减肥手术对中期体重减轻反应不佳患者的额外代谢影响：一项5年随访研究

Additional Metabolic Effects of Bariatric Surgery in Patients with a Poor Mid-Term Weight Loss Response: A 5-Year Follow-Up Study.

作者信息

Benaiges David, Bisbe Maria, Pedro-Botet Juan, de Vargas-Machuca Aleix, Ramon Jose M, Pera Manuel, Villatoro Montserrat, Fontané Laia, Julià Helena, Climent Elisenda, Castañer Olga, Flores-Le Roux Juana A, Goday Alberto

机构信息

Departament de Medicina, Universitat Autònoma de Barcelona, 08139 Barcelona, Spain.

Cardiovascular Risk and Nutrition Research Group (CARIN-ULEC), IMIM-Hospital del Mar, Barcelona, Biomedical Research Park (Parc de Recerca Biomèdica de Barcelona-PRBB), 08003 Barcelona, Spain.

出版信息

J Clin Med. 2020 Oct 1;9(10):3193. doi: 10.3390/jcm9103193.

DOI:10.3390/jcm9103193

PMID:33019725

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7600546/

Abstract

UNLABELLED

To ascertain the 5-year metabolic effects of bariatric surgery in poor weight loss (WL) responders and establish associated factors.

METHODS

Retrospective analysis of a non-randomised prospective cohort of bariatric surgery patients completing a 5-year follow-up. Mid-term poor WL was considered when 5-year excess weight loss was <50%.

RESULTS

Forty-three (20.3%) of the 212 included patients were mid-term poor WL responders. They showed an improvement in all metabolic markers at 2 years, except for total cholesterol. This improvement with respect to baseline was maintained at 5 years for plasma glucose, HbA1c, HOMA, HDL and diastolic blood pressure; however, LDL cholesterol, triglycerides and systolic blood pressure were similar to presurgical values. Comorbidity remission rates were comparable to those obtained in the good WL group except for hypercholesterolaemia (45.8% vs. poor WL, = 0.005). On multivariate analysis, lower baseline HDL cholesterol levels, advanced age and lower preoperative weight loss were independently associated with poor mid-term WL.

CONCLUSIONS

Although that 1 in 5 patients presented suboptimal WL 5 years after bariatric surgery, other important metabolic benefits were maintained.

摘要

未标注

为确定减重手术对体重减轻效果不佳者的5年代谢影响，并确定相关因素。

方法

对完成5年随访的减重手术患者的非随机前瞻性队列进行回顾性分析。当5年超重减轻<50%时，视为中期体重减轻不佳。

结果

纳入的212例患者中有43例（20.3%）为中期体重减轻不佳者。他们在2年时所有代谢指标均有改善，但总胆固醇除外。血浆葡萄糖、糖化血红蛋白、稳态模型评估、高密度脂蛋白和舒张压在5年时相对于基线的改善得以维持；然而，低密度脂蛋白胆固醇、甘油三酯和收缩压与术前值相似。合并症缓解率与体重减轻良好组相当，但高胆固醇血症除外（45.8%对体重减轻不佳组，P = 0.005）。多因素分析显示，较低的基线高密度脂蛋白胆固醇水平、高龄和较低的术前体重减轻与中期体重减轻不佳独立相关。