Prevalence of alcohol use disorders before and after bariatric surgery.
Prevalence of alcohol use disorders before and after bariatric surgery.
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DOI：
10.1001/jama.2012.6147
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发表时间：
2012-06-20
影响因子：
120.7
通讯作者：
Yanovski, Susan Z.
中科院分区：
文献类型：
--
作者：
King, Wendy C.;Chen, Jia-Yuh;Mitchell, James E.;Kalarchian, Melissa A.;Steffen, Kristine J.;Engel, Scott G.;Courcoulas, Anita P.;Pories, Walter J.;Yanovski, Susan Z.
坊间报道表明，减肥手术可能会增加酒精使用障碍(AUD)的风险，但缺乏前瞻性数据。确定手术前后AUD的患病率，以及术后AUD的独立预测因素。减肥手术纵向评估-2是一项前瞻性队列研究，研究对象是在美国10家医院接受减肥手术的成年人。在2458名参与者中，有1945名(78.8%女性，87.0%白人，中位年龄=47岁，中位体重指数=45.8公斤/平方米)在2006-2011年间完成了术前和术后(1年和/或2年)的评估。过去一年通过酒精使用障碍识别测试(酒精相关伤害、酒精依赖症状或≥8分)确定的酒精使用障碍症状。AUD的患病率与术后1年的患病率没有显著差异(7.6%对7.3%；p=.98)，但在术后2年显著升高(9.6%；p<；.01)。男性(调整后的优势比[OR]，2.1；95%可信区间[CI]，1.5-3.0；P<；.0001)，较年轻(OR，1.3；CI，1.03-1.7，每10岁未接受手术前AUD；OR，2.0；CI，1.7-2.3每10岁未手术前；P<；0.0001)，吸烟(OR，2.6；CI，1.2-5.6；P=.02)、经常饮酒(OR，6.4；CI，4.2-9.7；P<；.0001)、AUD(例如，OR，11.1；CI，7.7-16.1；P<；.0001)、娱乐用药(OR，2.4；CI，1.4-4.1；P<；.01)和较低的“归属感”人际支持(OR，1.1；CI，1.04-1.2；P<；P<；.01)术前和接受Roux-en-Y胃分流术(OR，2.1；CI，1.4-3.1；p<；.001；Reference=可调节胃带)与术后AUD的风险增加独立相关。在该队列中，AUD的患病率在术后第二年高于术前或术后第一年，并与术前AUD、经常饮酒和接受Roux-en-Y胃分流术有关。
Anecdotal reports suggest bariatric surgery may increase the risk of alcohol use disorders (AUD), but prospective data are lacking. Determine the prevalence of pre- and postoperative AUD, and independent predictors of postoperative AUD. Longitudinal Assessment of Bariatric Surgery-2 is a prospective cohort study of adults who underwent bariatric surgery at 10 U.S. hospitals. Of 2458 participants, 1945 (78.8% female, 87.0% white, median age=47 years, median body mass index=45.8 kg/m2) completed pre- and postoperative (1 and/or 2 years) assessments between 2006–2011. Past year AUD symptoms determined with the Alcohol Use Disorders Identification Test (indication of ‘alcohol-related harm,’ ‘alcohol dependence symptoms,’ or score ≥8). The prevalence of AUD did not significantly differ from pre- to 1 year postoperative (7.6% vs. 7.3%; p=.98), but was significantly higher at 2 years (9.6%; p<.01). Male sex (adjusted odds ratio [OR], 2.1; 95% confidence interval [CI], 1.5–3.0; p<.0001), younger age (OR, 1.3; CI, 1.03–1.7 per 10 years younger with pre-op AUD; p=.03; OR, 2.0; CI, 1.7–2.3 per 10 years younger without pre-op AUD; p<.0001), smoking (OR, 2.6; CI, 1.2–5.6; p=.02), regular alcohol consumption (OR, 6.4; CI, 4.2–9.7; p<.0001), AUD (e.g., OR, 11.1; CI, 7.7–16.1 at age 45; p<.0001), recreational drug use (OR, 2.4; CI, 1.4–4.1; p<.01) and lower ‘belonging’ interpersonal support (OR, 1.1; CI, 1.04–1.2; p<.01) preoperatively, and undergoing a Roux-en-Y gastric bypass (OR, 2.1; CI, 1.4–3.1; p<.001; reference=adjustable gastric band) were independently related to an increased odds of AUD postoperatively. In this cohort, the prevalence of AUD was greater in the second postoperative year than preoperatively or in the first postoperative year, and was associated with preoperative AUD and regular alcohol consumption, and undergoing Roux-en-Y gastric bypass.
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120.7
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