Bariatric surgery and reduction in morbidity and mortality: experiences from the SOS study
Bariatric surgery and reduction in morbidity and mortality: experiences from the SOS study
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DOI：
10.1038/ijo.2008.244
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发表时间：
2008-12-01
影响因子：
4.9
通讯作者：
Sjostrom, L.
中科院分区：
文献类型：
--
作者：
Sjostrom, L.
肥胖与发病率和死亡率增加有关。有意识的减肥可以改善心血管危险因素，但大多数观察性研究表明，减肥与总体死亡率和心血管死亡率增加有关。此前没有关于肥胖受试者死亡率的前瞻性干预研究报告。前瞻性对照瑞典肥胖受试者研究招募了接受减肥手术（n = 2010）或被分配到同期匹配的常规治疗肥胖对照组（n = 2037）的肥胖受试者。本综述总结了平均10年内对发病率和死亡率的影响。在长达15年的体重记录期间，对照组的平均体重变化小于+/- 2%。手术亚组的最大体重减轻在1-2年后观察到。10年后，体重较基线分别稳定在25%、16%和14%。减肥手术改善了所有传统的心血管风险状态，除了高胆固醇血症超过10年。对照组有129人死亡，而手术组有101人死亡。手术组（相对于对照组）未校正的总死亡率降低了23.7%（P = 0.0419），而性别、年龄和危险因素校正的死亡率降低了30.7%（P = 0.0102）。最常见的死亡原因是心肌梗死（对照组n = 25，手术组n = 13）和癌症（47/29）。严重肥胖症的减肥手术与长期体重减轻，改善风险因素和降低总体死亡率有关。
Obesity is associated with increased morbidity and mortality. Intentional weight loss results in improvement of cardiovascular risk factors, but most observational studies suggest that weight reduction is associated with increased overall and cardiovascular mortality. No prospective intervention studies on mortality have earlier been reported in obese subjects. The prospective, controlled Swedish Obese Subjects Study enrolled obese subjects who either underwent bariatric surgery (n = 2010) or were allocated to a contemporaneously matched, conventionally treated obese control group (n = 2037). This review sums up effects on morbidity and mortality over an average of 10 years. The mean weight change of the control group was less than +/- 2% over up to 15 years of weight recording. Maximum weight losses in the surgical subgroups were observed after 1-2 years. After 10 years, the weight losses from baseline were stabilized at 25, 16 and 14%, respectively. Bariatric surgery improved all traditional cardiovascular risk states except hypercholesterolemia over 10 years. There were 129 deaths in the control group compared with 101 in the surgery group. The unadjusted overall mortality was reduced by 23.7% (P = 0.0419) in the surgery group (relative to controls), whereas the gender-, age- and risk factor-adjusted mortality reduction was 30.7% (P = 0.0102). The most common causes of death were myocardial infarction (controls n = 25, surgery n = 13) and cancer (47/29). Bariatric surgery for severe obesity is associated with long-term weight loss, improved risk factors and decreased overall mortality.