General Surgery Department, Università degli Studi di Salerno, Via Giovanni Paolo II, Fisciano, SA, Italy.
Clinique Clementville, Montpellier, France.
Obes Surg. 2018 Jul;28(7):1966-1973. doi: 10.1007/s11695-018-3117-z.
BMI (body mass index) is used to identify candidates for bariatric surgery, with a criterion of BMI ≥ 40. For lesser degrees of obesity, BMI 35-39.9, comorbidities are also considered. A Body Shape Index (ABSI) was derived to correct WC (waist circumference) for BMI and height. ABSI has been shown to be a linear predictor of long-term mortality across the range of BMI. Anthropometric risk indicator (ARI) combines the complementary contributions of BMI and ABSI and further improves mortality hazard prediction. We report for the first time ABSI and ARI for a bariatric surgical cohort at baseline and with 3-year follow-up.
ABSI and BMI were calculated for 101 subjects from our bariatric surgery center database at baseline and after 3 years of follow-up. Raw values for BMI and ABSI were converted to Z scores and ARI values based on sex- and age-specific normals and risk associations from the National Health and Nutrition Examination Survey (NHANES) III sample of the US general population.
Baseline scores for the anthropometric variables BMI and ABSI and the corresponding ARI were all higher than for the NHANES population sample. At 3-year post surgery, all three measures decreased significantly. While baseline BMI did not predict the change in mortality risk by ARI, baseline ABSI did (r = - 0.73), as did baseline ARI (r = - 0.94).
Sleeve gastrectomy lowers ABSI and the associated mortality risk estimated from population studies after 3 years of follow-up. Considering our results, bariatric surgical candidates with BMI in the range of 35 to 39.9 with an increased ABSI-related mortality risk may have considerable survival benefit from bariatric surgery, even in the absence of qualifying comorbidities.
BMI（体重指数）用于确定接受减重手术的候选人，标准为 BMI≥40。对于较轻程度的肥胖，BMI 为 35-39.9，也考虑合并症。身体形状指数（ABSI）是为了校正 BMI 和身高的 WC（腰围）而得出的。ABSI 已被证明是 BMI 范围内预测长期死亡率的线性指标。人体测量风险指标（ARI）结合了 BMI 和 ABSI 的互补贡献，进一步提高了死亡率风险预测。我们首次报告了基线和 3 年随访的减重手术队列的 ABSI 和 ARI。
从我们的减重手术中心数据库中计算了 101 名患者的 ABSI 和 BMI，基线和随访 3 年后。BMI 和 ABSI 的原始值转换为 Z 分数和 ARI 值，基于美国普通人群国家健康和营养检查调查（NHANES）III 样本的性别和年龄特异性正常值和风险关联。
基线人体测量变量 BMI 和 ABSI 的得分和相应的 ARI 均高于 NHANES 人群样本。手术后 3 年，这三个指标均显著下降。虽然基线 BMI 不能预测 ARI 改变的死亡率风险，但基线 ABSI 可以（r=-0.73），基线 ARI 也可以（r=-0.94）。
袖状胃切除术降低了 ABSI 和 3 年后随访人群研究中估计的相关死亡率风险。考虑到我们的结果，BMI 在 35 到 39.9 范围内且 ABSI 相关死亡率风险增加的减重手术候选者可能会从减重手术中获得相当大的生存获益，即使没有符合条件的合并症。
2814。
