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减重手术对肥胖患者血清炎症因子的影响:系统评价和荟萃分析。

Effect of Bariatric Surgery on Serum Inflammatory Factors of Obese Patients: a Systematic Review and Meta-Analysis.

机构信息

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Obes Surg. 2019 Aug;29(8):2631-2647. doi: 10.1007/s11695-019-03926-0.

Abstract

Obesity is one of the main causes of inflammation. Previous studies have reported inconclusive results regarding the effect of bariatric surgery on inflammatory markers. This systematic review and meta-analysis is aimed at describing the effect of bariatric surgery on C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α). PubMed/Medline and Scopus were systematically searched for all eligible studies from inception to June 2018. Results are expressed as weighted mean difference (MD) with 95% confidence intervals (CI) using a random effects model. Overall, 116 studies which evaluated serum CRP, IL-6, and TNF-α after bariatric surgery were included. Pooled effect size showed significant reduction in serum CRP (- 5.30 mg/l, 95% CI - 5.46, - 5.15, P < 0.001), IL-6 (- 0.58 pg/ml, 95% CI - 0.64, - 0.53, P < 0.001), and TNF-α (- 0.20 pg/ml, 95% CI - 0.39, - 0.02, P = 0.031) with significant heterogeneity across studies (> 95% for all factors). Bariatric surgery significantly lowered inflammatory factors; however, baseline BMI, follow-up duration and type of surgery could impact the extent of observed effects.

摘要

肥胖是炎症的主要原因之一。先前的研究报告表明,减重手术对炎症标志物的影响结果并不一致。本系统评价和荟萃分析旨在描述减重手术对 C 反应蛋白(CRP)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的影响。从建库到 2018 年 6 月,我们通过 PubMed/Medline 和 Scopus 系统地搜索了所有符合条件的研究。结果以加权均数差(MD)和 95%置信区间(CI)表示,采用随机效应模型。总共纳入了 116 项评估减重手术后血清 CRP、IL-6 和 TNF-α 的研究。汇总效应大小显示,血清 CRP(-5.30mg/l,95%CI -5.46,-5.15,P<0.001)、IL-6(-0.58pg/ml,95%CI -0.64,-0.53,P<0.001)和 TNF-α(-0.20pg/ml,95%CI -0.39,-0.02,P=0.031)显著降低,且研究间存在高度异质性(所有因素均>95%)。减重手术显著降低了炎症因子;然而,基线 BMI、随访时间和手术类型可能会影响观察到的效果程度。

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