Nationwide cohort study of post-gastric bypass hypoglycaemia including 5,040 patients undergoing surgery for obesity in 1986-2006 in Sweden
Nationwide cohort study of post-gastric bypass hypoglycaemia including 5,040 patients undergoing surgery for obesity in 1986-2006 in Sweden
复制标题
DOI：
10.1007/s00125-010-1798-5
复制
发表时间：
2010-11-01
期刊：
影响因子：
8.2
通讯作者：
Naslund, E.
中科院分区：
文献类型：
--
作者：
Marsk, R.;Jonas, E.;Naslund, E.
症状性低血糖伴意识模糊、晕厥、癫痫或癫痫发作是胃旁路手术治疗肥胖症的新发现的并发症。这些情况的发生率尚不清楚。因此，我们研究了胃旁路术后低血糖和相关症状的发生率，在接受胃旁路手术的患者和瑞典普通人群的参考队列中进行了研究。这是一项全国性队列研究，基于国家登记处，有5，040名接受胃旁路手术的患者，1986年1月1日至2006年12月31日期间，在瑞典进行的垂直带状胃成形术或胃束带术治疗肥胖症，并从一般人群中随机抽取10例性别和年龄匹配的患者作为对照。人口对手术前后或纳入参考队列的患者因低血糖、意识模糊、晕厥、癫痫或癫痫发作而住院的发生率进行了研究。手术队列和参考队列术前因低血糖住院的发生率相似。胃旁路手术后，低血糖（2.7 [95% CI 1.2-6.3]）、意识模糊（2.8 [1.3-6.0]）、晕厥（4.9 [3.4-7.0]）、癫痫（3.0 [2.1-4.3]）和癫痫发作（7.3 [5.0-10.8]）的校正风险比显著升高。受低血糖影响的胃旁路术患者和参考参与者的比例非常低（分别为0.2%和0.04%）。与参考人群相比，垂直带状胃成形术或胃束带术后低血糖的风险没有增加。接受胃旁路术的肥胖患者因胃旁路术后低血糖相关诊断而住院的风险增加，尽管很少有患者受到影响。
Symptomatic hypoglycaemia with related confusion, syncope, epilepsy or seizures is a newly recognised complication of gastric bypass surgery for obesity. The incidence of these conditions is not known. We therefore studied the incidence of post-gastric bypass hypoglycaemia and related symptoms in patients who have undergone gastric bypass and a reference cohort from the general population of Sweden.This is a nationwide cohort study based on national registries with 5,040 persons who underwent gastric bypass, vertical banded gastroplasty or gastric banding for obesity in Sweden between 1 January 1986 and 31 December 2006 and a cohort of ten referents per patient matched for sex and age randomly sampled from the general population. The incidence rates of hospitalisation for hypoglycaemia, confusion, syncope, epilepsy or seizures before and after dates of surgery or inclusion in the reference cohort were studied.Preoperative incidences of hospitalisation for hypoglycaemia were similar in the surgical and referent cohorts. After gastric bypass surgery, the adjusted hazard ratios were significantly elevated for hypoglycaemia (2.7 [95% CI 1.2-6.3]), confusion (2.8 [1.3-6.0]), syncope (4.9 [3.4-7.0]), epilepsy (3.0 [2.1-4.3]) and seizures (7.3 [5.0-10.8]). The proportions of gastric bypass patients and reference participants affected by hypoglycaemia were very low (0.2% and 0.04%, respectively). There was no increased risk of hypoglycaemia after vertical banded gastroplasty or gastric banding compared with the referent population.Obese persons who have undergone gastric bypass have an increased risk of hospitalisation for diagnoses associated with post-gastric bypass hypoglycaemia, although few patients are affected.