Diabetes Obes Metab:减肥手术与心肌梗死和卒中后较低的死亡率相关

2019-05-05 xing.T 网络

由此可见,之前进行减肥手术对MI和CVA后的存活率具有显著的保护作用。

近日,代谢内分泌疾病领域权威杂志Diabetes Obesity & Metabolism上发表了一篇研究文章,研究人员旨在评估减肥手术对心肌梗死(MI)或脑血管意外(CVA)后死亡率的潜在保护作用。 

研究人员使用全国住院患者样本(2007-2014),确定了2218名主要出院诊断为急性心肌梗死的患者和2168名缺血性CVA患者,这些患者既往有减肥手术史。研究人员利用倾向评分将这些患者与主要诊断相似且无减肥手术史的患者(对照组)按照1:5的比例匹配。对照组-1仅包括肥胖患者(BMI≥35kg/m2),对照组-2根据手术后BMI与减肥手术进行匹配。主要和次要终点分别是院内全因死亡率和住院时间。在多变量回归模型中,MI和CVA后的结局在各组之间进行了单独比较。

该研究共有48300名(加权)患者被纳入分析。在倾向匹配后,协变量的分布很均衡。与对照组1(1.85% vs. 3.03%,比值比(OR)为0.61,95%可信区间(CI)为0.44-0.86,p=0.004)和对照组2(2.00% vs. 3.26%,OR为0.62,95%CI为0.44-0.88,p=0.008)相比,有减肥手术病史的患者MI后死亡率显著降低。同样,与对照组1(1.43% vs. 2.74%,OR为0.54,95%CI为0.37-0.79,p=0.001)和对照组2(1.54% vs. 2.59%,OR为0.61,95%CI为0.41-0.91,p=0.015)相比,减重手术史前患者的CVA后住院死亡率也显著降低。此外,减肥手术组与对照组相比,住院时间明显缩短(p<0.001)。

由此可见,之前进行减肥手术对MI和CVA后的存活率具有显著的保护作用。
 
原始出处:

Ali Aminian,et al.Bariatric Surgery is Associated with a Lower Rate of Death after Myocardial Infarction and Stroke: a Nationwide Study.Diabetes Obesity & Metabolism.2019.https://doi.org/10.1111/dom.13765

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    2020-03-19 guojianrong
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    2020-02-20 一闲
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    2019-05-05 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

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    2019-05-05 CHANGE

    什么时候有懒人用的减肥神药?

    0

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由此可见,在减肥手术后,使用体重调整的亭扎肝素进行延长的血栓预防治疗似乎是一种安全的策略,其术后VTE和大出血的发生率较低。

JCEM:减肥手术可减少肥胖患者尿线粒体DNA拷贝数

由此可见,肥胖与尿mtND-1拷贝数升高有关。减肥手术降低了肥胖患者升高的尿mtND-1拷贝数。这表明减肥手术可以减轻肥胖患者肾细胞中的线粒体损伤。

Lancet:减肥手术疗效及安全性比较研究——胃吻合术vs胃旁路术

研究发现,胃吻合术与胃旁路术对于肥胖患者2年减重以及代谢改善的效果差异不显著,但胃吻合术组患者腹泻、痔疮和营养不良等不良事件发生率较高

减肥手术揭秘:改变了你肠道感知食物的方式

越来越多的报道显示:减肥手术对于治疗合并肥胖的2型糖尿病患者格外有效。减肥手术后患者体重明显减轻,胰岛素分泌增加,胰岛素敏感性增强。但是在体重下降后,胰岛素敏感性改善的背景下,餐后胰岛素释放显着增加会使手术后患者出现餐后低血糖。因此,了解减肥手术后餐后胰岛素分泌升高的生理基础,对于预防易感人群术后低血糖的发生以及开发治疗2型糖尿病的新的治疗策略具有重要意义。减肥手术是如何帮助合并肥胖的糖尿病患者的

Ann Intern Med:减肥手术与常规治疗后糖尿病患者的微血管结局

由此可见,在这项针对T2DM成人的大型多中心研究中,与常规治疗相比,减肥手术与较低的微血管疾病的总体发病率(包括较低的神经病变、肾病和视网膜病变)相关。