Effect of bariatric surgery on the metabolic syndrome: a population-based, long-term controlled study.

Effect of bariatric surgery on the metabolic syndrome: a population-based, long-term controlled study.
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DOI:
10.4065/83.8.897
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发表时间:
2008-08
影响因子:
8.9
通讯作者:
Lopez-Jimenez F
Lopez-Jimenez F
中科院分区:
医学2区
文献类型:
--
作者:
Batsis JA;Romero-Corral A;Collazo-Clavell ML;Sarr MG;Somers VK;Lopez-Jimenez F

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评估减肥手术减肥对代谢综合征(MetS)患病率的影响,并检查MetS消退的预测因素。我们在1990年1月1日至2003年12月31日期间对接受AHA/NHLBI定义的MetS(甘油三酯升高、高密度脂蛋白降低、血压升高、空腹血糖升高和肥胖指标)减肥手术的患者进行了一项基于人群的回顾性研究。有180例Roux-en-Y胃旁路术患者和157例非手术患者在减肥计划中进行了评估。我们确定了代谢综合征患病率的变化,并使用逻辑回归模型来确定代谢综合征消退的预测因素。平均随访时间为3.4年。手术组的所有MetS成分均得到改善,药物使用量减少。非手术患者的高密度脂蛋白有所改善。在180例手术患者中,MetS患病率从156例(87%)降至53例(29%),非手术组从133例(85%)降至117例(75%)。在随访时发生代谢综合征的减肥手术患者的相对风险降低0.59(95%CI 0.48-0.67; p<0.001)]。需要手术治疗以解决1例MetS病例的数量为2.1。在排除糖尿病或心血管疾病患者或使用非BMI MetS诊断标准后,结果相似。代谢综合征消退的重要预测因素包括超重减轻5%(OR 1.26; 95%CI 1.19-1.34;p<0.001)和糖尿病(OR 0.32; 95%CI 0.15-0.68;p=0.003)。Roux-en-Y胃旁路术诱导MetS患病率的显著和持续改善。我们的研究结果表明,MetS的可逆性更多地取决于多余的重量损失的量比其他参数。
To assess the effect of weight loss by bariatric surgery on metabolic syndrome (MetS) prevalence and to examine predictors of MetS resolution. We performed a population-based, retrospective study between January 1st,1990 and December 31st,2003 of patients evaluated for bariatric surgery with AHA/NHLBI-defined MetS (increased triglycerides, low high density lipoprotein, increased blood pressure, increased fasting glucose, and a measure of obesity). There were 180 Roux-en-Y gastric bypass patients and 157 non-operative patients assessed in a weight-reduction program. We determined the change in MetS prevalence and used logistic regression models to determine predictors of MetS resolution. Mean follow-up was 3.4 years. All MetS components improved in the surgical group and medication use decreased. Non-operative patients had improvements in high density lipoprotein. Of the 180 surgical patients, MetS prevalence decreased from 156 patients (87%) to 53 (29%), and from 133 patients (85%) to 117 (75%) in the non-operative group. There was a relative risk reduction of 0.59 (95% CI 0.48-0.67; p<0.001)] with bariatric surgery patients having MetS at follow-up. The number needed to treat with surgery to resolve one case of MetS was 2.1. Results were similar after excluding patients with diabetes or cardiovascular disease or after using non-BMI diagnostic criteria for MetS. Significant predictors of MetS resolution included a 5% loss in excess weight (OR 1.26; 95%CI 1.19-1.34;p<0.001) and diabetes (OR 0.32; 95%CI 0.15-0.68;p=0.003). Roux-en-Y gastric bypass induces considerable and persistent improvement in MetS prevalence. Our results suggest that reversibility of MetS depends more on the amount of excess weight lost than on other parameters.
DOI: 10.1097/01.sla.0000137343.63376.19
发表时间: 2004-09-01
期刊: ANNALS OF SURGERY
影响因子: 9
作者:
Christou, NV;Sampalis, JS;MacLean, LD
通讯作者: MacLean, LD
DOI: 10.1097/01.sla.0000179652.07502.3f
发表时间: 2005-10-01
期刊: ANNALS OF SURGERY
影响因子: 9
作者:
Mattar, SG;Velcu, LM;Schauer, PR
通讯作者: Schauer, PR
DOI: 10.2337/diacare.28.5.1195
发表时间: 2005-05-01
期刊: DIABETES CARE
影响因子: 16.2
作者:
Ekelund, U;Brage, S;Wareham, NJ
通讯作者: Wareham, NJ
DOI: 10.1056/nejmoa035622
发表时间: 2004-12-23
影响因子: 158.5
作者:
Sjöström, L;Lindroos, AK;Wedel, H
通讯作者: Wedel, H
DOI: 10.1381/096089206779319347
发表时间: 2006-12-01
期刊: OBESITY SURGERY
影响因子: 2.9
作者:
Carey, Daniel Gene;Pliego, German J.;Raymond, Robert L.
通讯作者: Raymond, Robert L.