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对减重术后患者的酒精滥用风险、抑郁症状和健康相关生活质量下降进行筛查及其与体重反弹的关系。

Screening Risks of Alcohol Abuse, Depressive Symptoms, and Decreased Health-Related Quality of Life in Post-Bariatric Patients and Their Relations to Weight Regain.

机构信息

Postgraduate Program in Clinical and Experimental Physiopathology, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

Obesity Unit, Centro de Pesquisas Clínicas Multiusuário (CePeM), Hospital Universitário Pedro Ernesto (HUPE), State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

出版信息

Obes Surg. 2023 Jun;33(6):1797-1805. doi: 10.1007/s11695-023-06605-3. Epub 2023 Apr 25.

Abstract

PURPOSE

Not all patients who underwent bariatric surgery keep their regular medical follow-up. We screened alcohol use, depressive symptoms, and health-related quality of life (HRQoL) in post-bariatric patients who have lost medical follow-up at their first appointment in our healthcare unit. These screened disorders were compared between low vs. high ratios of weight regain (RWR) and correlated with surgical outcomes.

MATERIAL AND METHODS

Ninety-four post-bariatric patients without medical follow-up (87.2% female, aged 42 ± 9 years, BMI = 32.9 ± 6.5kg/m) were included. They underwent Roux-en-Y gastric bypass (n = 80) or sleeve gastrectomy (n = 14). They were divided into high RWR (≥ 20%) and low RWR (< 20%) groups. We used Alcohol Use Disorders Inventory Test, Beck Depression Inventory, and 36-Item Short-Form Health Survey.

RESULTS

Neck and waist circumferences, diastolic blood pressure, and time since surgery were higher in the high than low RWR group (P≤ 0.05). No differences between groups for alcohol use and depressive symptoms were detected (P≥ 0.07), but those who regained more weight exhibited poorer health scores in physical functioning, physical role limitations, bodily pain, and vitality (P≤ 0.05). In the low RWR group, the RWR was inversely correlated to physical/social functioning and vitality. Positive associations were present between RWR vs. depressive symptoms, while negative ones were noted to physical functioning and general health perception in the high RWR group.

CONCLUSIONS

HRQoL has deteriorated in those post-bariatric patients without medical follow-up who regained more weight, possibly indicating the need for regular long-term health care.

摘要

目的

并非所有接受减重手术的患者都能定期进行医疗随访。我们在医疗单位首次就诊时对失去医疗随访的减重后患者进行酒精使用、抑郁症状和健康相关生活质量(HRQoL)筛查。这些筛查出的疾病在体重恢复率(RWR)低与高的患者之间进行了比较,并与手术结果相关联。

材料与方法

纳入 94 名无医疗随访的减重后患者(87.2%为女性,年龄 42±9 岁,BMI=32.9±6.5kg/m)。他们接受了 Roux-en-Y 胃旁路术(n=80)或袖状胃切除术(n=14)。他们分为高 RWR(≥20%)和低 RWR(<20%)组。我们使用酒精使用障碍测试、贝克抑郁量表和 36 项简短健康调查问卷进行评估。

结果

高 RWR 组的颈围和腰围、舒张压以及手术时间均高于低 RWR 组(P≤0.05)。两组之间在酒精使用和抑郁症状方面无差异(P≥0.07),但体重恢复较多的患者在身体功能、身体角色限制、身体疼痛和活力方面的健康评分更差(P≤0.05)。在低 RWR 组中,RWR 与身体/社会功能和活力呈负相关。在高 RWR 组中,RWR 与抑郁症状呈正相关,而与身体功能和总体健康感知呈负相关。

结论

在失去医疗随访且体重恢复较多的减重后患者中,HRQoL 已经恶化,这可能表明需要定期进行长期的医疗保健。

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