Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain.
Obesity Unit, Hospital Clinic Barcelona and Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain.
Annu Rev Nutr. 2024 Aug;44(1):289-312. doi: 10.1146/annurev-nutr-061121-101547. Epub 2024 Aug 12.
Bariatric surgery is an important weight loss tool in individuals with severe obesity. It is currently the most effective long-term weight loss treatment that lowers obesity-related comorbidities. It also has significant physiological and nutritional consequences that can result in gastrointestinal complications and micronutrient deficiencies. After gastric bypass, clinical events that negatively affect nutritional status include malabsorption, dumping syndrome, kidney stones, altered intestinal bile acid availability, bowel obstruction, ulcers, gastroesophageal reflux, and bacterial overgrowth. Risk factors for poor nutritional status and excessive loss of lean body mass and bone include reduced dietary quality and inadequate intake, altered nutrient absorption, and poor patient compliance with nutrient supplementation. There are unique concerns in adolescents, older individuals, and individuals who become pregnant postoperatively. With careful management, health-care professionals can assist with long-term weight loss success and minimize the risk of acute and long-term nutrition complications after bariatric surgery.
减重手术是严重肥胖患者重要的减肥手段。它是目前降低肥胖相关合并症的最有效长期减肥治疗方法。它还会产生显著的生理和营养后果,导致胃肠道并发症和微量营养素缺乏。胃旁路手术后,影响营养状况的临床事件包括吸收不良、倾倒综合征、肾结石、肠内胆汁酸可用性改变、肠梗阻、溃疡、胃食管反流和细菌过度生长。导致营养不良和大量减少瘦体重和骨量的风险因素包括饮食质量下降和摄入不足、营养素吸收改变以及患者对营养补充的依从性差。青少年、老年人以及术后怀孕的个体存在独特的担忧。通过精心管理,医疗保健专业人员可以帮助长期减肥成功,并最大限度地降低减重手术后急性和长期营养并发症的风险。