Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
Surg Obes Relat Dis. 2022 Jul;18(7):902-910. doi: 10.1016/j.soard.2022.03.009. Epub 2022 Mar 18.
Long-term change in CRP is not well characterized in the context of RYGB.
To report C-reactive protein (CRP) after Roux-en-Y gastric bypass surgery (RYGB).
Between 2006 and 2009 1770 adults enrolled in a prospective cohort study underwent Roux-en-Y gastric bypass (RYGB) at 1 of 10 U.S. hospitals.
Research assessments were conducted before surgery and annually postoperatively for up to 7 years. This study included those with high-sensitivity CRP assessed before surgery and 1 or more follow-up assessments (n = 1180).
Before surgery, participants' median age was 46 years, and the median body mass index (BMI) was 46 kg/m; 80% were female. Before surgery, mean (95% confidence interval [CI]) CRP was the highest of all time points (1.01 [.95-1.08] mg/L); it then decreased to a nadir of .18 (.15-.22) mg/L at 2 years postoperatively (P < .001). CRP was higher at 7 years (.26 [.22, .29] mg/L) than at 2 years postoperatively (P < .001) but remained lower at 7 years than preoperatively (P < .001). Additionally, only 3.2% (95% CI: 1.6%-4.8%) of participants had elevated CRP (>1 mg/dL) 7 years postoperatively versus 32.9% (95% CI: 30.2%-35.3%) preoperatively (P < .001). Several preoperative factors were associated with following a less favorable CRP trajectory over time, including higher preoperative CRP level, higher BMI, current smoking, and diabetes.
The vast majority of adults who underwent RYGB experienced a sustained improvement in CRP throughout 7 years of follow-up with nonelevated values. However, those with higher preoperative CRP and BMI levels and diabetes and who smoke may benefit from additional testing and monitoring to ensure nonelevated inflammation after surgery.
在 RYGB 背景下，CRP 的长期变化尚不清楚。
报告 Roux-en-Y 胃旁路手术后（RYGB）的 C 反应蛋白（CRP）。
在 2006 年至 2009 年间，在美国的 10 家医院中的 1 家，1770 名成年人参与了一项前瞻性队列研究，并接受了 Roux-en-Y 胃旁路手术（RYGB）。
在手术前和手术后每年进行研究评估，最长可达 7 年。本研究包括术前评估高敏 CRP 并进行 1 次或更多次随访评估的患者（n = 1180）。
手术前，参与者的中位年龄为 46 岁，中位体重指数（BMI）为 46kg/m；80%为女性。手术前，CRP 的平均值（95%置信区间[CI]）为所有时间点中最高（1.01[0.95-1.08]mg/L）；术后 2 年降至最低点 0.18（0.15-0.22）mg/L（P<.001）。术后 7 年的 CRP （0.26[0.22，0.29]mg/L）高于术后 2 年（P<.001），但仍低于术前（P<.001）。此外，与术前相比，术后 7 年仅有 3.2%（95%CI：1.6%-4.8%）的参与者 CRP 升高（>1mg/dL）（P<.001）。几个术前因素与术后 CRP 轨迹呈负相关，包括术前 CRP 水平较高、BMI 较高、当前吸烟和糖尿病。
大多数接受 RYGB 的成年人在 7 年的随访中 CRP 持续改善，且无升高。然而，术前 CRP 和 BMI 水平较高、患有糖尿病且吸烟的患者可能需要进行额外的检查和监测，以确保手术后炎症无升高。
