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中文肥胖患者行袖状胃切除术/胃旁路术后的营养状况:一项回顾性多中心队列研究。

Nutritional Status in Chinese Patients with Obesity Following Sleeve Gastrectomy/Roux-en-Y Gastric Bypass: A Retrospective Multicenter Cohort Study.

机构信息

National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha 410011, China.

Department of Metabolic Surgery, Department of Biliopancreatic Surgery, The Second Xiangya Hospital, Central South University, Changsha 410011, China.

出版信息

Nutrients. 2022 May 5;14(9):1932. doi: 10.3390/nu14091932.

Abstract

Metabolic surgery (MS) is one of the most effective therapies for treating obesity. Due to the lack of multicenter cohort research on nutritional evaluations after surgery in Chinese patients, we explored the changes in nutritional status following MS in Chinese patients. This was a retrospective study of patients (n = 903) who underwent sleeve gastrectomy (SG) (n = 640) or Roux-en-Y gastric bypass (RYGB) (n = 263) for obesity at five different hospitals in China between 17 February 2011, and 20 December 2019. Major nutrients were evaluated at baseline and 1, 3, 6, and 12 months postoperatively. Hb levels decreased, and anemia prevalence increased at 12 months after MS in the premenopausal female group. Moreover, patients with preoperative anemia had an increased risk of postoperative anemia. The ferritin levels (p < 0.001) decreased and iron deficiency increased (p < 0.001) at 12 months after MS among premenopausal females. No significant changes in folate deficiency and vitamin B12 deficiency were found throughout the study. The bone mineral density (BMD) of the femoral neck, lumbar spine, and total hip significantly decreased from baseline to 12 months after MS; however, no new patients developed osteopenia or osteoporosis after MS. Based on 12 months of follow-up, premenopausal females presented a high incidence of anemia after MS. Although we found no differences in osteopenia and osteoporosis prevalence after MS, the BMD did decrease significantly, which suggests that nutrient supplements and long-term follow-up are especially necessary postoperation.

摘要

代谢手术(MS)是治疗肥胖症最有效的治疗方法之一。由于缺乏中国患者术后营养评估的多中心队列研究,我们探讨了 MS 后中国患者营养状况的变化。这是一项回顾性研究,纳入了 2011 年 2 月 17 日至 2019 年 12 月 20 日期间在中国五家不同医院因肥胖接受袖状胃切除术(SG)(n = 640)或 Roux-en-Y 胃旁路术(RYGB)(n = 263)的患者(n = 903)。在基线和术后 1、3、6 和 12 个月评估主要营养素。MS 后 12 个月,绝经前女性组的血红蛋白水平下降,贫血患病率增加。此外,术前贫血的患者术后贫血的风险增加。MS 后 12 个月,绝经前女性的铁蛋白水平(p < 0.001)下降,缺铁性贫血增加(p < 0.001)。在整个研究过程中,叶酸缺乏和维生素 B12 缺乏没有明显变化。MS 后 12 个月,股骨颈、腰椎和全髋关节的骨密度(BMD)均从基线显著下降;然而,MS 后没有新的患者发生骨质疏松症或骨质疏松症。基于 12 个月的随访,绝经前女性在 MS 后出现贫血的发生率较高。尽管我们发现 MS 后骨质疏松症和骨质疏松症的患病率没有差异,但 BMD 确实显著下降,这表明术后尤其需要补充营养物质并进行长期随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faee/9101375/4be8e68e8d5c/nutrients-14-01932-g001.jpg

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