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术前健康状况影响青少年行垂直袖状胃切除术的术后结果。

Presurgery health influences outcomes following vertical sleeve gastrectomy in adolescents.

机构信息

Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.

Division of Endocrinology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California, USA.

出版信息

Obesity (Silver Spring). 2024 Jun;32(6):1187-1197. doi: 10.1002/oby.24018. Epub 2024 Apr 25.

Abstract

OBJECTIVE

Weight loss following vertical sleeve gastrectomy (VSG) in youth can range from 10% to 50%. We examined whether there are differences in demographic or metabolic parameters before VSG in youth who achieve above-average weight loss (AAWL) versus below-average weight loss (BAWL) at 1 year post VSG and if youth with BAWL still achieve metabolic health improvements at 1 year post VSG.

METHODS

Demographic, anthropometric, and clinical lab data were collected before VSG and at 1, 3, 6, and 12 months after VSG.

RESULTS

Forty-three youth with a mean age of 16.9 (SD 1.7) years before VSG were studied; 70% were female, 19% non-Hispanic Black, 58% non-Hispanic White, and 23% mixed/other race. Mean baseline BMI was 51.1 (SD 10.5) kg/m. Average weight loss was 25.8%. The AAWL group lost 18.6 kg/m (35.3%) versus the BAWL group, who lost 8.8 kg/m (17.5%). BMI, age, race, sex, and socioeconomic status at baseline were similar between AAWL and BAWL groups; however, the BAWL group had a higher frequency of pre-VSG dysglycemia, steatotic liver disease, and dyslipidemia. At 1 year post VSG, fewer youth in the BAWL group achieved ideal health parameters, and they had less resolution of comorbidities.

CONCLUSIONS

The presence of comorbidities before VSG is associated with less weight loss and reduced resolution of metabolic conditions at 1 year post VSG.

摘要

目的

青少年行袖状胃切除术(VSG)后,体重减轻幅度为 10%至 50%。本研究旨在探讨 VSG 术后 1 年时,体质量减轻优于平均水平(AAWL)和低于平均水平(BAWL)的青少年在 VSG 术前是否存在人口统计学或代谢参数的差异,以及 BAWL 患者在 VSG 术后 1 年是否仍能改善代谢健康。

方法

收集 VSG 术前及术后 1、3、6 和 12 个月的人口统计学、人体测量学和临床实验室数据。

结果

本研究共纳入 43 例平均年龄为 16.9(SD 1.7)岁的青少年,其中 70%为女性,19%为非西班牙裔黑人,58%为非西班牙裔白人,23%为混合/其他种族。平均基线 BMI 为 51.1(SD 10.5)kg/m。平均体质量减轻 25.8%。AAWL 组患者减轻 18.6kg/m(35.3%),BAWL 组患者减轻 8.8kg/m(17.5%)。AAWL 组和 BAWL 组患者的基线 BMI、年龄、种族、性别和社会经济地位无显著差异;但 BAWL 组术前存在糖代谢异常、脂肪性肝病和血脂异常的比例更高。VSG 术后 1 年,BAWL 组青少年中达到理想健康参数的比例较低,且合并症的缓解程度较低。

结论

VSG 术前合并症的存在与 VSG 术后 1 年体质量减轻减少和代谢状况改善不足有关。

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