Li Yan, Huang Li-Hua, Zhu Hui-Di, He Ping, Li Bei-Bei, Wen Li-Jing
Department of Gastrointestinal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
World J Gastrointest Surg. 2024 Jul 27;16(7):2242-2254. doi: 10.4240/wjgs.v16.i7.2242.
The high incidence and mortality of gastric cancer (GC) pose a significant threat to human life and health, and it has become an important public health challenge in China. Body weight loss is a common complication after surgical treatment in patients with GC and is associated with poor prognosis and GC recurrence. However, current attention to postoperative weight change in GC patients remains insufficient, and the descriptions of postoperative weight change and its influencing factors are also different.
To investigate body weight changes in patients with GC within 6 mo after gastrectomy and identify factors that influence dynamic body weight changes.
We conducted a prospective longitudinal study of 121 patients with GC and collected data before (T0) and 1 (T1), 3 (T2), and 6 (T3) mo after gastrectomy using a general data questionnaire, psychological distress thermometer, and body weight measurements. The general estimation equation (GEE) was used to analyze the dynamic trends of body weight changes and factors that influence body weight changes in patients with GC within 6 mo of gastrectomy.
The median weight loss at T1, T2, and T3 was 7.29% (2.84%, 9.40%), 11.11% (7.64%, 14.91%), and 14.75% (8.80%, 19.84%), respectively. The GEE results showed that preoperative body mass index (BMI), significant psychological distress, religious beliefs, and sex were risk factors for weight loss in patients with GC within 6 mo after gastrectomy ( < 0.05). Compared with preoperative low-weight patients, preoperative obese patients were more likely to have weight loss (β = 14.685, < 0.001). Furthermore, patients with significant psychological distress were more likely to lose weight than those without (β = 2.490, < 0.001), and religious patients were less likely to lose weight 6 mo after gastrectomy than those without religious beliefs (β = -6.844, = 0.001). Compared to female patients, male patients were more likely to experience weight loss 6 mo after gastrectomy (β = 4.262, = 0.038).
Male patients with GC with high preoperative BMI, significant psychological distress, and no religious beliefs are more likely to lose weight after gastrectomy.
胃癌（GC）的高发病率和死亡率对人类生命健康构成重大威胁，已成为中国一项重要的公共卫生挑战。体重减轻是GC患者手术治疗后的常见并发症，与预后不良和GC复发相关。然而，目前对GC患者术后体重变化的关注仍不足，对术后体重变化及其影响因素的描述也不尽相同。
调查GC患者胃切除术后6个月内的体重变化，并确定影响体重动态变化的因素。
我们对121例GC患者进行了一项前瞻性纵向研究，使用一般数据问卷、心理困扰温度计和体重测量方法，收集了胃切除术前（T0）以及术后1（T1）、3（T2）和6（T3）个月的数据。采用广义估计方程（GEE）分析胃切除术后6个月内GC患者体重变化的动态趋势以及影响体重变化的因素。
T1、T2和T3时的体重减轻中位数分别为7.29%（2.84%，9.40%）、11.11%（7.64%，14.91%）和14.75%（8.80%，19.84%）。GEE结果显示，术前体重指数（BMI）、明显的心理困扰、宗教信仰和性别是胃切除术后6个月内GC患者体重减轻的危险因素（P<0.05）。与术前体重低的患者相比，术前肥胖患者更易出现体重减轻（β = 14.685，P<0.001）。此外，有明显心理困扰的患者比没有的患者更易体重减轻（β = 2.490，P<0.001），有宗教信仰的患者胃切除术后6个月体重减轻的可能性低于无宗教信仰者（β = -6.844，P = 0.001）。与女性患者相比，男性患者胃切除术后6个月更易体重减轻（β = 4.262，P = 0.038）。
术前BMI高、有明显心理困扰且无宗教信仰的男性GC患者胃切除术后更易体重减轻。
