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减重手术对营养和代谢参数的影响:抗抑郁药物的类型是否重要?

Effect of bariatric surgery on nutritional and metabolic parameters: does the type of antidepressant medication matter?

机构信息

Toronto General Hospital, University Health Network, Toronto, Canada.

Institute of Medical Science, University of Toronto, Toronto, Canada.

出版信息

Eat Weight Disord. 2024 Jul 25;29(1):48. doi: 10.1007/s40519-024-01680-6.

Abstract

PURPOSE

Depression is prevalent in patients undergoing bariatric surgery (BSx). Long-term use of antidepressant is associated with weight gain, particularly the use of selective serotonin reuptake inhibitors (SSRIs). Little is known about whether different types of antidepressants affect the response to BSx. The purpose of this study was to determine the relationship between SSRI use and nutritional and biochemical measurements in those with obesity pre-/post-BSx.

METHODS

This is a cross-sectional and prospective cohort study. Patients were enrolled pre-BSx and divided into 3 groups: SSRI, non-SSRI and no antidepressant. Nutritional, biochemical and pharmacological data were collected pre- and 6 months post-BSx.

RESULTS

Pre-BSx, 77 patients were enrolled: 89.6% female, median age 45 years and body mass index (BMI) of 45.3 kg/m. 14.3% were taking SSRIs and had a significantly higher BMI (52.1 kg/m) compared to 62.3% in no antidepressant (46.0 kg/m) and 23.4% in non-SSRI antidepressants (43.1 kg/m). At 6 months post-BSx (n = 58), the SSRI group still had significantly higher BMI in comparison to the other two groups. No other significant differences found between groups.

CONCLUSION

Despite higher BMI, patients taking SSRI and undergoing BSx had similar responses, based on nutritional and biochemical parameters, to those on non-SSRI or no antidepressants.

LEVEL OF EVIDENCE

Level III: Evidence obtained from well-designed cohort or case-control analytic studies.

摘要

目的

肥胖患者行减重手术(BSx)后常伴有抑郁。长期使用抗抑郁药与体重增加有关,尤其是选择性 5-羟色胺再摄取抑制剂(SSRIs)。对于不同类型的抗抑郁药是否会影响 BSx 的反应,知之甚少。本研究旨在确定 SSRI 使用与肥胖患者 BSx 前后营养和生化指标之间的关系。

方法

这是一项横断面前瞻性队列研究。患者在 BSx 前入组,并分为 3 组:SSRIs、非 SSRIs 和无抗抑郁药。收集 BSx 前和 6 个月后的营养、生化和药物数据。

结果

BSx 前共纳入 77 例患者:女性占 89.6%,中位年龄为 45 岁,体重指数(BMI)为 45.3kg/m2。14.3%的患者服用 SSRIs,其 BMI 明显高于无抗抑郁药组(62.3%,46.0kg/m2)和非 SSRIs 抗抑郁药组(23.4%,43.1kg/m2)。BSx 后 6 个月(n=58),SSRI 组的 BMI 仍明显高于其他两组。组间无其他显著差异。

结论

尽管 BMI 较高,但服用 SSRIs 并接受 BSx 的患者在营养和生化参数方面的反应与服用非 SSRIs 或无抗抑郁药的患者相似。

证据水平

III 级:来自精心设计的队列或病例对照分析研究的证据。

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本文引用的文献

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Management of Depression in Adults: A Review.成人抑郁症的管理:综述。
JAMA. 2024 Jul 9;332(2):141-152. doi: 10.1001/jama.2024.5756.
7
Depression and obesity: evidence of shared biological mechanisms.抑郁和肥胖:存在共同的生物学机制的证据。
Mol Psychiatry. 2019 Jan;24(1):18-33. doi: 10.1038/s41380-018-0017-5. Epub 2018 Feb 16.
8
Body Mass Index: Obesity, BMI, and Health: A Critical Review.体重指数:肥胖、BMI与健康:一项批判性综述。
Nutr Today. 2015 May;50(3):117-128. doi: 10.1097/NT.0000000000000092. Epub 2015 Apr 7.

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