School of Nursing, Jinan University, Guangzhou, 510632, China.
Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, 999077, China.
Obes Surg. 2023 Mar;33(3):789-806. doi: 10.1007/s11695-022-06444-8. Epub 2023 Jan 6.
The study aimed to perform a meta-analysis about the change in adipokines and gastrointestinal hormones after bariatric surgery in patients with obesity.
We searched the Cochrane Central Register of Controlled Trials, EMBASE, and PubMed for related articles and used Review Manager 5.4 for data aggregation. Sensitivity and subgroup analysis were also conducted when feasible.
As a result, 95 articles involving 6232 patients were included in the meta-analysis. After bariatric surgery, the levels of leptin, ghrelin, C-reactive protein (CRP), interleukin-6 (IL-6), high-sensitivity C-reactive protein (Hs-CRP), tumor necrosis, factor-α (TNF-α), and interleukin-1β (IL-1β) reduced, while adiponectin, glucagon-like peptide-1 (GLP-1), and peptide YY (PYY) levels increased significantly. Subgroup analysis indicated that there was a more significant reduction in leptin level with a longer follow-up time. OAGB had a greater effect on increasing adiponectin level compared with other procedures. SG procedure would bring about reduced ghrelin, while BPD resulted in increased ghrelin. Meta-regression analysis found that publication year, study design, number of patients, preoperative age, preoperative BMI, and quality assessment score were not significantly related to change in leptin, adiponectin, and ghrelin levels.
Bariatric surgery was associated with a significant decrease in leptin, ghrelin, CRP, IL-6, Hs-CRP, TNF-α, and IL-1β, as well as increase in adiponectin, GLP-1, and PYY levels.
本研究旨在进行荟萃分析,探讨肥胖患者行减重手术后,其脂联素和胃肠激素的变化。
我们检索了 Cochrane 对照试验中心注册库、EMBASE 和 PubMed 以获取相关文章,并使用 Review Manager 5.4 进行数据汇总。如有可能,还进行了敏感性和亚组分析。
最终,纳入了 95 项研究共 6232 例患者的资料进行荟萃分析。减重手术后,瘦素、胃饥饿素、C 反应蛋白(CRP)、白细胞介素-6(IL-6)、高敏 C 反应蛋白(Hs-CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-1β(IL-1β)的水平降低,而脂联素、胰高血糖素样肽-1(GLP-1)和肽 YY(PYY)水平显著升高。亚组分析表明,随访时间较长时,瘦素水平的降低更为显著。与其他术式相比,袖状胃切除术(SG)对增加脂联素水平的效果更显著。胃旁路术(OAGB)会降低胃饥饿素水平,而胆胰分流术(BPD)则会升高胃饥饿素水平。Meta 回归分析发现,发表年份、研究设计、患者数量、术前年龄、术前 BMI 和质量评估评分与瘦素、脂联素和胃饥饿素水平的变化无显著相关性。
减重手术与瘦素、胃饥饿素、CRP、IL-6、Hs-CRP、TNF-α和 IL-1β水平的显著降低以及脂联素、GLP-1 和 PYY 水平的显著升高相关。