新加坡肥胖症手术对心血管危险因素的长期影响。

Long-term effects of bariatric surgery on cardiovascular risk factors in Singapore.

机构信息

Department of Medicine, National University Health System, Singapore.

Department of Surgery, National University Hospital, Singapore.

出版信息

Singapore Med J. 2021 Sep;62(9):472-475. doi: 10.11622/smedj.2020047. Epub 2020 Apr 3.

DOI:10.11622/smedj.2020047

PMID:32241069

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9251237/

Abstract

INTRODUCTION

Bariatric surgery is considered an effective treatment for weight loss and for improving the metabolic profile of patients with obesity. Obesity-related comorbidities such as hyperlipidaemia and type 2 diabetes mellitus (DM) are significant cardiovascular risk factors. Additionally, prospective clinical trials have shown that statins increase the risk of development of DM, and many patients with obesity are on statins. We retrospectively examined the effect of bariatric surgery on lipid profile, DM control and weight loss at the five-year follow-up.

METHODS

In total, 104 patients undergoing bariatric surgery from 2008 to 2012 were retrospectively studied. 36 patients were on preoperative statins. Their lipid profile, DM control and weight loss were examined at the one-year and five-year follow-ups.

RESULTS

Both high-density lipoprotein and triglyceride levels showed significant improvement at the one-year and five-year follow-ups (p = 0.01). Total cholesterol showed significant improvement at the one-year follow-up (-0.30 mmol/dL, p = 0.0338); however, better control was not sustained at the five-year follow-up (-0.15 mmol/dL, p = 0.133). Low-density lipoprotein did not show any considerable improvement at the one- and five-year follow-ups (-0.27 mmol/dL, p = 0.150 and -0.24 mmol/dL, p = 0.138, respectively). A statistically significant improvement in DM control was observed in these patients and in those on preoperative statins. Weight loss was sustained at one and five years.

CONCLUSION

Bariatric surgery does not confer a uniform improvement in lipid profile in the long term. It does, however, induce efficient weight loss and improvement in diabetic profile, even in patients on preoperative statins.

摘要

简介

减重手术被认为是治疗肥胖症患者体重和代谢特征的有效方法。肥胖相关的合并症，如高脂血症和 2 型糖尿病（DM），是重要的心血管危险因素。此外，前瞻性临床试验表明，他汀类药物会增加 DM 的发病风险，而许多肥胖患者都在服用他汀类药物。我们回顾性地研究了减重手术对血脂谱、DM 控制和体重减轻的影响，随访时间为 5 年。

方法

共回顾性研究了 2008 年至 2012 年间接受减重手术的 104 例患者。36 例患者术前服用他汀类药物。检查他们的血脂谱、DM 控制和体重减轻在一年和五年的随访。

结果

高密度脂蛋白和甘油三酯水平在一年和五年的随访中均有显著改善（p = 0.01）。总胆固醇在一年的随访中也有显著改善（-0.30 mmol/dL，p = 0.0338）；然而，在五年的随访中，这种改善并未持续（-0.15 mmol/dL，p = 0.133）。LDL 水平在一年和五年的随访中均无明显改善（-0.27 mmol/dL，p = 0.150 和-0.24 mmol/dL，p = 0.138）。这些患者和术前服用他汀类药物的患者的 DM 控制都有显著改善。体重减轻在一年和五年时都得到了维持。