Toth Alexander T, Gomez Gricelda, Shukla Alpana P, Pratt Janey S, Cena Hellas, Biino Ginevra, Aronne Louis J, Stanford Fatima Cody
Adolescent Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA.
Department of Surgery-Urology, Brigham and Women's Hospital, Boston, MA 02115, USA.
Children (Basel). 2018 Aug 29;5(9):116. doi: 10.3390/children5090116.
This paper presents a retrospective cohort study of weight loss medications in young adults aged 21 to 30 following Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) between November 2000 and June 2014. Data were collected from patients who used topiramate, phentermine, and/or metformin postoperatively. Percentage of patients achieving ≥5%, ≥10%, or ≥15% weight loss on medications was determined and percent weight change on each medication was compared to percent weight change of the rest of the cohort. Our results showed that 54.1% of study patients lost ≥5% of their postsurgical weight; 34.3% and 22.9% lost ≥10% and ≥15%, respectively. RYGB had higher median percent weight loss (-8.1%) than SG (-3.3%) ( = 0.0515). No difference was found in median percent weight loss with medications started at weight plateau (-6.0%) versus after weight regain (-5.4%) ( = 0.5304). Patients taking medications at weight loss plateau lost 41.2% of total body weight from before surgery versus 27.1% after weight regain ( = 0.076). Median percent weight change on metformin was -2.9% compared to the rest of the cohort at -7.7% ( = 0.0241). No difference from the rest of the cohort was found for phentermine ( = 0.2018) or topiramate ( = 0.3187). Topiramate, phentermine, and metformin are promising weight loss medications for 21 to 30 year olds. RYGB patients achieve more weight loss on medications but both RYGB and SG benefit. Median total body weight loss from pre-surgical weight may be higher in patients that start medication at postsurgical nadir weight. Participants on metformin lost significantly smaller percentages of weight on medications, which could be the result of underlying medical conditions.
本文呈现了一项回顾性队列研究，该研究针对2000年11月至2014年6月间接受 Roux-en-Y胃旁路术（RYGB）和袖状胃切除术（SG）的21至30岁年轻成年人使用减肥药物的情况。数据收集自术后使用托吡酯、苯丁胺和/或二甲双胍的患者。确定了在药物治疗下体重减轻≥5%、≥10%或≥15%的患者百分比，并将每种药物的体重变化百分比与队列中其他患者的体重变化百分比进行比较。我们的结果显示，54.1%的研究患者术后体重减轻≥5%；分别有34.3%和22.9%的患者体重减轻≥10%和≥15%。RYGB的体重减轻中位数百分比（-8.1%）高于SG（-3.3%）（P = 0.0515）。在体重稳定期开始使用药物的患者，其体重减轻中位数百分比（-6.0%）与体重反弹后开始使用药物的患者（-5.4%）相比，未发现差异（P = 0.5304）。在体重减轻稳定期服用药物的患者，与体重反弹后相比，术前体重减轻了全身总体重的41.2%，而体重反弹后为27.1%（P = 0.076）。二甲双胍的体重变化中位数百分比为-2.9%，而队列中其他患者为-7.7%（P = 0.0241）。苯丁胺（P = 0.2018）或托吡酯（P = 0.3187）与队列中其他患者相比未发现差异。托吡酯、苯丁胺和二甲双胍对于21至30岁的人来说是有前景的减肥药物。RYGB患者在药物治疗下体重减轻更多，但RYGB和SG患者均有益处。在术后最低点体重时开始用药的患者，术前体重的总体重减轻中位数可能更高。服用二甲双胍的参与者在药物治疗下体重减轻的百分比明显更小，这可能是潜在疾病导致的。
