Department of Endocrinology, Diabetes and Metabolism - WISDEM Centre, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, UK.
Department of Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, UK.
Obes Surg. 2020 Aug;30(8):2913-2919. doi: 10.1007/s11695-020-04613-1.
Obesity is a chronic relapsing-remitting disease and a global pandemic, being associated with multiple comorbidities. Laparoscopic adjustable gastric banding (LAGB) is one of the safest surgical procedures used for the treatment of obesity, and even though its popularity has been decreasing over time, it still remains an option for a certain group of patients, producing considerable weight loss and improvement in obesity-associated comorbidities.
The aim of this study was to evaluate the impact of weight loss following LAGB on obesity-associated comorbidities, and to identify factors that could predict better response to surgery, and patient sub-groups exhibiting greatest benefit. A total of 99 severely obese patients (81.2% women, mean age 44.19 ± 10.94 years, mean body mass index (BMI) 51.84 ± 8.77 kg/m) underwent LAGB in a single institution. Results obtained 1, 2, and 5 years postoperatively were compared with the pre-operative values using SPPS software version 20.
A significant drop in BMI was recorded throughout the follow-up period, as well as in A1c and triglycerides, with greatest improvement seen 2 years after surgery (51.8 ± 8.7 kg/m vs 42.3 ± 9.2 kg/m, p < 0.05, 55.5 ± 19.1 mmol/mol vs 45.8 ± 13.7 mmol/mol, p < 0.05, and 2.2 ± 1.7 mmol/l vs 1.5 ± 0.6 mmol/l). Better outcomes were seen in younger patients, with lower duration of diabetes before surgery, and lower pre-operative systolic blood pressure.
Younger age, lower degree of obesity, and lower severity of comorbidities at the time of surgery can be important predictors of successful weight loss, making this group of patients the ideal candidates for LAGB.
肥胖是一种慢性复发性疾病，也是一种全球性的流行疾病，与多种合并症有关。腹腔镜可调节胃束带术（LAGB）是治疗肥胖症最安全的手术之一，尽管其受欢迎程度随着时间的推移而下降，但它仍然是某些患者的选择，可以显著减轻体重并改善肥胖相关的合并症。
本研究旨在评估 LAGB 后体重减轻对肥胖相关合并症的影响，并确定可预测手术更好反应的因素，以及表现出最大获益的患者亚组。共有 99 名严重肥胖患者（81.2%为女性，平均年龄 44.19±10.94 岁，平均体重指数（BMI）为 51.84±8.77 kg/m）在一家机构接受了 LAGB。使用 SPPS 软件版本 20 将术后 1、2 和 5 年获得的结果与术前值进行比较。
在整个随访期间，BMI 显著下降，A1c 和甘油三酯也显著下降，手术后 2 年改善最大（51.8±8.7 kg/m 与 42.3±9.2 kg/m，p<0.05，55.5±19.1 mmol/mol 与 45.8±13.7 mmol/mol，p<0.05，2.2±1.7 mmol/l 与 1.5±0.6 mmol/l）。年轻患者的结果更好，术前糖尿病持续时间更短，术前收缩压更低。
手术时年龄较小、肥胖程度较低、合并症严重程度较低，可以成为成功减肥的重要预测因素，使这组患者成为 LAGB 的理想人选。
