重度肥胖青少年的减肥手术与肾脏疾病转归
Bariatric surgery and kidney disease outcomes in severely obese youth.
作者信息
Bjornstad Petter, Nehus Edward, van Raalte Daniel
机构信息
Section of Endocrinology, Department of Pediatrics, Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado School of Medicine, United States.
Section of Nephrology, Department of Pediatrics, University of Cincinnati College of Medicine, United States.
出版信息
Semin Pediatr Surg. 2020 Feb;29(1):150883. doi: 10.1016/j.sempedsurg.2020.150883. Epub 2020 Jan 20.
Bariatric surgery, an emerging treatment for severely obese youth with and without T2D, provides marked improvement in insulin resistance, beta-cell function, and central adiposity. Further, preliminary data suggest that bariatric surgery also results in significant improvement in markers of obesity-related nephropathy and DKD, beyond that which can be achieved with current medical interventions. Yet, the mechanisms whereby bariatric surgery attenuates kidney disease remain unclear. This review summarizes the data on the effects of bariatric surgery on obesity-related nephropathy and DKD in youth with and without T2D, in addition to potential mechanisms underlying the nephroprotective effects of weight loss surgery and how these may differ in Roux-en-Y gastric bypass vs. vertical sleeve gastrectomy. Finally, we discuss potential future non-surgical therapies to mitigate kidney disease.
减重手术是一种针对患有和未患有2型糖尿病的严重肥胖青少年的新兴治疗方法，它能显著改善胰岛素抵抗、β细胞功能和中心性肥胖。此外，初步数据表明，减重手术还能显著改善肥胖相关肾病和糖尿病肾病的标志物，其改善程度超过了目前医学干预所能达到的效果。然而，减重手术减轻肾脏疾病的机制仍不清楚。本综述总结了减重手术对患有和未患有2型糖尿病的青少年肥胖相关肾病和糖尿病肾病影响的数据，以及减重手术肾保护作用的潜在机制，以及这些机制在Roux-en-Y胃旁路手术和垂直袖状胃切除术之间可能存在的差异。最后，我们讨论了未来减轻肾脏疾病的潜在非手术疗法。
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