on the Framingham-BMI 10-year risk score.
We retrospectively reviewed all patients that underwent bariatric surgery at our institution between 2010 and 2014. Patients who met the criteria for calculating the Framingham BMI 10-year risk score were included. Data collected included baseline demographics, perioperative parameters such as tobacco use, diagnosis of diabetes, treatment for hypertension, BMI and postoperative outcomes at 3 and 12 months.
From our 1129 bariatric patients, 358 (31.7%) met criteria for the Framingham BMI 10-year risk score calculation. LSG was the most prevalent surgery 61.45% (N = 220) followed by LRYGB 22.06% (N = 79). Females composed 69% (N = 248) of our population. The average age for females was 52.3 ± 10.8 years and for males 54.07 ± 11.2 years. The initial Framingham 10-year score risk was significantly higher in males compared with females (36.16% ± 22.3 vs. 16.97% ± 15.6 (p < 0.001)). After 12-month follow-up, the absolute risk reduction in males was 11.58% (p < 0.001) and 6.17% in females (p < 0.001). The preoperative heart age was high in females and males (69.23 ± 15.72 years and 73.55 ± 13.55 years, respectively (p = 0.012)), and after 12 months it was reduced 7.19 years in females (p < 0.001) and 7.04 years in males (p < 0.001). The percentage of estimated BMI loss at 1 year was 64.43% in females and 60.69% in males.
Sleeve gastrectomy has demonstrated to be an effective method of treatment for obesity. Our results suggest that rapid weight loss after LSG has a positive impact in the reduction of the 10-year cardiovascular disease risk. Further prospective studies may be needed to better assess these findings.
有大量证据表明肥胖症在心血管疾病的发病机制和进展中起着重要作用。腹腔镜 Roux-en-Y 胃旁路术（RYGB）和可调胃束带术（LAGB）引起的快速体重减轻已被证明是有益的。本研究旨在评估腹腔镜袖状胃切除术（LSG）作为一种替代治疗方法及其对弗雷明汉-BMI10 年风险评分的影响。
我们回顾性分析了 2010 年至 2014 年期间在我院接受减重手术的所有患者。纳入了符合弗雷明汉 BMI10 年风险评分计算标准的患者。收集的数据包括基线人口统计学资料、围手术期参数（如吸烟、糖尿病诊断、高血压治疗）、BMI 以及术后 3 个月和 12 个月的结果。
在我们的 1129 例肥胖症患者中，有 358 例（31.7%）符合弗雷明汉 BMI10 年风险评分计算标准。LSG 是最常见的手术方式，占 61.45%（N=220），其次是 RYGB 占 22.06%（N=79）。女性占我们人群的 69%（N=248）。女性的平均年龄为 52.3±10.8 岁，男性为 54.07±11.2 岁。男性的初始弗雷明汉 10 年风险评分明显高于女性（36.16%±22.3 与 16.97%±15.6（p<0.001））。经过 12 个月的随访，男性的绝对风险降低了 11.58%（p<0.001），女性降低了 6.17%（p<0.001）。女性和男性的术前心脏年龄都较高（分别为 69.23±15.72 岁和 73.55±13.55 岁（p=0.012）），经过 12 个月后，女性降低了 7.19 岁（p<0.001），男性降低了 7.04 岁（p<0.001）。女性和男性的 BMI 估计损失百分比在 1 年后分别为 64.43%和 60.69%。
袖状胃切除术已被证明是治疗肥胖症的有效方法。我们的结果表明，LSG 后的快速体重减轻对降低心血管疾病 10 年风险有积极影响。可能需要进一步的前瞻性研究来更好地评估这些发现。
