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美国多囊卵巢综合征女性行减重手术的模式。

Patterns of Bariatric Surgeries Among U.S. Women Diagnosed with Polycystic Ovarian Syndrome.

机构信息

Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, Virginia.

Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, Maryland.

出版信息

J Womens Health (Larchmt). 2020 Apr;29(4):585-595. doi: 10.1089/jwh.2019.7947. Epub 2020 Feb 20.

Abstract

To examine patterns and outcomes of bariatric surgeries, including Roux-en-Y gastric bypass (RYGB), laparoscopic sleeve gastrectomy (LSG) and laparoscopic adjustable gastric banding (LAGB), among women diagnosed with polycystic ovarian syndrome (PCOS). Retrospective cohort study using 1998-2011 Nationwide Inpatient Sample data. A total of 52,668 hospital discharge records met eligibility criteria among PCOS women, 18-49 years. Of those, 17,759 had an obesity/overweight diagnosis and 4310 underwent bariatric surgery. Furthermore, 3086 underwent RYGB ( = 2411), LSG ( = 126), or LAGB ( = 549), and were compared to 78,931 non-PCOS controls. Multiple regression models were constructed to examine patient- and hospital-level predictors of obesity/overweight and bariatric surgery, as well as type of bariatric surgery (RYGB, LSG, or LAGB) as a predictor of in-hospital outcomes and PCOS status. The prevalence of obesity/overweight (≈34%) among women diagnosed with PCOS, and of bariatric surgery (≈24%) among women diagnosed with PCOS and obese/overweight varied by patient- and hospital-level characteristics. Women having PCOS and overweight/obesity, who underwent LSG or LAGB, had shorter hospital stay, reduced hospital charges, and better disposition at discharge compared to those who underwent RYGB. PCOS cases and non-PCOS controls experienced similar treatment selection and in-hospital outcomes after bariatric surgery. Also, PCOS cases and non-PCOS controls experienced similar in-hospital outcomes after undergoing RYGB, LSG, or LAGB. Compared to RYGB, LSG and LAGB resulted in improved in-hospital outcomes among obese/overweight PCOS and non-PCOS patients. Further research is needed to examine health care disparities in the context of PCOS, obesity/overweight, and bariatric surgery.

摘要

为了研究多囊卵巢综合征(PCOS)女性患者中减肥手术(包括 Roux-en-Y 胃旁路术 [RYGB]、腹腔镜袖状胃切除术 [LSG] 和腹腔镜可调胃束带术 [LAGB])的模式和结果,我们进行了一项回顾性队列研究,使用了 1998 年至 2011 年全国住院患者样本数据。在符合条件的 PCOS 女性患者(18-49 岁)中,共有 52668 例住院记录,其中 17759 例肥胖/超重,4310 例行减肥手术。此外,3086 例行 RYGB(2411 例)、LSG(126 例)或 LAGB(549 例),并与 78931 例非 PCOS 对照组进行比较。构建了多回归模型,以检查患者和医院水平的肥胖/超重和减肥手术的预测因素,以及减肥手术类型(RYGB、LSG 或 LAGB)作为住院结果和 PCOS 状态的预测因素。患有 PCOS 的女性中肥胖/超重的患病率(≈34%),以及患有 PCOS 和肥胖/超重的女性中减肥手术的患病率(≈24%)因患者和医院水平的特征而异。与 RYGB 相比,行 LSG 或 LAGB 的 PCOS 合并超重/肥胖患者的住院时间更短、住院费用更低,出院时的转归更好。减肥手术后,PCOS 病例和非 PCOS 对照组经历了类似的治疗选择和住院结果。此外,PCOS 病例和非 PCOS 对照组在接受 RYGB、LSG 或 LAGB 后经历了相似的住院结果。与 RYGB 相比,LSG 和 LAGB 改善了肥胖/超重的 PCOS 和非 PCOS 患者的住院结果。需要进一步研究,以在 PCOS、肥胖/超重和减肥手术的背景下检查医疗保健的差异。

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