减重代谢手术对身体成分构成的影响  

Effects of bariatric metabolic surgery on body composition

作　　者：崔贝贝 朱利勇[1] 李鹏洲[1] 李伟正[1] 王国慧[1] 孙许龙[1] 嵇光年 俞照妹 汤海波 易显浩 凌佳璞 朱晒红[1] Cui Beibei;Zhu Liyong;Li Pengzhou;Li Weizheng;Wang Guohui;Sun Xulong;Ji Guangnian;Yu Zhaomei;Tang Haibo;Yi Xianhao;Ling Jiapu;Zhu Shaihong(Department of General Surgery,the Third Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅三医院普通外科,长沙410008

出　　处：《中华消化外科杂志》2020年第11期1173-1182,共10页Chinese Journal of Digestive Surgery

基　　金：湖南省自然科学基金(2020JJ5856)。

摘　　要：目的探讨减重代谢手术对身体成分构成的影响。方法采用回顾性队列研究方法。收集2013年1月至2014年12月中南大学湘雅三医院收治的66例代谢性疾病患者的临床病理资料;男42例,女24例;年龄为(40±11)岁,年龄范围为17~63岁。66例患者中,27例行腹腔镜袖状胃切除术(LSG),设为LSG组;39例行腹腔镜Roux⁃en⁃Y胃旁路术(LRYGB),设为LRYGB组。所有患者于术前及术后6个月通过双能X射线吸收法测定身体成分构成指标。观察指标:(1)术前和术后6个月人体测量学参数、糖脂代谢指标、体脂质量百分比(BF%)、Android区BF%与Gynoid区BF%比值(A/G比值)变化情况。(2)术前和术后6个月全身和局部身体成分变化情况。(3)BF%与人体测量学参数、糖脂代谢指标相关性分析。(4)随访情况。采用门诊或再住院方式进行随访,了解患者术后6个月身体成分变化情况,随访时间为术后6个月,随访时间截至2015年7月。正态分布的计量资料以x±s表示,组内比较采用配对样本t检验,组间比较采用独立样本t检验(基线一致)或协方差分析(基线不一致)。偏态分布的计量资料以M(P25,P75)表示,组间比较采用Wilcoxon秩和检验。采用Pearson双变量进行相关性检验。结果(1)术前和术后6个月人体测量学参数、糖脂代谢指标、BF%和A/G比值变化情况:LSG组患者术前和术后6个月体质量、体质量指数(BMI)、腰围、腰臀比、舒张压、收缩压、空腹血糖、糖化血红蛋白、高密度脂蛋白胆固醇、甘油三酯、全身BF%、手臂BF%、腿部BF%、躯干BF%、Android区BF%、Gynoid区BF%、A/G比值分别为(102±17)kg、(37±5)kg/m^2、(118±14)cm、1.01±0.06、(94±14)mmHg(1 mmHg=0.133 kPa)、(137±15)mmHg、(8.1±4.2)mmol/L、7.3%±2.4%、(1.11±0.26)mmol/L、2.14 mmol/L(1.73 mmol/L,2.59 mmol/L)、40%±6%、46%±10%、36%±8%、42%±6%、45%±6%、37%±7%、1.23±0.18和(82±15)kg、(29±4)kg/m^2、(101±13)cm、0.95±0.08、(76±10)mmHg、(118±1Objective To explore the effects of bariatric metabolic surgery on body composition.Methods The retrospective cohort study was conducted.The clinicopathological data of 66 patients with metabolic diseases who were admitted to the Third Xiangya Hospital of Central South University from January 2013 to December 2014 were collected.There were 42 males and 24 females,aged(40±11)years,with a range from 17 to 63 years.Of the 66 patients,27 undergoing laparoscopic sleeve gastrectomy(LSG)and 39 undergoing laparoscopic Roux⁃en⁃Y gastric bypass(LRYGB)were allocated into LSG group and LRYGB group,respectively.The body composition of all patients was determined by dual⁃energy X⁃ray absorptiometry at preoperation and postoperative 6 months.Observation indicators:(1)the changes of anthropometric parameters,glucolipid metabolism,body fat mass percentage(BF%)and the ratio of Android BF%and Gynoid BF%(A/G ratio)from preoperation to postoperative 6 months;(2)the changes of whole and local body composition from preoperation to postoperative 6 months;(3)analysis of the correlation between BF%and anthropometric parameters,glucolipid metabolism.(4)Follow⁃up.Follow⁃up was conducted using outpatient or hospitalization examination to detect the changes of body composition at the time of postoperative 6 month.The follow⁃up time was up to July 2015.Measurement data with normal distribution were represented as Mean±SD,paired⁃samples t test was used for intra⁃group comparison,and independent⁃samples t test when baseline data were consistency or covariance analysis when baseline data were not consistency was used for inter⁃group comparison.Measurement data with skewed distribution were represented as M(P25,P75),and comparison between groups was analyzed using Wilcoxon signed rank test.The correlation test was undertaken with the Pearson bivariate analysis.Results(1)The changes of anthropometric parameters,glucolipid metabolism,BF%and A/G ratio from preoperation to postoperative 6 months:for patients in the LSG group,th

关 键 词：肥胖症 2型糖尿病 减重代谢手术 腹腔镜袖状胃切除术 腹腔镜Roux⁃en⁃Y胃旁路术 身体成分 双能X射线吸收法 

分 类 号：R656.61[医药卫生—外科学]