减重手术患者代谢健康型肥胖临床表型分析  

Clinical Phenotype Analysis of Metabolically Healthy Obesity in Patients Undergoing Bariatric Surgery

作　　者：李浩天 朱孝成 姚立彬 洪健 邵永 LI Hao-tian;ZHU Xiao-cheng;YAO Li-bin;HONG Jian;SHAO Yong(Graduate School,Xuzhou Medical University,Xuzhou 221004,Jiangsu,China;Department of Gastrointestinal Surgery,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221002,Jiangsu,China)

机构地区：[1]徐州医科大学研究生院,江苏徐州221004 [2]徐州医科大学附属医院胃肠外科,江苏徐州221002

出　　处：《医学信息》2024年第5期123-127,共5页Journal of Medical Information

基　　金：徐州医科大学附属医院发展基金面上项目(编号:XYFM2021023)。

摘　　要：目的 分析减重手术患者代谢健康型肥胖(MHO)的临床表型特点。方法 回顾性收集2019年1月-2022年6月在徐州医科大学附属医院减重代谢外科行减重手术的1220例(最终纳入1039例)肥胖症患者的临床资料,根据诊断标准分为代谢健康型肥胖组(MHO)、代谢异常型肥胖组(MUO),分析两组临床数据,并采用Logistic回归分析MHO的独立影响因素。结果 减重手术患者中MHO的占比为10.49%。MHO组年龄、收缩压、舒张压、空腹血糖、糖化血红蛋白、甘油三酯、谷草转氨酶、谷丙转氨酶、皮质醇均低于MUO组,高密度脂蛋白、总蛋白、白蛋白高于MUO组(P<0.05)。多因素Logistic回归分析显示年龄(OR<1,P<0.05)是MHO的独立危险因素,总蛋白水平(OR>1,P<0.05)是MHO的保护性因素。结论 MHO不应被误解为没有任何健康损害的肥胖人群,诊断为MHO的肥胖个体仍然是开始治疗的提示,但MHO患者是否需要进行减重代谢手术,以及进行手术的疗效仍需进一步研究。Objective To analyze the clinical and phenotypic characteristics of metabolically healthy obesity(MHO)patients who underwent bariatric surgery.Methods Clinical data were retrospectively collected from 1220 obese patients(1039 patients were finally included)who underwent bariatric surgery at the Department of Metabolic and Bariatric Surgery,Xuzhou Medical University Hospital from January 2019 to June 2022.Patients were divided into metabolically healthy obesity(MHO)and metabolically unhealthy obesity(MUO)groups based on diagnostic criteria.Differences in clinical data between the two groups and factors affecting MUO were analyzed using logistic regression.Results The proportion of MHO in patients undergoing bariatric surgery was 10.49%.Age,systolic blood pressure,diastolic blood pressure,fasting blood glucose,glycosylated hemoglobin,triglyceride,aspartate aminotransferase,alanine aminotransferase and cortisol in MHO group were lower than those in MUO group,while high density lipoprotein,total protein and albumin were higher than those in MUO group(P<0.05).Multivariate logistic regression analysis showed that age(OR<1,P<0.05)was an independent risk factor for MHO,and total protein level(OR>1,P<0.05)was a protective factor for MHO.Conclusion MUO should not be misinterpreted as an obese population without any health impairment.Obese individuals diagnosed with MHO are still a sign to start treatment,but whether MHO patients need to undergo weight reduction metabolic surgery and the efficacy of performing surgery still needs further research.

关 键 词：减重手术 代谢健康型肥胖 代谢异常型肥胖 危险因素 

分 类 号：R656[医药卫生—外科学]