Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
Surg Obes Relat Dis. 2020 Aug;16(8):1011-1021. doi: 10.1016/j.soard.2020.04.011. Epub 2020 Apr 19.
Long-term changes in cardiovascular disease (CVD) risk after bariatric surgery are not well characterized.
To report sex-specific changes in CVD risk after Roux-en-Y gastric bypass surgery (RYGB).
Observational cohort study at ten hospitals throughout the United States.
Between 2006 and 2009, 1770 adults enrolled in a prospective cohort study underwent RYGB at 1 of 10 U.S. hospitals. Research assessments were conducted presurgery and annually postsurgery over 7 years. Sex specific-predicted 10-year and lifetime CVD risk were calculated using the Framingham10-year and lifetime risk scores, Framingham-body mass index, and atherosclerotic CVD scoring algorithms among participants with no history of CVD. Of 1566 eligible participants, 1234 (75.9%) with CVD risk determination pre- and postsurgery were included (1013 females, 221 males).
Based on the Framingham10-year and lifetime risk scores, the percentage of females with predicted high (>20%) 10-year CVD risk declined from presurgery (6.5% [95% confidence interval: 6.7-7.5]) to 1 year postsurgery (1.0% [95% confidence interval: .8-1.2]; P < .001), then increased 1 to 7 years postsurgery (to 2.8% [95% confidence interval: 1.6-3.3]; P = .003), but was lower 7 years postsurgery versus presurgery (P < .001). Time trends for percentage of high-risk participants and mean CVD risk scores were similar for both sexes and other evaluated CVD risk scores. For example, among males mean lifetime atherosclerotic CVD score declined from presurgery to 1 year postsurgery, then increased 1 to 7 years postsurgery. However, there was a net decline from presurgery (P < .001).
Among both females and males, predicted 10-year and lifetime CVD risk was substantially lower 7 years post RYGB than presurgery, suggesting RYGB surgery can lead to sustained improvements in short- and long-term CVD risk.
减重手术后心血管疾病（CVD）风险的长期变化尚不清楚。
报告 Roux-en-Y 胃旁路手术（RYGB）后 CVD 风险的性别特异性变化。
美国十家医院的观察性队列研究。
2006 年至 2009 年，1770 名成年人在 10 家美国医院中的 1 家接受 RYGB。研究评估在 7 年期间进行术前和术后每年一次。在无 CVD 病史的参与者中，使用 Framingham10 年和终生风险评分、Framingham-体重指数和动脉粥样硬化性 CVD 评分算法计算特定性别预测的 10 年和终生 CVD 风险。在 1566 名符合条件的参与者中，包括 1234 名（75.9%）有 CVD 风险测定的参与者（1013 名女性，221 名男性）。
基于Framingham10 年和终生风险评分，女性预测高（>20%）10 年 CVD 风险的百分比从术前（6.5%[95%置信区间：6.7-7.5]）下降到术后 1 年（1.0%[95%置信区间：0.8-1.2]；P<0.001），然后在术后 1 至 7 年增加（增加到 2.8%[95%置信区间：1.6-3.3]；P=0.003），但术后 7 年低于术前（P<0.001）。两种性别和其他评估 CVD 风险评分的高危参与者百分比和平均 CVD 风险评分的时间趋势相似。例如，在男性中，术前平均终生动脉粥样硬化性 CVD 评分下降，然后在术后 1 年增加，然后在术后 1 至 7 年增加。然而，与术前相比，术后有净下降（P<0.001）。
在女性和男性中，预测的 10 年和终生 CVD 风险在 RYGB 术后 7 年明显低于术前，表明 RYGB 手术可导致短期和长期 CVD 风险的持续改善。
