Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, UFRGS, Porto Alegre, Brazil.
Centro de Tratamento da Obesidade, Hospital Santa Rita/Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil.
Obes Surg. 2019 Mar;29(3):953-957. doi: 10.1007/s11695-018-03627-0.
Obesity and its complications are prevalent in women and increase with age. Polyneuropathy (PNP) is a complication of obesity and bariatric surgery (BS). In subjects with severe (grades II and III) obesity and without DM who are candidates for BS, the prevalence of PNP and associated conditions are not well characterized. The aim of this study was to evaluate the prevalence of PNP in severely obese (SO) women without DM or common nutritional deficiencies in order to determine factors associated with the presence of PNP.
A cross-sectional study was performed on 450 SO women. They were evaluated with the Michigan Neuropathy Screening Instrument, a Sleep Apnea Questionnaire, and the short form of the International Physical Activity Questionnaire. Data on blood pressure, body mass index, waist circumference, serum glucose, glycated hemoglobin, LDL and HDL cholesterol, triglycerides, vitamin B12, and postmenopausal (PM) status were also collected. Patients with DM and other common causes of PNP were excluded. To evaluate which variables were independently associated with PNP (dependent variable), Poisson regression models were used.
The prevalence of PNP was 11.6%. In univariate analysis, PNP was associated with age, PM status, and diagnosis of systemic arterial hypertension (p < 0.001, p < 0.001, and p = 0.016, respectively), and there was a trend toward an association with sleep apnea risk (p = 0.101). In multivariate analysis, PM status (PR = 2.836, 95% CI 1.735-4.636, p = 0.001) and age (PR = 1.0511, 95% CI 1.031-1.071, p = 0.001) were independently associated with PNP diagnosis in two different models.
Even prior to BS, PNP is highly prevalent and is associated with PM status and age in SO women without diabetes.
肥胖及其并发症在女性中很常见,并随着年龄的增长而增加。多发性神经病(PNP)是肥胖和减重手术(BS)的并发症。在患有严重(II 级和 III 级)肥胖且无糖尿病的 BS 候选者中,PNP 及相关疾病的患病率尚未得到很好的描述。本研究旨在评估无糖尿病或常见营养缺乏症的严重肥胖(SO)女性中 PNP 的患病率,以确定与 PNP 存在相关的因素。
对 450 名 SO 女性进行了横断面研究。使用密歇根神经病筛查工具、睡眠呼吸暂停问卷和国际体力活动问卷短表对她们进行了评估。还收集了血压、体重指数、腰围、血清葡萄糖、糖化血红蛋白、LDL 和 HDL 胆固醇、甘油三酯、维生素 B12 以及绝经(PM)状态的数据。排除了患有糖尿病和其他常见 PNP 病因的患者。为了评估哪些变量与 PNP(因变量)独立相关,使用泊松回归模型。
PNP 的患病率为 11.6%。在单变量分析中,PNP 与年龄、PM 状态和系统性动脉高血压诊断相关(p<0.001、p<0.001 和 p=0.016),且与睡眠呼吸暂停风险呈趋势相关(p=0.101)。在多变量分析中,PM 状态(PR=2.836,95%CI 1.735-4.636,p=0.001)和年龄(PR=1.0511,95%CI 1.031-1.071,p=0.001)在两个不同的模型中与 PNP 诊断独立相关。
即使在 BS 之前,PNP 在无糖尿病的 SO 女性中也非常普遍,且与 PM 状态和年龄相关。