肥胖患者胃旁路手术对血清酶水平的影响。

Effect of Bariatric Surgery on Serum Enzyme Status in Obese Patients.

机构信息

Department of Gastrointestinal Surgery, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.

Department of Nursing Science, School of Nursing, Jinan University, Guangzhou, 510632, China.

出版信息

Obes Surg. 2020 Jul;30(7):2700-2707. doi: 10.1007/s11695-020-04554-9.

DOI:10.1007/s11695-020-04554-9

PMID:32180113

Abstract

BACKGROUND

Scarce data exists about serum enzyme in bariatric patients. We attempted to evaluate serum enzyme status in patients receiving Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) and to identify related predictors.

METHODS

We retrospectively reviewed the patients receiving RYGB and SG in our center from January 2013 to January 2018. Anthropometric data and serum enzyme data were collected preoperatively and 6 and 12 months postoperatively.

RESULTS

Five hundred patients (201 RYGB, 299 SG) were included. Serum enzyme abnormalities were common preoperatively, with 50.8% for elevated alanine aminotransferase (ALT), 33.0% for elevated aspartate aminotransferase (AST), 36.6% for elevated γ-glutamyltranspeptidase (γ-GT), 17.6% for elevated creatine kinase (CK), 15.2% for elevated lactic dehydrogenase (LDH), 9.0% for elevated adenosine deaminase (ADA), 6.2% for elevated hydroxybutyrate dehydrogenase (HBDH), and 8.4% for decreased superoxide dismutase (SOD). After RYGB and SG, the prevalence of serum ALT, AST, γ-GT, LDH, and HBDH abnormalities reduced. The levels of ALT, AST, γ-GT, ADA, cholinesterase (CHE), LDH, CK, and HBDH reduced significantly, while amylase and SOD levels increased. Age and preoperative γ-GT level were independent predictors of ALT, AST, γ-GT, and LDH change 1 year postoperatively. Preoperative ALT, AST, ALP, LDH, and HBDH levels could predict postoperative change, respectively. Gender and surgical procedure could predict postoperative ALP change.

CONCLUSION

Serum enzyme abnormalities are common in bariatric surgery candidates, with reduced prevalence of abnormalities postoperatively. RYGB and SG are related with reduced ALT, AST, γ-GT, ADA, CHE, LDH, CK, and HBDH levels, as well as increased amylase and SOD levels.

摘要

背景

肥胖患者的血清酶数据稀缺。我们试图评估接受 Roux-en-Y 胃旁路术（RYGB）和袖状胃切除术（SG）患者的血清酶状态，并确定相关预测因素。

方法

我们回顾性分析了 2013 年 1 月至 2018 年 1 月期间在我院接受 RYGB 和 SG 的患者。收集了术前、术后 6 个月和 12 个月的人体测量数据和血清酶数据。

结果

共纳入 500 例患者（RYGB 组 201 例，SG 组 299 例）。术前血清酶异常常见，丙氨酸氨基转移酶（ALT）升高占 50.8%，天门冬氨酸氨基转移酶（AST）升高占 33.0%，γ-谷氨酰转肽酶（γ-GT）升高占 36.6%，肌酸激酶（CK）升高占 17.6%，乳酸脱氢酶（LDH）升高占 15.2%，腺苷脱氨酶（ADA）升高占 9.0%，羟丁酸脱氢酶（HBDH）升高占 6.2%，超氧化物歧化酶（SOD）降低占 8.4%。RYGB 和 SG 后，血清 ALT、AST、γ-GT、LDH 和 HBDH 异常的发生率降低。ALT、AST、γ-GT、ADA、胆碱酯酶（CHE）、LDH、CK 和 HBDH 水平显著降低，而淀粉酶和 SOD 水平升高。年龄和术前 γ-GT 水平是术后 1 年 ALT、AST、γ-GT 和 LDH 变化的独立预测因素。术前 ALT、AST、碱性磷酸酶（ALP）、LDH 和 HBDH 水平可分别预测术后变化。性别和手术方式可预测术后 ALP 变化。