Division of Gastroenterology, Hepatology, and Nutrition, GI Motility Research, University of Louisville, 8 Frazier, 220 Abraham Flexner Dr, Louisville, KY, 40202, USA.
Vanderbilt University Medical Center, Nashville, TN, 37235, USA.
Obes Surg. 2024 Sep;34(9):3147-3160. doi: 10.1007/s11695-024-07360-9. Epub 2024 Jul 24.
Changes in autonomic (ANS) and enteric nervous systems (ENS) may be involved in pathogenesis of obesity. We hypothesized that baseline autonomic and enteric parameters may predict outcomes of diverse obesity therapies.
We studied ANS and ENS physiology in 37 patients (8 male, 29 female, age 45 years, weight 129.7 kg) at 4 centers in patients undergoing medical (9: low-calorie diet) versus invasive (22: 16 sleeve, 6 bypass) and semi-invasive (6: 2 band, 2 high energy stimulation, 2 aspiration) weight loss therapies. Weight loss was reported as percent weight loss from baseline to latest values at 1 year and in some up to 5 years; classified as < or > /= 20% for each group. ANS testing included sympathetic adrenergic function by measuring reflex vasoconstriction and postural adjustment ratio. ENS was measured non-invasively using cutaneous low-resolution electrogastrogram.
Percent weight loss was greater with the invasive (28.5%) than semi-invasive (9.1%) or non-invasive low-calorie diet (4.4%) (p < .001). Percent weight loss at 1 year (and up to 5 years) corresponded to the adrenergic measure of postural adjustment ratio (r = .42, p = .012), total pulse amplitude at rest (r = .56, p < .001), and electrogastrogram standing-to-rest difference (r = .33, p = .056).
Baseline autonomic and enteric function measures correspond to percentage with loss in this pilot study using diverse weight loss methods. Autonomic and enteric profiling has potential clinical use for evaluation and treatment of obesity but needed larger controlled trials.
自主神经系统（ANS）和肠神经系统（ENS）的变化可能与肥胖的发病机制有关。我们假设基线自主和肠参数可能预测不同肥胖治疗方法的结果。
我们在 4 个中心研究了 37 名患者（8 名男性，29 名女性，年龄 45 岁，体重 129.7kg）的 ANS 和 ENS 生理学，这些患者正在接受医学治疗（9：低热量饮食）与侵入性治疗（22：16 袖状胃切除术，6 例旁路手术）和半侵入性治疗（6：2 带，2 例高能刺激，2 例抽吸）。体重减轻的报告是从基线到 1 年的最新值的百分比体重减轻，在某些情况下高达 5 年；每个组分为<或=20%。ANS 测试包括通过测量反射性血管收缩和姿势调整比来测量交感肾上腺素能功能。ENS 是使用皮肤低分辨率胃电图无创测量的。
与半侵入性（9.1%）或非侵入性低热量饮食（4.4%）相比，侵入性治疗（28.5%）的体重减轻百分比更大（p<0.001）。1 年（甚至 5 年）的体重减轻百分比与姿势调整比的肾上腺素能测量值相对应（r=0.42，p=0.012），静息时的总脉搏幅度（r=0.56，p<0.001）和站立到休息时的胃电图差异（r=0.33，p=0.056）。
在这项使用不同减肥方法的初步研究中，基线自主和肠功能测量值与损失百分比相对应。自主和肠功能分析具有评估和治疗肥胖的潜在临床用途，但需要更大的对照试验。
