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肥胖青少年行代谢减重手术与不行手术者的 5 年身体和心理社会结局。

Five-Year Physical and Psychosocial Outcomes in Obese Adolescents With and Without Metabolic Bariatric Surgery.

机构信息

Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China.

Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China.

出版信息

J Adolesc Health. 2023 Oct;73(4):784-789. doi: 10.1016/j.jadohealth.2023.05.034. Epub 2023 Jul 1.

Abstract

PURPOSE

Metabolic bariatric surgery (MBS) is increasingly accepted as a treatment for severely obese adolescents. However, its long-term efficacy and safety are not well characterized, particularly in the Eastern Asian population. We aimed to explore the long-term effects of MBS on Chinese adolescents with severe obesity.

METHODS

A total of 44 obese adolescents (≤18 years old) underwent MBS at our institution from May 2011 to May 2017. A matched nonsurgical control group, including 43 patients, was recruited from lifestyle modification programs in the same period. All patients completed assessments at presurgery/baseline and five years after surgery. The data were collected and analyzed using the χ2 test and an independent sample t-test.

RESULTS

Comparing the surgical and control groups revealed that the surgical patients showed significant weight loss and improvement in comorbidities, while the nonsurgical patients showed a trend of weight gain and increased comorbidities (p < .05). Furthermore, the surgical patients had a higher composite physical quality of life (as determined by the Short Form-36 questionnaire). On the other hand, the patients who underwent MBS had a higher risk of malnutrition.

DISCUSSION

Compared with nonsurgical patients, severely obese adolescents who undergo MBS exhibit more effective long-term weight loss, remission of comorbidities, and improved quality of life. Furthermore, more attention should be paid to helping adolescents avoid malnutrition after they undergo MBS.

摘要

目的

代谢减重手术(MBS)越来越被认为是治疗严重肥胖青少年的一种方法。然而,其长期疗效和安全性尚未得到充分描述,特别是在东亚人群中。我们旨在探讨 MBS 对中国严重肥胖青少年的长期影响。

方法

2011 年 5 月至 2017 年 5 月,我院共对 44 名肥胖青少年(≤18 岁)进行了 MBS。同期,从生活方式改变计划中招募了 43 名匹配的非手术对照组患者。所有患者均在术前/基线和手术后五年完成评估。使用卡方检验和独立样本 t 检验收集和分析数据。

结果

与手术组和对照组相比,手术组患者体重明显减轻,合并症改善,而非手术组患者体重呈增加趋势,合并症增多(p<0.05)。此外,手术组患者的综合生理生活质量更高(通过 36 项简短健康调查问卷评估)。另一方面,接受 MBS 的患者发生营养不良的风险更高。

讨论

与非手术患者相比,接受 MBS 的严重肥胖青少年表现出更有效的长期减重、合并症缓解和生活质量改善。此外,应更加关注帮助青少年在接受 MBS 后避免营养不良。

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