Department of Gastroenterology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, 44307, Kaunas, Lithuania.
Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Surg Endosc. 2022 Jun;36(6):4333-4341. doi: 10.1007/s00464-021-08778-3. Epub 2021 Oct 27.
Scarce evidence exists in the literature about the factors influencing the long-term quality of life (QoL) and weight regain (WR) after Roux-en-Y gastric bypass (RYGB). The aim of the present study was to investigate factors associated with WR and QoL, measured by obesity specific Moorehead-Ardelt Quality of Life Questionnaire II (M-A QoLQ II), 12 years after RYGB.
This prospective longitudinal cohort study included 74 patients with obesity who had RYGB at the Lithuanian University of Health Sciences hospital Surgery department in 2005. Gastrointestinal and dumping symptoms, hypoglycemia, depression and anxiety disorders, hunger, satiety after meals, portion size, and grazing were assessed in the patients who agreed to participate in the study. General linear models were constructed to estimate the effect of variables on the WR and QoL.
12-year follow-up data were available for 50 patients (38 female, median body mass index (BMI) before surgery 42.4). The mean % excess BMI loss (%EBMIL) after 12 years was 63.1 (24.6) and the average %WR was 32.2 (19.4). The mean M-A QoLQ II score was 1.44 (1.3). Majority of the patients (76.6%) reported good or very good QoL. In multivariable analysis, only grazing (17.41% 95% CI 7.61-27.21; P = 0.001) was found to be a significant independent factor associated with WR. Factors independently associated with worse QoL were grazing (- 0.97 95% CI - 1.72, - 0.22; P = 0.013) and frequency of abdominal pain once or more per month (- 1.82 95% CI - 2.79, - 0.85; P = 0.001).
12 years after RYGB majority of the patients report good or very good QoL and despite some WR have achieved and maintained significant weight loss. Grazing was associated with both WR and worse QoL, while the frequency of abdominal pain once or more per month was associated with only decreased QoL.
关于影响 Roux-en-Y 胃旁路术（RYGB）后长期生活质量（QoL）和体重反弹（WR）的因素，文献中证据很少。本研究的目的是调查与 WR 和 QoL 相关的因素，WR 和 QoL 通过肥胖特定的 Moorehead-Ardelt 生活质量问卷 II（M-A QoLQ II）进行测量，这是在 RYGB 后 12 年进行的。
这项前瞻性纵向队列研究包括 2005 年在立陶宛健康科学大学医院外科部门接受 RYGB 的 74 名肥胖患者。同意参与研究的患者评估了胃肠道和倾倒症状、低血糖、抑郁和焦虑障碍、饥饿、餐后饱腹感、餐量和杂食。构建了一般线性模型来估计变量对 WR 和 QoL 的影响。
可获得 50 名患者（38 名女性，手术前中位数体重指数（BMI）为 42.4）的 12 年随访数据。12 年后的平均% excess BMI loss（%EBMIL）为 63.1（24.6），平均%WR 为 32.2（19.4）。平均 M-A QoLQ II 得分为 1.44（1.3）。大多数患者（76.6%）报告 QoL 良好或非常好。多变量分析发现，只有杂食（17.41%95%CI 7.61-27.21；P=0.001）是与 WR 相关的独立显著因素。与 QoL 较差相关的因素是杂食（-0.97 95%CI -1.72，-0.22；P=0.013）和每月腹痛一次或多次的频率（-1.82 95%CI -2.79，-0.85；P=0.001）。
RYGB 后 12 年，大多数患者报告 QoL 良好或非常好，尽管存在一些 WR，但仍实现并维持了显著的体重减轻。杂食与 WR 和较差的 QoL 均相关，而每月腹痛一次或多次的频率仅与 QoL 降低相关。
