首页 国内政策 社会万象 太阳城亚洲 高层领导 地方热点 时政要闻 金融财经 网贷资讯健康知识 太阳城亚洲官方网站 新虐军事新虐论坛教师资格麻城网站目录天天特价网贷平台教育免费试用

太阳城亚洲:【学术2015-340】减重手术或可降低T2DM、MI和高血压

记者:太阳城亚洲 时间:2017-10-07 03:26  来源:太阳城亚洲国际娱乐
相关阅读国内政策】:太阳城亚洲国际娱乐平台:最高法公布30家事案例 夫妻离
社会万象】:太阳城亚洲国际娱乐平台:湖南零陵“政协常委组酒局致
时政要闻】:太阳城亚洲国际娱乐平台:习近平主席特使吉炳轩出席阿
国内政策】:太阳城亚洲国际娱乐平台:国务院:分类分层推进国有企
社会万象】:太阳城亚洲国际娱乐平台:“线下”2015 OCT-LOFT创意节深圳
健康知识】:太阳城亚洲国际娱乐 :惊!睡前不良习惯可能会招来
健康知识】:太阳城亚洲国际娱乐 :“心”病之下的心律失常!
健康知识】:太阳城亚洲国际娱乐 :为您支招 冬季吃什么预防心脏

  20151222日,PLOS在线发表一项英国研究结果显示,减重手术可大幅减轻体重,并且至少可在术后持续4年。体重减轻还伴随着此前就存在的2型糖尿病(T2DM)及高血压的明显改善,此外T2DM、高血压、心绞痛、心梗(MI)和阻塞性睡眠呼吸暂停(OSA)的发生危险也随之下降。扩大减重手术的使用范围可能带给许多病态肥胖者明显的健康益处。

  减重手术已越来越广泛地用于肥胖症的治疗,但目前还缺乏这种手术在日常临床实践中用于大型人群的长期疗效证据。这项观察性回顾队列研究采用英国临床实践研究数据链的数据,对截至20141231日接受减重手术的所有3882例患者进行评估,目的是衡量减重手术、BMI和肥胖症相关合并症之间的相关性。主要转归是4年间的体重及BMI变化,T2DM、高血压、心绞痛、MI、卒中、骨折和OSA及癌症的诊断,死亡率,以及高血压及T2DM的缓解情况。

  结果显示,在术后1~4个月,5~12个月以及13~48个月期间分别有3847例、2884例和2258例患者提供了体重测量数据。减重手术患者术后最初4个月的体重迅速减轻,减重速度达到4.98 kg/mo。截至4年结束时较缓慢的体重减轻得以维持。胃旁路术(6.56 kg/mo)和袖状胃切除术(6.29 kg/mo)的初始体重降幅大于胃束带术(2.77 kg/mo)。减重手术对T2DM、高血压、心绞痛、MIOSA的保护性风险比(HR)分别为0.680.350.590.280.55。研究发现减重手术与T2DMHR:9.29)和高血压(HR:5.64)的缓解强相关。研究未检出减重手术与骨折、癌症或卒中之间具有相关性。此外研究也未发现总体上减重手术对死亡具有保护作用(HR:0.97)。

  (英文原文)Bariatric Surgery in the United Kingdom: ACohort Study of Weight Loss and Clinical Outcomes in Routine Clinical Care

  BackgroundBariatric surgery is becoming a morewidespread treatment for obesity. Comprehensive evidence of the long-termeffects of contemporary surgery on a broad range of clinical outcomes in largepopulations treated in routine clinical practice is lacking. The objective ofthis study was to measure the association between bariatric surgery, weight,body mass index, and obesity-related co-morbidities.

  Methods and FindingsThis was an observational retrospective cohort studyusing data from the United Kingdom Clinical Practice Research Datalink. All3,882 patients registered in the database and with bariatric surgery on orbefore 31 December 2014 were included and matched by propensity score to 3,882obese patients without surgery. The main outcome measures were change in weightand body mass index over 4 y; incident diagnoses of type 2 diabetes mellitus(T2DM), hypertension, angina, myocardial infarction (MI), stroke, fractures,obstructive sleep apnoea, and cancer; mortality; and resolution of hypertensionand T2DM. Weight measures were available for 3,847 patients between 1 and 4 mo,2,884 patients between 5 and 12 mo, and 2,258 patients between 13 and 48 mopost-procedure. Bariatric surgery patients exhibited rapid weight loss for thefirst four postoperative months, at a rate of 4.98 kg/mo (95% CI 4.88–5.08).Slower weight loss was sustained to the end of 4 y. Gastric bypass (6.56 kg/mo)and sleeve gastrectomy (6.29 kg/mo) were associated with greater initial weightreduction than gastric banding (2.77 kg/mo). Protective hazard ratios (HRs)were detected for bariatric surgery for incident T2DM, 0.68 (95% CI 0.55–0.83);hypertension, 0.35 (95% CI 0.27–0.45); angina, 0.59 (95% CI 0.40–0.87);MI, 0.28(95% CI 0.10–0.74); and obstructive sleep apnoea, 0.55 (95% CI 0.40–0.87).Strong associations were found between bariatric surgery and the resolution ofT2DM, with a HR of 9.29 (95% CI 6.84–12.62), and between bariatric surgery andthe resolution of hypertension, with a HR of 5.64 (95% CI 2.65–11.99). Noassociation was detected between bariatric surgery and fractures, cancer, orstroke. Effect estimates for mortality found no protective association withbariatric surgery overall, with a HR of 0.97 (95% CI 0.66–1.43). The data usedwere recorded for the management of patients in primary care and may be subjectto inaccuracy, which would tend to lead to underestimates of true relativeeffect sizes.

  ConclusionsBariatric surgery as delivered in the UKhealthcare system is associated with dramatic weight loss, sustained at least 4y after surgery. This weight loss is accompanied by substantial improvements inpre-existing T2DM and hypertension, as well as a reduced risk of incident T2DM,hypertension, angina, MI, and obstructive sleep apnoea. Widening theavailability of bariatric surgery could lead to substantial health benefits formany people who are morbidly obese.

  来源:ACC CV News DigestDecember 222015

.
【编辑:太阳城亚洲国际娱乐平台 】
阅读推荐