Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Institute of Health and Care Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Obesity (Silver Spring). 2023 Aug;31(8):2171-2177. doi: 10.1002/oby.23800.
The goal of this study was to investigate whether bariatric surgery is associated with substance use disorder (SUD) with substances other than alcohol.
The prospective, controlled Swedish Obese Subjects study enrolled 2010 patients with obesity who underwent bariatric surgery (gastric bypass n = 265; vertical banded gastroplasty n = 1369; gastric banding n = 376) and 2037 matched control individuals receiving usual obesity care. Participants with SUD other than alcohol use disorder were identified using International Statistical Classification of Diseases (ICD) codes from the Swedish National Patient Register (covering treatment in hospital but not primary care). Those with a history of non-alcohol SUD were excluded. Median follow-up was 23.8 years.
During follow-up, non-alcohol SUD incidence rates per 1000 person-years with 95% CI were 1.6 (0.8-3.1), 0.8 (0.5-1.2), 1.1 (0.5-2.2), and 0.6 (0.4-0.8) for gastric bypass, vertical banded gastroplasty, gastric banding, and control individuals, respectively. Only gastric bypass was associated with increased incidence of non-alcohol SUD (adjusted hazard ratio 2.54 [95% CI: 1.14-5.65], p = 0.022) compared with control participants.
Gastric bypass surgery was associated with increased risk of non-alcohol SUD, and this should be considered in long-term postoperative care.
本研究旨在探讨减重手术是否与除酒精以外的物质相关的物质使用障碍（SUD）有关。
前瞻性、对照的瑞典肥胖受试者研究纳入了 2010 名接受减重手术的肥胖患者（胃旁路术 n=265；垂直捆绑胃成形术 n=1369；胃束带术 n=376）和 2037 名接受常规肥胖治疗的匹配对照个体。使用瑞典国家患者登记处（涵盖医院治疗但不包括初级保健）中的国际疾病分类（ICD）代码来确定除酒精使用障碍以外的 SUD 患者。排除有非酒精性 SUD 病史的患者。中位随访时间为 23.8 年。
在随访期间，每 1000 人年非酒精 SUD 的发生率及其 95%CI 分别为 1.6（0.8-3.1）、0.8（0.5-1.2）、1.1（0.5-2.2）和 0.6（0.4-0.8），胃旁路术、垂直捆绑胃成形术、胃束带术和对照组个体。仅胃旁路术与非酒精性 SUD 的发生率增加相关（调整后的危险比 2.54[95%CI：1.14-5.65]，p=0.022），与对照组相比。
胃旁路手术与非酒精性 SUD 的风险增加相关，这应在长期术后护理中加以考虑。
