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腹腔镜胃旁路术后 2 年的代谢综合征。

Metabolic syndrome 2 years after laparoscopic gastric bypass.

机构信息

The Obesity Clinic at Hospital General Tláhuac, Avenida la Turba # 655, Col. Villa Centroamericana y del Caribe, Delegación Tláhuac, México City, Zip 13250, Mexico.

出版信息

Int J Surg. 2018 Apr;52:264-268. doi: 10.1016/j.ijsu.2018.02.056. Epub 2018 Mar 1.

Abstract

BACKGROUND

The latest diabetes consensus identified obesity as key component of the metabolic syndrome. The role of bariatric surgery over such syndrome has been less explored with a lack of long term studies, and especially among Mexicans.

METHODS

Retrospective study including patients with metabolic syndrome submitted to laparoscopic gastric bypass at a single institution with complete data after 24 months. The objective was to analyze the improvement of the syndrome and each component. Demographic, anthropometric, biochemical and clinical parameters were analyzed at 12 and 24 months. Secondarily weight loss and other parameters were also analyzed. Finally, an analysis of syndrome improvement related to weight loss was performed.

RESULTS

Sixty-three patients were included. The 2 most common components associated with obesity were reduced HDL and raised glucose or Type 2 diabetes. There was a significant improvement of metabolic syndrome and its components, as well as for the rest of the analyzed data, from the first check point and throughout follow-up. Prevalence of such syndrome was 6.3% at 12 and 24 months. Hypertension and raised glucose or Type 2 diabetes were the components with the greatest and fastest improvement; HDL levels and obesity were the least improved. There was a direct relationship between percentage of excess weight loss or percentage of excess BMI loss, and syndrome's improvement.

CONCLUSION

Patients with metabolic syndrome improved after gastric bypass, with results lasting after 2 years; other metabolic parameters important for cardiovascular risk were also positively affected. There was a relationship between the amount of weight loss and improvement of metabolic syndrome.

摘要

背景

最新的糖尿病共识将肥胖确定为代谢综合征的关键组成部分。减重手术在代谢综合征中的作用尚未得到充分探讨,尤其是在墨西哥人群中。

方法

这是一项单中心的回顾性研究,共纳入了 63 例接受腹腔镜胃旁路手术的代谢综合征患者,所有患者在术后 24 个月时均获得了完整的数据。本研究旨在分析该综合征及其各组成部分的改善情况。分析了患者的人口统计学、人体测量学、生化和临床参数,这些参数分别在 12 个月和 24 个月时进行了评估。其次还分析了体重减轻和其他参数。最后,还对与体重减轻相关的综合征改善进行了分析。

结果

最常见的与肥胖相关的两个组成部分是高密度脂蛋白(HDL)降低和血糖升高或 2 型糖尿病。代谢综合征及其各组成部分均有显著改善,从第一个检查点开始,一直持续到随访结束。术后 12 个月和 24 个月时,该综合征的患病率分别为 6.3%。高血压和血糖升高或 2 型糖尿病是改善最快的两个组成部分;HDL 水平和肥胖是改善最慢的组成部分。超重百分比或超重 BMI 百分比与综合征改善之间存在直接关系。

结论

胃旁路手术后,代谢综合征患者得到了改善,且在 2 年后仍持续存在;对心血管风险具有重要意义的其他代谢参数也得到了积极影响。体重减轻的量与代谢综合征的改善之间存在关联。

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