Biobaku Fatimo, Ghanim Husam, Monte Scott V, Caruana Joseph A, Dandona Paresh
Division of Endocrinology, Diabetes and Metabolism, State University of New York at Buffalo, New York.
Synergy Bariatrics (Erie County Medical Center), Williamsville, NY.
J Endocr Soc. 2020 Aug 4;4(9):bvaa049. doi: 10.1210/jendso/bvaa049. eCollection 2020 Sep 1.
Obesity is associated with increased mortality as a result of several comorbidities which occur in tandem with the obese state. Chronic inflammation is well documented in obesity, and evidence from numerous studies support the notion that the increased inflammation in individuals with obesity accentuates the comorbidities seen in this condition. The remission of comorbidities such as metabolic, cardiovascular, and neurological complications occurs following bariatric procedures. Bariatric surgery significantly reduces mortality and results in remarkable weight loss and reversal in several obesity-related comorbidities. There is indisputable evidence that the resolution of inflammation that occurs after bariatric surgery mitigates some of these comorbidities. With the increasing use of bariatric surgery for the treatment of severe obesity, it is pivotal to elucidate the underlying mechanisms responsible for the notable improvements seen after the procedure. This review summarizes underlying mechanisms responsible for the remission of obesity-related abnormalities and discusses the common adverse effects of bariatric surgery. Well-stratified, large-scale studies are still needed for a proper evaluation of these underlying mechanisms.
肥胖与多种合并症导致的死亡率增加有关，这些合并症与肥胖状态同时出现。肥胖中的慢性炎症已有充分记录，大量研究的证据支持这样一种观点，即肥胖个体中炎症增加会加剧这种情况下出现的合并症。代谢、心血管和神经并发症等合并症在减肥手术后会得到缓解。减肥手术显著降低死亡率，并导致显著的体重减轻以及逆转多种与肥胖相关的合并症。有确凿证据表明，减肥手术后炎症的消退减轻了其中一些合并症。随着减肥手术越来越多地用于治疗重度肥胖，阐明该手术后出现显著改善的潜在机制至关重要。本综述总结了肥胖相关异常缓解的潜在机制，并讨论了减肥手术的常见不良反应。仍需要进行分层良好的大规模研究来正确评估这些潜在机制。
