Bariatric surgery and the risk of alcohol-related cirrhosis and alcohol misuse.
Bariatric surgery and the risk of alcohol-related cirrhosis and alcohol misuse.
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DOI：
10.1111/liv.14805
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发表时间：
2021-05
期刊：
影响因子：
--
通讯作者：
Lok ASF
中科院分区：
文献类型：
--
作者：
Mellinger JL;Shedden K;Winder GS;Fernandez AC;Lee BP;Waljee J;Fontana R;Volk ML;Blow FC;Lok ASF
减肥手术很常见，但据报道，手术后出现了酒精滥用。我们的目的是确定减肥手术是否与酒精相关性肝硬化（AC）和酒精滥用的风险增加有关。2008-2016年肥胖成人雇主赞助保险行政索赔回顾性观察分析纳入有减肥手术诊断代码的受试者。主要结局为AC风险，次要结局为酒精滥用风险。减肥手术分为2008年之前和2008年之后，以说明在研究期间接受手术的患者。以年龄为时间变量的Cox比例风险回归模型与减肥手术和性别的相互作用分析相结合。“从2008年到2016年，有194130人接受了手术，而在2008年之前，有209090人接受了减肥手术。年龄44.1岁，61%为女性，入组年龄3.7岁。4,774人（0.07%）有AC。在研究期间，接受袖式胃切除术和腹腔镜捆扎术的患者发生AC的总体风险较低（HR 0.4, p<0.001; HR 0.43, p=0.02），而Roux-en-Y和袖式胃切除术的患者酒精滥用增加（HR 1.86和1.35,p<0.001）。在2008年之前接受过手术的女性中，与未接受减肥手术的女性相比，AC和酒精滥用的风险增加(HR 2.1 (95% CI: 1.79-2.41)；Hr 1.98 (95% ci 1.93-2.04))。减肥手术与女性AC的短期风险降低有关，但长期可能增加AC的风险。术后酒精监测是降低这种风险的必要措施。减肥手术对肥胖治疗是有效的，但已被证明会导致术后酒精滥用的增加，这可能会增加酒精相关肝病的风险。我们在一组有私人保险的患者中检查了酒精相关肝硬化和酒精滥用的风险，发现减肥手术后酒精相关肝硬化的短期风险降低了，但酒精滥用的风险增加了。从长期来看，我们发现酒精相关肝硬化的风险增加了，尤其是在女性中。
Bariatric surgery is common, but alcohol misuse has been reported following these procedures. We aimed to determine if bariatric surgery is associated with increased risk of alcohol-related cirrhosis (AC) and alcohol misuse. Retrospective observational analysis of obese adults with employer-sponsored insurance administrative claims from 2008–2016. Subjects with diagnosis codes for bariatric surgery were included. Primary outcome was risk of AC. Secondary outcome was risk of alcohol misuse. Bariatric surgery was divided into before 2008 and after 2008 to account for patients who had a procedure during the study period. Cox proportional hazard regression models using age as the time variable were used with interaction analyses for bariatric surgery and gender. “194,130 had surgery from 2008–2016 while 209,090 patients had bariatric surgery prior to 2008. Age was 44.1 years, 61% women, and enrollment was 3.7 years. 4,774 (0.07%) had AC. Overall risk of AC was lower for those who received sleeve gastrectomy and laparoscopic banding during the study period (HR 0.4, p<0.001; HR 0.43, p=0.02) and alcohol misuse increased for Roux-en-Y and sleeve gastrectomy recipients (HR 1.86 and 1.35, p<0.001, respectively). In those who had surgery before 2008, women had increased risk of AC and alcohol misuse compared to women without bariatric surgery (HR 2.1 (95% CI: 1.79–2.41) for AC; HR 1.98 (95% CI 1.93–2.04)).” Bariatric surgery is associated with a short-term decreased risk of AC but potential long-term increased risk of AC in women. Post-operative alcohol surveillance is necessary to reduce this risk. Weight loss surgery is effective for obesity treatment but has been shown to result in increased alcohol misuse post-operatively which could increase the risk of alcohol-related liver disease. We examined the risk of alcohol-related cirrhosis and alcohol misuse in a cohort of patients with private insurance and found that the short-term risk of alcohol-related cirrhosis after bariatric surgery was reduced, but the risk of alcohol misuse was increased. In the long-term, we found that the risk of alcohol-related cirrhosis was increased, especially in women.
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影响因子：
3.1
作者：
Acevedo, Maria Belen;Teran-Garcia, Margarita;Pepino, Marta Yanina
通讯作者：
Pepino, Marta Yanina
影响因子：
6.6
作者：
Horie, Yoshinori;Yamagishi, Yoshiyuki;Hibi, Toshifumi
通讯作者：
Hibi, Toshifumi
影响因子：
25.8
作者：
Grant, Bridget F.;Chou, S. Patricia;Hasin, Deborah S.
通讯作者：
Hasin, Deborah S.
影响因子：
--
作者：
Barry, Lisa C.;Allore, Heather G.;Gill, Thomas M.
通讯作者：
Gill, Thomas M.
影响因子：
13.5
作者：
Mellinger, Jessica L.;Shedden, Kerby;Lok, Anna S. F.
通讯作者：
Lok, Anna S. F.