代谢性减重手术的长期全身影响:多学科视角
Long-term systemic effects of metabolic bariatric surgery: A multidisciplinary perspective.
作者信息
Rajabi Mohammad Reza, Rezaei Masoud, Abdollahi Arash, Gholi Zahra, Mokhber Somayeh, Mohammadi-Farsani Gholamreza, Abdoli Danial, Mousavi Seyed Davood, Amini Helen, Ghandchi Maryam
机构信息
Department of Cardiology, School of Medicine, Shahed University, Tehran, Iran.
Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
出版信息
Heliyon. 2024 Jul 11;10(14):e34339. doi: 10.1016/j.heliyon.2024.e34339. eCollection 2024 Jul 30.
BACKGROUND
Obesity is a global health crisis with profound implications on various body systems, contributing to a series of comorbidities. Metabolic Bariatric Surgery (MBS) has emerged as an effective treatment option for severe obesity, with significant weight reduction and potential systemic physiological alterations.
OBJECTIVES
This narrative review aims to provide a comprehensive analysis of the long-term effects of MBS on a wide array of body systems, including the heart, liver, kidneys, reproductive system, skin, lungs, digestive tract, pancreas, and blood, as well as related cancers of these organs.
METHODS
A systematic search was conducted in academic databases (PubMed, ISI Web of Science, and Scopus) for observational studies and reviews published between July 2000 and December 2023, investigating the association between MBS and the subsequent function of different organ systems. High-quality studies were prioritized to ensure reliable evidence synthesis.
RESULTS
MBS has demonstrated favorable outcomes in reducing cardiovascular disease risk, improving cardiac function, and alleviating heart failure symptoms. It has also been associated with improved respiratory function, remission of obstructive sleep apnea, and reduced cancer incidence and mortality. Additionally, MBS has shown benefits in managing gastrointestinal disorders, enhancing glycemic control, and promoting pancreatic beta-cell regeneration in type 2 diabetes mellitus. However, some methods of MBS are associated with a higher risk of cholelithiasis, GERD, and pancreatic exocrine insufficiency.
CONCLUSION
MBS has far-reaching systemic effects beyond weight loss, offering potential long-term benefits for various organ systems and comorbidities associated with obesity. For many patients with severe obesity, the potential benefits of Metabolic and Bariatric Surgery (MBS) can outweigh the associated risks. However, careful evaluation by a qualified healthcare professional is crucial to determine candidacy and ensure a successful outcome. Further research is needed to fully elucidate the long-term impacts and tailor personalized treatment approaches.
背景
肥胖是一场全球性的健康危机,对身体各个系统有着深远影响,会引发一系列合并症。代谢性减重手术(MBS)已成为治疗重度肥胖的一种有效选择,能显著减轻体重,并引发潜在的全身生理变化。
目的
本叙述性综述旨在全面分析MBS对一系列身体系统的长期影响,这些系统包括心脏、肝脏、肾脏、生殖系统、皮肤、肺、消化道、胰腺和血液,以及这些器官的相关癌症。
方法
在学术数据库(PubMed、ISI科学网和Scopus)中进行系统检索,查找2000年7月至2023年12月期间发表的观察性研究和综述,这些研究调查了MBS与不同器官系统后续功能之间的关联。优先选择高质量研究以确保可靠的证据综合。
结果
MBS在降低心血管疾病风险、改善心脏功能和缓解心力衰竭症状方面已显示出良好效果。它还与呼吸功能改善、阻塞性睡眠呼吸暂停缓解以及癌症发病率和死亡率降低有关。此外,MBS在管理胃肠道疾病、加强血糖控制以及促进2型糖尿病患者胰腺β细胞再生方面也显示出益处。然而,某些MBS方法与胆结石、胃食管反流病和胰腺外分泌功能不全的较高风险相关。
结论
MBS除了减重之外还具有深远的全身影响,为与肥胖相关的各种器官系统和合并症带来潜在的长期益处。对于许多重度肥胖患者而言,代谢性减重手术(MBS)的潜在益处可能超过相关风险。然而,由合格的医疗保健专业人员进行仔细评估对于确定是否适合手术以及确保手术成功至关重要。需要进一步研究以充分阐明长期影响并制定个性化治疗方案。