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在中国,将肥胖症患者接受减重手术以获得早期心血管益处后缺血性心血管疾病的10年风险降低。

Reducing the 10-year risk of ischemic cardiovascular disease to receive early cardiovascular benefits from bariatric surgery for obesity in China.

作者信息

Li Yinhui, Liu Jia, Zhou Biao, Li Xiaohui, Wu Zhenyu, Meng Hua, Wang Guang

机构信息

Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

Department of General Surgery and Obesity, Metabolic Disease Center, China-Japan Friendship Hospital, Beijing, China.

出版信息

Front Cardiovasc Med. 2022 Oct 11;9:978682. doi: 10.3389/fcvm.2022.978682. eCollection 2022.

Abstract

BACKGROUND

Cardiovascular risk due to obesity can be improved greatly by bariatric surgery. However, there is no research involving appropriate model for evaluating cardiovascular disease risk reduction in bariatric surgery for obesity in China. We selected the ischemic cardiovascular disease (ICVD) risk score that accurately predict cardiovascular risk in Chinese adults to evaluate the 10-year risk of ICVD and estimated early cardiovascular benefits of bariatric surgery in obese Chinese patients through its reduction.

METHODS

From 2017 to 2019 we followed up 107 patients 6 months after surgery and measured the ICVD 10-year risk and other cardiovascular factors before and after surgery.

RESULTS

There were significant reductions in the ICVD total score ( < 0.001) and ICVD 10-year risk (%) ( < 0.001) 6 months post-operation compared with baseline. Furthermore, we found significant reductions in body mass index (BMI), body adiposity index (BAI), low-density lipoprotein (LDL), small dense-low-density lipoprotein (sd-LDL) and triglycerides (TG) 6 months after surgery compared with pre-operation (all < 0.05). The decrease in ICVD total score was correlated with excess BMI loss (%EBMIL), reduced BAI, reduced LDL, reduced sd-LDL and reduced TG respectively (all < 0.05) at 6 months post-operation. Moreover, there were significant reductions in the ICVD total score in the male subgroup [3 (3, 5) vs. 2.5 (2, 4), < 0.001] and female subgroup [3 (2, 4) vs. 2 (1, 3), < 0.001] 6 months post-operation compared with baseline. At last there were also significant reductions in the ICVD total score in the diabetic subgroup [5 (4, 6) vs. 4 (3, 5), < 0.001] and non-diabetic subgroup [2 (2,3) vs. 2 (1, 2), < 0.001] 6 months post-operation compared with baseline.

CONCLUSIONS

Bariatric surgery could provide early cardiovascular benefits for patients with obesity in China by reducing the 10-year risk of ICVD. Both men and women with obesity achieved cardiovascular benefits according to bariatric surgery, so did diabetic and non-diabetic patients.

摘要

背景

肥胖引起的心血管风险可通过减肥手术得到显著改善。然而,在中国,尚无研究采用合适的模型来评估减肥手术对肥胖患者心血管疾病风险降低的效果。我们选择了能准确预测中国成年人心血管风险的缺血性心血管疾病(ICVD)风险评分,以评估ICVD的10年风险,并通过其降低情况来估计减肥手术对中国肥胖患者早期心血管的益处。

方法

2017年至2019年,我们对107例患者术后6个月进行随访,并测量手术前后的ICVD 10年风险及其他心血管因素。

结果

与基线相比,术后6个月ICVD总分(<0.001)和ICVD 10年风险(%)(<0.001)显著降低。此外,与术前相比,术后6个月体重指数(BMI)、身体脂肪指数(BAI)、低密度脂蛋白(LDL)、小而密低密度脂蛋白(sd-LDL)和甘油三酯(TG)均显著降低(均<0.05)。术后6个月,ICVD总分的降低分别与超重BMI降低百分比(%EBMIL)、BAI降低、LDL降低、sd-LDL降低和TG降低相关(均<0.05)。此外,与基线相比,术后6个月男性亚组[3(3,5)对2.5(2,4),<0.001]和女性亚组[3(2,4)对2(1,3),<0.001]的ICVD总分均显著降低。最后,与基线相比,术后6个月糖尿病亚组[5(4,6)对4(3,5),<0.001]和非糖尿病亚组[2(2,3)对2(1,2),<0.001]的ICVD总分也显著降低。

结论

减肥手术可通过降低ICVD的10年风险为中国肥胖患者提供早期心血管益处。肥胖的男性和女性通过减肥手术均获得了心血管益处,糖尿病和非糖尿病患者也是如此。

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