Department of Food Science and Human Nutrition, College of Agricultural, Consumer and Environmental Sciences, University of Illinois Urbana-Champaign, Urbana, Illinois.
Division of Nutritional Sciences, University of Illinois Urbana-Champaign, Urbana, Illinois; Department of Human Development and Family Studies, University of Illinois Urbana-Champaign, Urbana, Illinois.
Surg Obes Relat Dis. 2020 Apr;16(4):536-544. doi: 10.1016/j.soard.2020.01.014. Epub 2020 Jan 23.
Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), the most common bariatric surgeries performed worldwide, increase the risk to develop an alcohol use disorder. This might be due, in part, to surgery-related changes in alcohol pharmacokinetics. Another risk factor, unexplored within this population, is having a reduced subjective response to alcohol's sedative effects.
To assess whether the alcohol sensitivity questionnaire (ASQ), a simple self-report measure, could pinpoint reduced alcohol sensitivity in the bariatric population.
University medical centers in Missouri and Illinois.
Women who had RYGB (n = 16), SG (n = 28), or laparoscopic adjustable gastric banding surgery (n = 11) within the last 5 years completed the ASQ for both pre- and postsurgical timeframes, and 45 of them participated in oral alcohol challenge testing postsurgery. Blood alcohol concentration (BAC) and subjective stimulation and sedation were measured before and for 3.5 hours after drinking.
In line with faster and higher peak BACs after RYGB and SG than laparoscopic adjustable gastric banding surgery (P < .001), postsurgery ASQ scores were more reduced from presurgery scores after RYGB/SG than after laparoscopic adjustable gastric banding surgery (-2.3 ± .3 versus -1.2 ± .2; P < .05). However, despite the dramatic changes in BAC observed when ingesting alcohol after RYGB/SG surgeries, which resulted in peak BAC that were approximately 50% above the legal driving limit, a third of these women felt almost no alcohol-related sedative effects.
Although RYGB/SG dramatically increased sensitivity to alcohol in all participants, meaningful interindividual differences remained. The ASQ might help identify patients at increased risk to develop an alcohol use disorder after surgery.
Roux-en-Y 胃旁路术（RYGB）和袖状胃切除术（SG）是全球最常见的减肥手术，会增加发生酒精使用障碍的风险。这可能部分归因于手术相关的酒精药代动力学变化。另一个在该人群中尚未探索的风险因素是对酒精镇静作用的主观反应降低。
评估酒精敏感问卷（ASQ）是否可以确定减肥手术人群中酒精敏感性降低。
密苏里州和伊利诺伊州的大学医学中心。
在过去 5 年内接受过 RYGB（n=16）、SG（n=28）或腹腔镜可调节胃束带手术（n=11）的女性在术前和术后时间段完成 ASQ，并对其中 45 名女性进行术后口服酒精挑战测试。在饮酒前和饮酒后 3.5 小时测量血液酒精浓度（BAC）和主观刺激和镇静程度。
与腹腔镜可调节胃束带手术相比，RYGB 和 SG 术后更快且更高的峰值 BAC（P<0.001），RYGB/SG 术后的 ASQ 评分比术前更显著降低（-2.3±0.3 与-1.2±0.2；P<0.05）。然而，尽管 RYGB/SG 手术后饮酒导致 BAC 急剧上升，峰值约为法定驾驶限制的 50%以上，但其中三分之一的女性几乎没有感觉到与酒精相关的镇静作用。
尽管 RYGB/SG 使所有参与者对酒精的敏感性显著增加，但仍存在显著的个体间差异。ASQ 可能有助于识别手术后发生酒精使用障碍风险增加的患者。
