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腹腔镜 Roux-en-Y 胃旁路术对脂代谢的选择性影响。

Selective effect of laparoscopic Roux-en-Y gastric bypass on lipid metabolism.

机构信息

Cátedra de Medicina Interna, Facultad de Medicina Universidad Nacional del Nordeste (UNNE), Corrientes, Argentina; Departamento de Nutrición y Diabetes, Centro de Endocrinología y Nutrición (CIEN), Corrientes, Argentina.

Departamento de Cirugía Bariátrica y Metabólica, Centro de Endocrinología y Nutrición (CIEN), Corrientes, Argentina.

出版信息

Clin Investig Arterioscler. 2022 Mar-Apr;34(2):68-74. doi: 10.1016/j.arteri.2021.09.005. Epub 2021 Dec 5.

Abstract

INTRODUCTION

Bariatric surgery (BS) has shown to reduce cardiovascular morbidity and mortality in obesity. The BS has improved the dyslipidemia of the insulin resistant patient, our objective was to evaluate if there was a difference in the lipid profile between the laparoscopic roux-en-Y gastric bypass (RYGB) technique vs. the sleeve gastrectomy (SG) technique at 18 months of follow-up.

METHODS

An observational, open, prospective study of morbidly obese patients who underwent bariatric surgery at 18-month follow-up. Anthropometric analysis, body composition, energy expenditure at rest, glucose, insulin, HbA, LDL, HDL, TG and CT were performed.

RESULTS

Absence baseline differences were found in the proportion of patients with hypertension, diabetes, steatosis, and sex between the RYGB vs SG groups. A reduction of TG was observed at 6 months in favor of RYGB vs SG: 108.60±34.86 vs. 124.59±44.58, P = 0.044), however, a decrease in both LDL levels was found at 12 and 18 months in favor of the RYGB vs. SG group: 96.23±24.33 vs. 107.83±28.88, P = 0.025; 90.98±20.62 vs 106.22±31.48, P = 0.003; the decrease in CT was observed only at 18 months in favor of the RYGB vs. SG group: 171.39±25.058 vs. 186.89±31.81, P = 0.005. CONCLUSIóN: RYBG has shown to be more effective in reducing LDL and CT levels compared to SG, which provides an additional benefit of RYGB in relation to the lipid profile of the patient.

摘要

简介

减重手术(BS)已被证明可降低肥胖患者的心血管发病率和死亡率。BS 改善了胰岛素抵抗患者的血脂异常,我们的目的是评估在 18 个月的随访中,腹腔镜 Roux-en-Y 胃旁路术(RYGB)与袖状胃切除术(SG)技术之间的血脂谱是否存在差异。

方法

对接受减重手术的病态肥胖患者进行了一项观察性、开放性、前瞻性研究,随访时间为 18 个月。进行了人体测量分析、身体成分、休息时能量消耗、血糖、胰岛素、HbA、LDL、HDL、TG 和 CT。

结果

RYGB 与 SG 组之间在高血压、糖尿病、脂肪肝和性别患者的比例上无基线差异。在 6 个月时观察到 TG 下降,RYGB 优于 SG:108.60±34.86 vs. 124.59±44.58,P=0.044),然而,在 12 个月和 18 个月时,两组 LDL 水平均下降,RYGB 优于 SG 组:96.23±24.33 vs. 107.83±28.88,P=0.025;90.98±20.62 vs 106.22±31.48,P=0.003;仅在 18 个月时观察到 CT 下降,RYGB 优于 SG 组:171.39±25.058 vs. 186.89±31.81,P=0.005。结论:RYGB 降低 LDL 和 CT 水平的效果优于 SG,这为 RYGB 与患者的血脂谱相关的提供了额外的益处。

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