减肥手术与血清脂质代谢关联性的研究进展  

Research progress on correlation between weight loss surgery and serum lipid metabolism

作　　者：秦亚鑫 王和月 武毅 杨芮 韩建立[1] QIN Yaxin;WANG Heyue;WU Yi;YANG Rui;HAN Jianli(Department of General Surgery,Third Hospital of Shanxi Medical University/Shanxi Bethune Hospital/Shanxi Academy of Medical Sciences/Tongji Shanxi Hospital,Taiyuan,Shanxi 030032,China)

机构地区：[1]山西医科大学第三医院/山西白求恩医院/山西医院科学院/同济山西医院普通外科,太原030032

出　　处：《重庆医学》2024年第24期3821-3827,共7页Chongqing Medical Journal

基　　金：山西白求恩医院科研项目(2021YZ05)。

摘　　要：肥胖是一个非常普遍的公共卫生问题,是一种多因素起源的慢性代谢疾病,治疗选择有限。减肥手术被认为是肥胖症最有效的治疗方法,可减轻体重、改善新陈代谢。约有60%的肥胖患者合并有血脂水平的异常变化,而血脂异常被认为是动脉粥样硬化相关疾病发展的独立危险因素。减肥手术能够明显改善肥胖患者血清脂质谱,降低心血管疾病风险,但其具体机制尚无定论。该文从内脏脂肪组织质量变化、脂肪因子变化、胰岛素敏感性改善、胃肠道激素与肠道菌群、胆汁酸代谢途径、维生素与微量元素等方面介绍了减肥手术后血脂代谢变化的可能机制,期望在未来进一步明确减肥手术的降脂机制,为治疗血脂异常提供新的途径。Obesity is a very common public health problem.It is a chronic metabolic disease of multifactorial origin with limited treatment options.Weight loss surgery is considered to be the most effective treatment option for obesity,which can reduce the body weight and improve metabolism.About 60%of obese patients have abnormal changes in blood lipid levels,and dyslipidemia is considered to be an independent risk factor for the development of atherosclerosis-related diseases.Weight loss surgery can significantly improve the serum lipid profile of obese patients and reduce the risk of cardiovascular disease,but its specific mechanism is still inconclusive.This paper introduces the possible mechanism of lipid metabolism changes from the aspects of the mass change of visceral tissues,adipokine changes,insulin sensitivity improvement,gastrointestinal hormones and intestinal flora,bile acid metabolism pathway,vitamins and trace elements.It is expected to further clarify the lipid-lowering mechanism of weight loss surgery in the future and provide a new way for the treatment of dyslipidemia.

关 键 词：肥胖 减肥手术 血清脂质代谢 病理生理 综述 

分 类 号：R656.61[医药卫生—外科学]