General Surgery Department & Obesity and Metabolic Disease Center, China-Japan Friendship Hospital, Beijing, China.
Xiangya School of Medicine, Central South University, Changsha, China.
Obesity (Silver Spring). 2024 Jun;32(6):1047-1058. doi: 10.1002/oby.24007. Epub 2024 Apr 5.
The objective of this meta-analysis was to quantify the overall effects of gene mutations in the leptin-melanocortin pathway on short- and long-term weight loss after bariatric surgery.
MEDLINE, PubMed, and Embase were searched, and data were analyzed using ReviewManager (RevMan) version 5.4. The datasets were divided into two subgroups based on postoperative time, and the outcome measure was the percentage of total weight loss. Meta-regression analysis was performed, and the outcome was presented as the weighed mean difference of percentage of total weight loss.
The results showed that patients with mutations in the leptin-melanocortin pathway experienced 3.03% lower total weight loss after bariatric surgery (mean difference, -3.03; 95% CI: -3.63 to -2.44), mainly reflected in lower long-term postoperative weight loss (mean difference, -3.43; 95% CI: -4.09 to -2.77), whereas mutation carriers exhibited a magnitude of short-term postoperative weight loss that was similar to patients without such mutations (total difference value, -1.13; 95% CI: -2.57 to 0.31).
Mutations in leptin-melanocortin pathway genes reduce long-term weight loss after bariatric surgery, whereas this effect may not be reflected during the period of rapid weight loss within 12 months. These genetic variants increase the difficulties in maintaining patients' long-term weight loss.
本荟萃分析的目的是量化肥胖症手术治疗后瘦素-黑素皮质素途径基因变异对短期和长期体重减轻的总体影响。
检索 MEDLINE、PubMed 和 Embase，并使用 ReviewManager（RevMan）版本 5.4 进行数据分析。数据集根据术后时间分为两组，主要结局指标为总体重减轻的百分比。进行了元回归分析，结果以总体重减轻百分比的加权均数差表示。
结果表明，瘦素-黑素皮质素途径基因突变患者在肥胖症手术后的总体重减轻率降低 3.03%（平均差异，-3.03；95%CI：-3.63 至-2.44），主要反映在长期术后体重减轻率降低（平均差异，-3.43；95%CI：-4.09 至-2.77），而突变携带者的短期术后体重减轻幅度与无此类突变的患者相似（总差值，-1.13；95%CI：-2.57 至 0.31）。
瘦素-黑素皮质素途径基因突变可减少肥胖症手术后的长期体重减轻，而这种影响在 12 个月内快速体重减轻期间可能不会显现。这些遗传变异增加了维持患者长期体重减轻的难度。
