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青少年和年轻成人接受减重手术的一年期结局比较:一项匹配病例对照研究,德黑兰肥胖治疗研究(TOTS)。

Comparison of the one-year outcomes of bariatric surgery in adolescents and young adults: a matched case-control study, Tehran Obesity Treatment Study (TOTS).

机构信息

Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Surgery, Faculty of Medicine, Tehran Obesity Treatment Center, Shahed University, Tehran, Iran.

出版信息

Surg Today. 2021 Nov;51(11):1764-1774. doi: 10.1007/s00595-021-02281-x. Epub 2021 Apr 10.

Abstract

PURPOSES

The increasing use of bariatric surgery in adolescents has raised some concerns regarding the postoperative outcomes and the optimal time of surgery at young ages. However, no study has yet compared the weight loss and comorbidity resolution following bariatric surgery between adolescents and young adults.

METHODS

This study was conducted on a case group of adolescents (aged 11-18) and a control group of young adults (aged 19-29) undergoing bariatric surgery (sleeve gastrectomy or gastric bypass). The two groups were matched in terms of gender, body mass index (BMI), and surgery type and were assessed regarding the surgical outcomes at 1 year after surgery.

RESULTS

The baseline characteristics of the adolescents (n = 118, mean age: 17.0 ± 1.6 years) and young adults (n = 236, mean age: 25.2 ± 3.2 years) were similar, as well as surgery-associated complications. The mean loss of BMI (- 15.4 ± 3.6 vs. -15.8 ± 4.6 kg/m) and 12-month percentage of excess weight loss (80.4 ± 20.1 vs. 80.2 ± 20.1%) were similar in the two groups. Both groups showed parallel reductions in the cardiovascular risk factors. The remission of hypertension, diabetes mellitus, and dyslipidemia was similar between the groups. The increase in the hemoglobin level and copper deficiency was greater in young adults, whereas the increase in ferritin deficiency was greater in adolescents.

CONCLUSION

Similar to young adults, bariatric surgery is an effective and safe method to achieve weight loss, resolve obesity-related comorbidities, and improve cardiovascular risk factors in the adolescents.

摘要

目的

减重手术在青少年中的应用日益增多,这引发了人们对术后结果和青少年时期进行手术的最佳时间的担忧。然而,目前还没有研究比较过青少年和年轻成年人接受减重手术后的体重减轻和合并症缓解情况。

方法

本研究纳入了一组青少年(年龄 11-18 岁)和一组年轻成年人(年龄 19-29 岁)作为病例组和对照组,他们都接受了减重手术(袖状胃切除术或胃旁路术)。这两组在性别、体重指数(BMI)和手术类型方面相匹配,并在手术后 1 年评估手术结果。

结果

青少年组(n=118,平均年龄:17.0±1.6 岁)和年轻成年人组(n=236,平均年龄:25.2±3.2 岁)的基线特征相似,手术相关并发症也相似。两组的 BMI 平均丢失量(-15.4±3.6 与-15.8±4.6 kg/m²)和 12 个月时超重体重减轻百分比(80.4±20.1%与 80.2±20.1%)也相似。两组的心血管危险因素都有平行下降。高血压、糖尿病和血脂异常的缓解情况在两组间相似。年轻成年人的血红蛋白水平和铜缺乏症的增加更为明显,而青少年的铁蛋白缺乏症的增加更为明显。

结论

与年轻成年人一样,减重手术是一种有效且安全的方法,可以实现青少年的体重减轻、缓解肥胖相关合并症,并改善心血管危险因素。

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