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在确定肥胖人群的心脏代谢风险状况方面,腰高比是否是比体重指数更好的参数?

IS THE WAIST/HEIGHT RATIO A BETTER PARAMETER THAN BMI IN DETERMINING THE CARDIOMETABOLIC RISK PROFILE OF OBESE PEOPLE?

作者信息

Malafaia Andressa Bressan, Nassif Paulo Afonso Nunes, Lucas Ricardo Wallace das Chagas, Garcia Rodrigo Ferreira, Ribeiro José Guilherme Agner, Proença Laura Brandão DE, Mattos Maria Eduarda, Ariede Bruno Luiz

机构信息

Mackenzie Evangelical Faculty of Paraná, Curitiba, PR, Brazil.

University Evangelical Mackenzie Hospital, Curitiba, PR, Brazil.

出版信息

Arq Bras Cir Dig. 2022 Jan 5;34(3):e1610. doi: 10.1590/0102-672020210003e1610. eCollection 2022.

Abstract

BACKGROUND

The increased prevalence of obesity has led to a significant increase in the occurrence of metabolic syndrome, a recognized risk factor for increased morbidity and mortality from cardiovascular diseases. Hyperglycemia or type 2 diabetes mellitus, dyslipidemia and arterial hypertension are its main components. Since 2015, international guidelines have recognized the benefits of bariatric surgery in each isolated factor of this syndrome.

AIM

To evaluate the impact of Roux-en-Y gastric bypass in this syndrome comparing pre- and postoperative periods with laboratory analysis and to compare waist/height ratio and BMI in relation to the determination of the cardiometabolic risk profile.

METHODS

A retrospective study was carried out, selecting 80 patients undergoing Roux-en-Y gastric bypass. Total cholesterol, HDL, LDL, triglycerides, fasting glucose, glycated hemoglobin, insulin, body mass index (BMI), vitamin D, vitamin B12, waist circumference and waist/height ratio in three periods were analyzed: the preoperative period from 1 to 6 months, postoperative from 1 to 6 months and postoperative from 1 to 2 years.

RESULTS

There was an improvement in all parameters of the clinical analyses. The preoperative BMI had a mean value of 39.8, in the preoperative period from 1 to 6 months, the values ​​dropped to 33.2 and in the postoperative period of 1 year, the mean was 26. The perimeter mean values ​​of 118.5 preoperatively, 105.2 postoperatively from 1 to 6 months and 90.3 postoperatively from 1 to 2 years. Waist/height ratio was 0.73, 0.65 and 0.56 in pre, post 1 to 6 months and 1 to 2 years respectively.

CONCLUSION

Roux-en-Y gastric bypass improves metabolic syndrome and waist-to-height ratio is superior to BMI in the assessment of the cardiometabolic risk profile.

摘要

背景

肥胖患病率的上升导致代谢综合征的发生率显著增加,代谢综合征是心血管疾病发病率和死亡率增加的公认危险因素。高血糖或2型糖尿病、血脂异常和动脉高血压是其主要组成部分。自2015年以来,国际指南已认识到减重手术对该综合征各独立因素的益处。

目的

通过实验室分析比较术前和术后阶段,评估Roux-en-Y胃旁路手术对该综合征的影响,并比较腰高比和体重指数与心脏代谢风险状况的测定。

方法

进行了一项回顾性研究,选择80例行Roux-en-Y胃旁路手术的患者。分析三个阶段的总胆固醇、高密度脂蛋白、低密度脂蛋白、甘油三酯、空腹血糖、糖化血红蛋白、胰岛素、体重指数(BMI)、维生素D、维生素B12、腰围和腰高比:术前1至6个月、术后1至6个月和术后1至2年。

结果

临床分析的所有参数均有改善。术前BMI平均值为39.8,术前1至6个月时降至33.2,术后1年时平均值为26。术前腰围平均值为118.5,术后1至6个月为105.2,术后1至2年为90.3。腰高比在术前、术后1至6个月和1至2年分别为0.73、0.65和0.56。

结论

Roux-en-Y胃旁路手术可改善代谢综合征,在评估心脏代谢风险状况方面,腰高比优于BMI。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5896/8735133/4dc37c6cca82/0102-6720-abcd-34-03-e1610-gf1.jpg

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