NEJM:减肥手术对青少年影响的3年的随访结果

2015-11-07 MedSci译 MedSci原创

对严重肥胖的青少年,减肥手术的应用越来越多,不过该方式对该人群的有效性和安全性究竟如何,目前临床上还缺乏相关数据。研究者进行了一项前瞻性研究,纳入242名进行减肥手术的青少年。有161名选择了Roux-en-Y胃旁路手术,67名患者行了缩胃手术。研究者获取了术后3年参与者体重变化等数据。研究对象基线平均年龄为 17±1.6岁,平均BMI为53;75%为女性,72%是白人。研究数据显示,术后3年,研

对严重肥胖的青少年,减肥手术的应用越来越多,不过该方式对该人群的有效性和安全性究竟如何,目前临床上还缺乏相关数据。

研究者进行了一项前瞻性研究,纳入242名进行减肥手术的青少年。有161名选择了Roux-en-Y胃旁路手术,67名患者行了缩胃手术。研究者获取了术后3年参与者体重变化等数据。

研究对象基线平均年龄为 17±1.6岁,平均BMI为53;75%为女性,72%是白人。研究数据显示,术后3年,研究对象体重平均下降27% (95% CI , 25 to 29);行胃旁路手术人群体重平均下降28%(95% CI, 25 to 30),缩胃手术人群体重平均下降26% (95% CI, 22 to 30) 。

术后3年以下纳入研究时的并发症得到改善:2型糖尿病患者缓解率为95%(95% CI, 85 to 100),肾功能异常缓解 86% (95% CI, 72 to 100),前驱糖尿病缓解76% (95% CI, 56 to 97),血压升高缓解 74% (95% CI, 64 to 84),血脂异常缓解66% (95% CI, 57 to 74。体重相关生活质量也得到显著改善。

不过减肥术后3年,有57% (95% CI, 50 to 65) 的患者发生了低铁蛋白血症,还有13% (95% CI, 9 to 18)的患者经历了至少一次的腹部手术。

研究结果表明,对严重肥胖的青少年进行减肥手术3年后,可显著改善体重、心血管代谢健康以及体重相关生活质量。风险包括特定的微量营养素缺乏和腹部手术的风险增加。

原始出处:

Thomas H. Inge, Anita P. Courcoulas,et al.Weight Loss and Health Status 3 Years after Bariatric Surgery in Adolescents.NEJM.November 6, 2015

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  1. [GetPortalCommentsPageByObjectIdResponse(id=85035, encodeId=0968850356f, content=旁路手术对营养素吸收显著而长期影响青春期减肥以坛加中等强度运动时间和饮食低热量1600-1700千卡饮食内容减油减动物脂肪坛加杂粮多蔬避免消化改道过度肥胖BMI>35值以上等严重肥胖儿童方行手术可以吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e8231711773, createdName=1dea6088m20(暂无匿称), createdTime=Mon May 09 14:46:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1818769, encodeId=d55d1818e697c, content=<a href='/topic/show?id=9687984e5e3' target=_blank style='color:#2F92EE;'>#随访结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98475, encryptionId=9687984e5e3, topicName=随访结果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3ff68, createdName=维他命, createdTime=Thu Aug 04 08:09:00 CST 2016, time=2016-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60768, encodeId=4a9b60e6843, content=不错,赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:52:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60770, encodeId=cdb160e7041, content=这篇文章有一定深度, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:52:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60771, encodeId=6b3c60e712a, content=是一篇不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:52:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42817, encodeId=cf5c4281e2e, content=减肥减肥, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150625/IMG558B8C995D7262168.jpg, createdBy=36ad1623080, createdName=cyzj007, createdTime=Sun Nov 08 11:00:00 CST 2015, time=2015-11-08, status=1, ipAttribution=)]
    2016-05-09 1dea6088m20(暂无匿称)

    旁路手术对营养素吸收显著而长期影响青春期减肥以坛加中等强度运动时间和饮食低热量1600-1700千卡饮食内容减油减动物脂肪坛加杂粮多蔬避免消化改道过度肥胖BMI>35值以上等严重肥胖儿童方行手术可以吗

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=85035, encodeId=0968850356f, content=旁路手术对营养素吸收显著而长期影响青春期减肥以坛加中等强度运动时间和饮食低热量1600-1700千卡饮食内容减油减动物脂肪坛加杂粮多蔬避免消化改道过度肥胖BMI>35值以上等严重肥胖儿童方行手术可以吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e8231711773, createdName=1dea6088m20(暂无匿称), createdTime=Mon May 09 14:46:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1818769, encodeId=d55d1818e697c, content=<a href='/topic/show?id=9687984e5e3' target=_blank style='color:#2F92EE;'>#随访结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98475, encryptionId=9687984e5e3, topicName=随访结果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3ff68, createdName=维他命, createdTime=Thu Aug 04 08:09:00 CST 2016, time=2016-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60768, encodeId=4a9b60e6843, content=不错,赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:52:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60770, encodeId=cdb160e7041, content=这篇文章有一定深度, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:52:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60771, encodeId=6b3c60e712a, content=是一篇不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:52:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42817, encodeId=cf5c4281e2e, content=减肥减肥, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150625/IMG558B8C995D7262168.jpg, createdBy=36ad1623080, createdName=cyzj007, createdTime=Sun Nov 08 11:00:00 CST 2015, time=2015-11-08, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=85035, encodeId=0968850356f, content=旁路手术对营养素吸收显著而长期影响青春期减肥以坛加中等强度运动时间和饮食低热量1600-1700千卡饮食内容减油减动物脂肪坛加杂粮多蔬避免消化改道过度肥胖BMI>35值以上等严重肥胖儿童方行手术可以吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e8231711773, createdName=1dea6088m20(暂无匿称), createdTime=Mon May 09 14:46:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1818769, encodeId=d55d1818e697c, content=<a href='/topic/show?id=9687984e5e3' target=_blank style='color:#2F92EE;'>#随访结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98475, encryptionId=9687984e5e3, topicName=随访结果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3ff68, createdName=维他命, createdTime=Thu Aug 04 08:09:00 CST 2016, time=2016-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60768, encodeId=4a9b60e6843, content=不错,赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:52:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60770, encodeId=cdb160e7041, content=这篇文章有一定深度, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:52:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60771, encodeId=6b3c60e712a, content=是一篇不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:52:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42817, encodeId=cf5c4281e2e, content=减肥减肥, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150625/IMG558B8C995D7262168.jpg, createdBy=36ad1623080, createdName=cyzj007, createdTime=Sun Nov 08 11:00:00 CST 2015, time=2015-11-08, status=1, ipAttribution=)]
    2016-01-27 doctording1

    不错,赞一个

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=85035, encodeId=0968850356f, content=旁路手术对营养素吸收显著而长期影响青春期减肥以坛加中等强度运动时间和饮食低热量1600-1700千卡饮食内容减油减动物脂肪坛加杂粮多蔬避免消化改道过度肥胖BMI>35值以上等严重肥胖儿童方行手术可以吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e8231711773, createdName=1dea6088m20(暂无匿称), createdTime=Mon May 09 14:46:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1818769, encodeId=d55d1818e697c, content=<a href='/topic/show?id=9687984e5e3' target=_blank style='color:#2F92EE;'>#随访结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98475, encryptionId=9687984e5e3, topicName=随访结果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3ff68, createdName=维他命, createdTime=Thu Aug 04 08:09:00 CST 2016, time=2016-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60768, encodeId=4a9b60e6843, content=不错,赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:52:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60770, encodeId=cdb160e7041, content=这篇文章有一定深度, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:52:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60771, encodeId=6b3c60e712a, content=是一篇不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:52:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42817, encodeId=cf5c4281e2e, content=减肥减肥, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150625/IMG558B8C995D7262168.jpg, createdBy=36ad1623080, createdName=cyzj007, createdTime=Sun Nov 08 11:00:00 CST 2015, time=2015-11-08, status=1, ipAttribution=)]
    2016-01-27 doctording1

    这篇文章有一定深度

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=85035, encodeId=0968850356f, content=旁路手术对营养素吸收显著而长期影响青春期减肥以坛加中等强度运动时间和饮食低热量1600-1700千卡饮食内容减油减动物脂肪坛加杂粮多蔬避免消化改道过度肥胖BMI>35值以上等严重肥胖儿童方行手术可以吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e8231711773, createdName=1dea6088m20(暂无匿称), createdTime=Mon May 09 14:46:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1818769, encodeId=d55d1818e697c, content=<a href='/topic/show?id=9687984e5e3' target=_blank style='color:#2F92EE;'>#随访结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98475, encryptionId=9687984e5e3, topicName=随访结果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3ff68, createdName=维他命, createdTime=Thu Aug 04 08:09:00 CST 2016, time=2016-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60768, encodeId=4a9b60e6843, content=不错,赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:52:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60770, encodeId=cdb160e7041, content=这篇文章有一定深度, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:52:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60771, encodeId=6b3c60e712a, content=是一篇不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:52:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42817, encodeId=cf5c4281e2e, content=减肥减肥, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150625/IMG558B8C995D7262168.jpg, createdBy=36ad1623080, createdName=cyzj007, createdTime=Sun Nov 08 11:00:00 CST 2015, time=2015-11-08, status=1, ipAttribution=)]
    2016-01-27 doctording1

    是一篇不错的文章

    0

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    2015-11-08 cyzj007

    减肥减肥

    0

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