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腹腔镜袖状胃切除术对血脂异常的影响。

Impact on Dyslipidemia After Laparoscopic Sleeve Gastrectomy.

机构信息

General Surgery Department, Bariatric Surgery Program, Hospital Privado Universitario de Córdoba, Naciones Unidas 346, 5016, Córdoba, Argentina.

出版信息

Obes Surg. 2018 Oct;28(10):3111-3115. doi: 10.1007/s11695-018-3343-4.

Abstract

BACKGROUND

Improvement of dyslipidemia is an important benefit of bariatric surgery. The benefits of laparoscopic sleeve gastrectomy (LSG) among dyslipidemia are still a matter of debate.

METHODS

We conducted a retrospective descriptive study between 2010 and 2013. Obese patients undergoing LSG, with recorded dyslipidemia at admission and a follow-up for at least 1 year, were included for analysis. Demographic characteristics, medication in use, and a complete lipid profile were collected before surgery. After surgery, weight was controlled at 1, 3, 6, and 12 months. Lipid profile was re-evaluated 1 year after surgery. Patients were divided according to weight loss into two groups: (A) adequate weight loss and (B) inadequate weight loss. Lipid profile evolution was then compared between groups.

RESULTS

One hundred seven patients met the inclusion criteria. Pre-op mean BMI was 45.13 ± 7.5 kg/m. One year after LSG, mean BMI was 30.6 ± 7.1 kg/m with a change in BMI of 11.5 ± 6.6 kg/m, a %TWL of 26.9 ± 13.5%, and a %EWL of 60.3 ± 36.6%. Hypercholesterolemia and hypertriglyceridemia remission was achieved in 45 and 86% of the patients and improved in another 19 and 4% respectively. Seventy-four percent improved HDL levels. LDL levels improved in 39% and remitted in 37%. Medication was discontinued in 43.7%. HDL increase and LDL, TG, and non-HDL-C decrease were significantly greater in group A.

CONCLUSIONS

LSG produces an improvement in lipid profile, with a significant increase in HDL and a decrease in LDL, triglycerides, and non-HDL-C.

摘要

背景

改善血脂异常是减重手术的重要益处。腹腔镜袖状胃切除术(LSG)在血脂异常方面的益处仍存在争议。

方法

我们进行了一项回顾性描述性研究,时间为 2010 年至 2013 年。纳入了接受 LSG 手术且入院时记录有血脂异常并随访至少 1 年的肥胖患者进行分析。收集了手术前的人口统计学特征、用药情况和完整的血脂谱。手术后,在 1、3、6 和 12 个月时控制体重。手术后 1 年重新评估血脂谱。根据体重减轻情况将患者分为两组:(A)体重减轻充足和(B)体重减轻不足。然后比较两组之间的血脂谱变化。

结果

107 名患者符合纳入标准。术前平均 BMI 为 45.13±7.5kg/m。LSG 术后 1 年,平均 BMI 为 30.6±7.1kg/m,BMI 变化为 11.5±6.6kg/m,体重减轻百分比为 26.9±13.5%,体重减轻指数为 60.3±36.6%。45%的患者达到高胆固醇血症和高甘油三酯血症缓解,另外 19%和 4%的患者分别得到改善。74%的患者 HDL 水平提高。LDL 水平改善 39%,缓解 37%。43.7%的患者停止了药物治疗。HDL 增加和 LDL、TG 和非 HDL-C 降低在 A 组更为显著。

结论

LSG 可改善血脂谱,显著增加 HDL,降低 LDL、甘油三酯和非 HDL-C。

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