Jiang Li, Sun Wei, Zhang Mi, Wang Yaqing, Tian Yunfan, Li Peng, Lu Yan, Xu Tianhua, Qiu Ming, Yang Yun, Jia Xuemei, Kong Xiangqing
Department of Pediatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
Diabetes Metab Syndr Obes. 2021 Dec 29;14:4921-4930. doi: 10.2147/DMSO.S272879. eCollection 2021.
Several studies have demonstrated that increased omental adipose is a risk factor for obesity and metabolic syndrome. It remains unclear whether it is responsible for hypertension as an independent risk. This study was designed to assess the impact of omental adipose removal by surgery on blood pressure in cancer patients with or without hypertension.
In this prospective observational study, 133 patients with gastric or gynecological cancer were divided into 3 groups: non-hypertensive and omentum removed (NH&OR), hypertensive and omentum removed (H&OR), and hypertensive and omentum present (H&OP). Patients were followed up with systolic and diastolic blood pressure (SBP and DBP), changes in related body mass index and metabolic indices. The time points of the 2 follow-up visits were 1 month ± 7 days after the operation before the start of chemotherapy and the endpoint of 8 ± 1 month. Omental adipose tissues from both non-hypertensive and hypertensive patients in surgery were collected. We included 133 patients (84.2% female, 20.3% malignant gastric cancer and 79.7% malignant gynecological cancer, 78.2% omentum removal, 48.9% hypertensive), and all completed follow-up. H&OR group showed significant reductions in systolic and diastolic blood pressure compared with the baseline at 1-m (-16.94/-10.50 mmHg, both < 0.001) and 8-m end point (-16.00/-5.50 mmHg, < 0.001 and = 0.004). Little reductions were observed with the body mass index of patients in 3 groups till the endpoint of study (H&OR group: 24.60 kg/m to 23.57 kg/m, NH&OR group: 23.45 kg/m to 23.25 kg/m, H&OP group: 25.74 kg/m to 25.24 kg/m, all > 0.05). No correlation was found between the baseline body mass index and 8-m change of systolic and diastolic blood pressure in omentum removed groups. In both groups, triglyceride levels were significantly increased at 4 ± 1 week after surgery (NH&OR 0.32 mmol/L, = 0.006; H&OR 0.40 mmol/L, = 0.010).
Resection of omental adipose tissue represents an effective strategy for reducing systolic and diastolic blood pressure at 8 months in hypertensive patients, even in the non-obese hypertensive population.
多项研究表明，网膜脂肪增加是肥胖和代谢综合征的危险因素。网膜脂肪作为独立危险因素是否会导致高血压尚不清楚。本研究旨在评估手术切除网膜脂肪对患有或未患高血压的癌症患者血压的影响。
在这项前瞻性观察研究中，133例胃癌或妇科癌症患者被分为3组：非高血压且网膜已切除（NH&OR）组、高血压且网膜已切除（H&OR）组和高血压且网膜未切除（H&OP）组。对患者进行收缩压和舒张压（SBP和DBP）、相关体重指数和代谢指标变化的随访。两次随访的时间点分别为术后1个月±7天（化疗开始前）和8±1个月的终点。收集手术中来自非高血压和高血压患者的网膜脂肪组织。我们纳入了133例患者（女性占84.2%，恶性胃癌占20.3%，恶性妇科癌症占79.7%，网膜切除率为78.2%，高血压患者占48.9%），所有患者均完成随访。H&OR组在术后1个月时收缩压和舒张压较基线显著降低（分别为-16.94/-10.50 mmHg，均<0.0０1），在8个月终点时也显著降低（-16.00/-5.50 mmHg，<0.0０1和=0.004）。直到研究终点，3组患者的体重指数均有轻微下降（H&OR组：从24.60 kg/m²降至23.57 kg/m²，NH&OR组：从23.45 kg/m²降至23.25 kg/m²，H&OP组：从25.74 kg/m²降至25.24 kg/m²，均>0.05）。在网膜切除组中，基线体重指数与8个月时收缩压和舒张压的变化之间未发现相关性。两组患者术后4±1周时甘油三酯水平均显著升高（NH&OR组为0.32 mmol/L，=0.006；H&OR组为0.40 mmol/L，=0.010）。
切除网膜脂肪组织是降低高血压患者8个月时收缩压和舒张压的有效策略，即使在非肥胖高血压人群中也是如此。
