Effects of Heterozygous Variants in the Leptin-Melanocortin Pathway on Transoral Outlet Reduction After Roux-en-Y Gastric Bypass: A Case-Control Study and Review of Literature.
Effects of Heterozygous Variants in the Leptin-Melanocortin Pathway on Transoral Outlet Reduction After Roux-en-Y Gastric Bypass: A Case-Control Study and Review of Literature.
复制标题
瘦素-黑皮质素途径杂合变异体对 Roux-en-Y 胃绕道手术后经口出口减少的影响：病例对照研究和文献综述。
DOI：
10.1007/s11695-023-06462-0
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发表时间：
2023
期刊：
影响因子：
2.9
通讯作者：
Acosta,Andres
中科院分区：
文献类型：
--
作者：
Gala,Khushboo;Ghusn,Wissam;Fansa,Sima;AbuDayyeh,BarhamK;Ghanem,OmarM;Kellogg,Todd;Acosta,Andres
研究背景经口出口减容术（transoral outlet reduction，TORe）是一种安全有效的控制Roux-en-Y胃旁路术（Roux-en-Y Gastric Bypass，RYGB）后体重恢复的方法。瘦素黑皮质素途径（LMP）中杂合子变体的携带者在RYGB后的中期和长期内具有高WR风险。我们的病例系列包括4例杂合子LMP变异，并提出了新的数据，他们的体重减轻后TORe.MethodsWe进行了一项回顾性研究的马约诊所生物库和确定成人参与者谁已被基因分型，并发现有或没有杂合子变异的LMP（“载体”与“非载体”，分别），并经历了TORe程序。根据TORe手术时的基线体重计算第1、3、6、9和12个月± 15天的TBWL%。四名患者（平均年龄51.0 [5.2]岁，100%女性，体重指数[BMI] 40.5 [8.7] kg/m2），LMP变异体和10例非携带者（年龄55.4 [15.3]岁，90%为女性，BMI 37.3 [7.7] kg/m2）。在TORe手术时，携带者和非携带者之间没有基线差异。在TORE之后，与非携带者相比，携带者在3、6、9和12个月时体重减轻较少。在12个月的差异有统计学意义（1.6比12.3%;p= 0.03）。结论LMP变异和接受RYGB的患者在接受TORe后体重减轻。需要进一步和更大规模的研究来了解TORe对LMP变异患者的影响。
BackgroundTransoral outlet reduction (TORe) is a safe and effective technique for management of weight regain (WR) after Roux-en-Y Gastric Bypass (RYGB). Carriers of a heterozygous variant in the leptin melanocortin pathway (LMP) have been shown to be at high risk for WR in the mid- and long-term after RYGB. Our case series includes four patients with heterozygous LMP variants and presents novel data on their weight loss after TORe.MethodsWe performed a retrospective study of the Mayo Clinic Biobank and identified adult participants who had been genotyped and found to have or do not have a heterozygous variant in the LMP (“carriers” vs “non-carriers”, respectively) and had undergone a TORe procedure. TBWL% at 1, 3, 6, 9, and 12 months ± 15 days were calculated based on baseline weight at TORe procedure.ResultsA total of 14 patients were included in the analysis: four patients (mean age 51.0 [5.2] years, 100% females, body mass index [BMI] 40.5 [8.7] kg/m2) with LMP variant and 10 non-carriers (age 55.4 [15.3] years, 90% females, BMI 37.3 [7.7] kg/m2). There were no baseline differences between carriers and non-carriers at time of TORe procedure. After TORE, carriers lost less weight when compared to non-carriers at 3, 6, 9, and 12 months. The difference at 12 months was statistically significant (1.6 vs 12.3%;p= 0.03).ConclusionsPatients with a LMP variant and that underwent RYGB showed decreased weight loss after undergoing TORe. Further and larger studies are needed to comprehend the effect of TORe on patients with LMP variants.