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减肥手术后倾倒综合征和低血糖症状的患病率:一项基于问卷调查的横断面研究。

Prevalence of dumping and hypoglycaemia symptoms after bariatric surgery: A questionnaire-based cross-sectional study.

作者信息

Jans Anders, Rask Eva, Ottosson Johan, Szabo Eva, Stenberg Erik

机构信息

Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.

University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.

出版信息

Clin Obes. 2025 Feb;15(1):e12709. doi: 10.1111/cob.12709. Epub 2024 Oct 11.

Abstract

Dumping and post-bariatric hypoglycaemia (PBH) are side effects that occur after bariatric surgery. The aim of this study was to estimate the prevalence of dumping and PBH symptoms before Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) at 6 months, 1 year, 2 years and 5 years after surgery in a Swedish population. A cross-sectional single-centre study was performed at Lindesberg Hospital, Region Örebro County, Sweden, between 2020 and 2023. The Swedish version of the Dumping Severity Scale (DSS-Swe) questionnaire, which includes eight items regarding dumping symptoms and six items regarding hypoglycaemia symptoms, was used. A total of 742 DSS-Swe questionnaires were included. The average age at surgery was 42.0 years (standard deviation [SD] = 11.9), and the average body mass index was 41.8 kg/m (SD = 5.9). The surgical methods consisted of RYGB (66.3%) and SG (33.7%). The proportion of RYGB patients with highly suspected dumping increased from 4.9% before surgery to 26.3% (adjusted odds ratio [OR] = 7.35, 95% confidence interval [CI] = 3.08-17.52) at the 5-year follow-up. PBH symptoms increased from 1.4% before surgery to 19.3% at the 5-year follow-up (adjusted OR = 17.88, 95% CI = 4.07-78.54). For SG patients, no significant increase in dumping or PBH symptoms was observed. In patients with persistent type 2 diabetes (T2D), there were no cases of highly suspected hypoglycaemia following RYGB or SG. Symptoms of dumping and PBH were common after RYGB, while no clear increase was observed after SG. Persistent T2D seems to be a protective factor against PBH symptoms.

摘要

倾倒综合征和减重术后低血糖症(PBH)是减重手术后出现的副作用。本研究的目的是估计瑞典人群在接受Roux-en-Y胃旁路术(RYGB)和袖状胃切除术(SG)后6个月、1年、2年和5年时倾倒综合征和PBH症状的发生率。2020年至2023年期间,在瑞典厄勒布鲁郡林德斯贝里医院进行了一项横断面单中心研究。使用了瑞典版的倾倒严重程度量表(DSS-Swe)问卷,该问卷包括8项关于倾倒症状的条目和6项关于低血糖症状的条目。共纳入742份DSS-Swe问卷。手术时的平均年龄为42.0岁(标准差[SD]=11.9),平均体重指数为41.8kg/m²(SD=5.9)。手术方法包括RYGB(66.3%)和SG(33.7%)。在5年随访时,高度疑似倾倒的RYGB患者比例从术前的4.9%增加到26.3%(调整优势比[OR]=7.35,95%置信区间[CI]=3.08-17.52)。PBH症状从术前的1.4%增加到5年随访时的19.3%(调整OR=17.88,95%CI=4.07-78.54)。对于SG患者,未观察到倾倒或PBH症状有显著增加。在持续性2型糖尿病(T2D)患者中,RYGB或SG术后未出现高度疑似低血糖的病例。RYGB术后倾倒和PBH症状常见,而SG术后未观察到明显增加。持续性T2D似乎是预防PBH症状的保护因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8288/11706738/e6594a9c7945/COB-15-e12709-g001.jpg

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