Eact Carolina Univ. Bariatric Surgery Clinical Center

卡罗莱纳大学

• 批准号: 6727832
• 负责人: WALTER Julius PORIES
• 金额: $ 26.8万
• 依托单位: EAST CAROLINA UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-30 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6727832
• 关键词: body composition; clinical research; comorbidity; cooperative study; data collection; ethics; exercise; gastrointestinal surgery; health economics; health science research; human morbidity; human subject; informed consent; insulin sensitivity /resistance; interdisciplinary collaboration; laparoscopy; metabolism; obesity; outcomes research; patient oriented research; patient safety /medical error; postoperative state; quality of life; racial /ethnic difference; stomach /intestine bypass

DESCRIPTION (provided by applicant): Obesity, the most prevalent, fatal, chronic disease of the 21st Century, is increasing at a rate seen before only with infectious diseases. Morbid obesity, the most severe form, afflicts 23 million Americans. These individuals are not only limited by their bulk but are sharply compromised by life-endangering co-morbidities. Surgery has proven to be an effective therapy. The Greenville gastric bypass operation (GGB), developed at this institution, produces not only durable weight loss greater than 100 Ibs but also induces full remission of type 2 diabetes in 83 percent of patients, control of hypertension in over half, as well as full reversal of such co-morbidities as asthma, Pickwickian syndrome, stress incontinence, and pseudotumor cerebri. The reproducible reversal of type 2 diabetes in GGB patients is a provocative finding and requires further basic research. However, the GGB, like other bariatric procedures, is associated with serious long-term nutritional deficiencies and, in vulnerable individuals, emotional disorders. Generally, there is no consensus about which of the seven common bariatric procedures should be used. There is also considerable variation in surgical outcomes across the US for the same operation due to a lack of standardization of the surgical care. Thus, bariatric surgery is ripe for a collaborative approach to answering both clinical and basic research issues. Our current center efforts include three major areas: 1. Fostering collaboration within the bariatric surgical community to promote clinical, behavioral, and basic research in morbid obesity and its co-morbidities; 2. Clinical studies of the efficacy, efficiency, and safety of two types of gastric bypass operations with an emphasis on differences in outcomes between African-American and Caucasian women. 3. Basic science studies of insulin action and sensitivity in human subjects prior to and after bariatric surgery. In addition, this application includes three proposals for inter-institutional projects: 1. Comparison of the most commonly performed bariatric operations; 2. the mechanism for increased insulin sensitivity after gastric bypass surgery; and 3. the ethics of the informed consent in bariatric surgery. Because East Carolina University has a productive tradition of interdisciplinary clinical, basic science, and behavioral research in morbid obesity as well as a record of national leadership, we submit this application to become one of the Bariatric Surgery Clinical Centers of the NIDDK.

描述（由申请人提供）： 肥胖症是21世纪最普遍、最致命的慢性疾病，它正以以前只有传染病才能看到的速度增长。病态肥胖是最严重的形式，困扰着2300万美国人。这些个体不仅受到其体积的限制，而且还受到危及生命的合并症的严重影响。手术已被证明是一种有效的治疗方法。格林维尔胃旁路手术（GGB），在这个机构开发，不仅产生持久的体重减轻超过100磅，但也诱导完全缓解2型糖尿病患者的83%，控制高血压超过一半，以及完全逆转等共病哮喘，匹克威克综合征，压力性尿失禁，和假性脑瘤。GGB患者2型糖尿病的可重复逆转是一个具有挑战性的发现，需要进一步的基础研究。 然而，GGB，像其他减肥手术一样，与严重的长期营养缺乏有关，在脆弱的个体中，与情绪障碍有关。一般来说，对于应该使用七种常见减肥方法中的哪一种没有共识。由于缺乏标准化的手术护理，同一手术在美国各地的手术结局也存在相当大的差异。因此，减肥手术是成熟的合作方法来回答临床和基础研究问题。 我们目前的中心工作包括三个主要领域：1。促进减肥外科社区内的合作，以促进病态肥胖及其并发症的临床，行为和基础研究; 2。两种胃旁路手术的疗效、效率和安全性的临床研究，重点是非裔美国人和白人女性之间的结局差异。3.减肥手术前后胰岛素作用和敏感性的基础科学研究。此外，本申请还包括三个机构间项目提案：1.比较最常见的减肥手术; 2。胃旁路手术后胰岛素敏感性增加的机制; 3.减肥手术中知情同意的伦理学。由于东卡罗莱纳大学在病态肥胖症的跨学科临床，基础科学和行为研究方面有着丰富的传统，以及国家领导的记录，我们提交了此申请，成为NIDDK的减肥手术临床中心之一。