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减重手术对心血管危险因素的影响:年龄是需要考虑的因素吗?

Bariatric Surgery Impact on Cardiovascular Risk Factors: Is Age a Factor to Consider?

机构信息

Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de S. João, Porto, Portugal,

Faculty of Medicine, Universidade do Porto, Porto, Portugal,

出版信息

Obes Facts. 2021;14(1):72-77. doi: 10.1159/000511737. Epub 2020 Dec 15.

Abstract

INTRODUCTION

Despite the abundance of data addressing the influence of patient's age on surgery-related complications, its impact on cardiometabolic outcomes following bariatric surgery has been overlooked.

METHODS

Retrospective unicentric study of 1,728 obese patients who underwent bariatric surgery between January 2010 and June 2015. Patients were divided in 3 age groups, according to their age at surgery: ˂40 (n = 751), 40-59 (n = 879), and ≥60 years (n = 98). Parameters with cardiometabolic impact, such as body anthropometric measures, lipid profile, and glycemic status, before and 24 months after surgery, were compared between these groups. A multiple linear regression was performed, adjusting differences between groups for sex, surgery type, and body mass index variation.

RESULTS

The group ˂40 years presented more weight loss (-35.4 ± 9.0 kg, p ˂ 0.001), greater BMI reduction (-15.8 ± 6.1 kg/m2, p ˂ 0.001), and larger changes in waist (-34 ± 13.8 cm, p ˂ 0.001) and hip circumferences (-28.7 ± 11.9 cm, p ˂ 0.05). The group of ≥60 years presented the heaviest reduction in fasting glucose (-17.7 ± 32.8 mg/dL, p ˂ 0.001) and HbA1c (0.7 ± 1.0, p ˂ 0.001), and also had a tendency to have the biggest changes in systolic blood pressure (-14.7 ± 18.7 mm Hg, p = 0.071).

CONCLUSION

Patients with ≥60 years benefit the most from bariatric surgery regarding cardiometabolic parameters, presenting heavier reductions in fasting glucose, as well as HbA1c and a tendency towards a higher decrease in systolic blood pressure. No clinically significant differences in lipid profile were observed between groups.

摘要

简介

尽管有大量数据表明患者年龄会影响与手术相关的并发症,但人们忽视了其对减重手术后心脏代谢结果的影响。

方法

这是一项回顾性单中心研究,纳入了 1728 名于 2010 年 1 月至 2015 年 6 月期间接受减重手术的肥胖患者。根据手术时的年龄,患者被分为 3 个年龄组:˂40 岁(n = 751)、40-59 岁(n = 879)和 ≥60 岁(n = 98)。比较这些组在手术前后具有心脏代谢影响的参数,如人体测量指标、血脂谱和血糖状态。对性别、手术类型和体重指数变化进行了调整,以消除组间差异。

结果

˂40 岁组体重减轻(-35.4 ± 9.0 kg,p ˂ 0.001)、体重指数降低(-15.8 ± 6.1 kg/m2,p ˂ 0.001)和腰围(-34 ± 13.8 cm,p ˂ 0.001)、臀围(-28.7 ± 11.9 cm,p ˂ 0.05)变化更大。≥60 岁组空腹血糖(-17.7 ± 32.8 mg/dL,p ˂ 0.001)和糖化血红蛋白(HbA1c)(0.7 ± 1.0,p ˂ 0.001)降幅最大,收缩压(-14.7 ± 18.7 mm Hg,p = 0.071)也有降低趋势。

结论

≥60 岁的患者从减重手术中获益最多,其空腹血糖、HbA1c 降幅最大,收缩压有下降趋势。各组之间血脂谱无显著差异。

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