Effects of Heterozygous Variants in the Leptin-Melanocortin Pathway on Roux-en-Y Gastric Bypass Outcomes: a 15-Year Case-Control Study.
Effects of Heterozygous Variants in the Leptin-Melanocortin Pathway on Roux-en-Y Gastric Bypass Outcomes: a 15-Year Case-Control Study.
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DOI：
10.1007/s11695-022-06122-9
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发表时间：
2022-08
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：
Campos, Alejandro;Cifuentes, Lizeth;Hashem, Anas;Busebee, Bradley;Hurtado-Andrade, Maria D.;Ricardo-Silgado, Maria L.;McRae, Alison;de la Rosa, Alan;Feris, Fauzi;Bublitz, Joshua T.;Hensrud, Donald;Camilleri, Michael;Kellogg, Todd A.;Eckel-Passow, Jeanette E.;Olson, Janet;Acosta, Andres
瘦素-黑皮质素途径中的杂合变体与肥胖相关。然而，它们对Roux-en-Y胃旁路术（RYGB）后的长期结局的影响仍然未知。在这项配对病例对照研究中，对来自马约诊所生物库的701名有RYGB病史的参与者进行了基因分型。63例患者在瘦素-黑皮质素通路中存在杂合变异。在排除潜在混杂因素后，携带者与两名非携带者对照随机匹配（性别、年龄、体重指数（BMI）和手术后年数）。携带者和匹配的非携带者的电子病历在RYGB后长达15年进行了审查。共有50名携带者和100名匹配的有RYGB病史的非携带者被纳入研究。在瘦素-黑皮质素途径中鉴定了7个不同的基因（LEPR、PCSK 1、POMC、SH 2B 1、SRC 1、MC 4 R和SIM 1）。手术时，平均年龄为50.8±10.6岁，BMI为45.6±7.3 kg/m2，79%为女性。两组之间的术后随访年数、Roux肢体长度或胃袋大小无差异。RYGB后15年，携带者的TBWL %为−16.6±10.7，而非携带者为−28.7±12.9（diff= 12.1%，95%CI，4.8至19.3），最大体重减轻后的体重恢复率在携带者中为52.7±29.7%，而在非携带者中为29.8±20.7%。（diff= 22.9%，95% CI，5.3至40.5）。携带者的最低值%TBWL为−32.1±8.1%，而非携带者为−36.8±10.4（diff= 4.8%，95% CI 1.8 - 7.8）。瘦素-黑皮质素途径中杂合子变体的携带者在RYGB后的中长期内具有进行性和显著的体重恢复。对RYGB后体重明显恢复的患者进行基因分型可以帮助实施多学科和个性化的减肥干预措施，以改善手术后的体重维持。
Heterozygous variants in the leptin-melanocortin pathway are associated with obesity. However, their effect on the long-term outcomes after Roux-en-Y gastric bypass (RYGB) is still unknown. In this matched case-control study, 701 participants from the Mayo Clinic Biobank with a history of RYGB were genotyped. Sixty-three patients had a heterozygous variant in the leptin-melanocortin pathway. After excluding patients with potential confounders, carriers were randomly matched (on sex, age, body-mass index [BMI], and years since surgery) with two non-carrier controls. The electronic medical record of carriers and matched non-carriers was reviewed for up to 15 years after RYGB. A total of 50 carriers and 100 matched non-carriers with a history of RYGB were included in the study. Seven different genes (LEPR, PCSK1, POMC, SH2B1, SRC1, MC4R, and SIM1) in the leptin-melanocortin pathway were identified. At the time of surgery, the mean age was 50.8±10.6 years, BMI 45.6±7.3 kg/m2, 79% women. There were no differences in postoperative years of follow-up, Roux limb length, or gastric pouch size between groups. Fifteen years after RYGB, the %TBWL in carriers was −16.6±10.7 compared with −28.7±12.9 in non-carriers (diff=12.1%, 95% CI, 4.8 to 19.3) and weight regain after maximum weight loss was 52.7±29.7% in carriers compared with 29.8±20.7% in non-carriers (diff=22.9%, 95% CI, 5.3 to 40.5). The nadir %TBWL was lower −32.1±8.1% in carriers compared with −36.8±10.4 in non-carriers (diff=4.8%, 95% CI 1.8 to 7.8). Carriers of a heterozygous variant in the leptin-melanocortin pathway have a progressive and significant weight regain in the mid- and long-term after RYGB. Genotyping patients experiencing significant weight regain after RYGB could help implement multidisciplinary and individualized weight-loss interventions to improve weight maintenance after surgery.
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影响因子：
2.9
作者：
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通讯作者：
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影响因子：
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作者：
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