接受代谢手术青少年与成人肥胖患者术前人体成分及肥胖相关并发症比较的研究  

A comparative study of preoperative body composition and obesity?related complication between adolescent and adult with obesity undergoing metabolic surgery

作　　者：韩涛 汤文娟[1] 张宁静 沈媛媛 黄元灏 张冰青 冯文焕[1] HAN Tao;TANG Wenjuan;ZHANG Ningjing(Department of Endocrinology,Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University,Nanjing 210008,China)

机构地区：[1]南京医科大学鼓楼临床医学院内分泌科,210008

出　　处：《中国糖尿病杂志》2024年第12期886-890,共5页Chinese Journal of Diabetes

基　　金：江苏省自然科学基金面上项目(BK20201115);中华国际交流基金会森美中华糖尿病科研基金(Z-2017-26-1902);四大慢病重大专项(2023ZD0508105)。

摘　　要：目的探讨青少年和成人肥胖患者接受代谢手术前人体成分及肥胖相关并发症的差异。方法选取2016年7月至2022年7月于南京医科大学鼓楼临床医学院减重代谢外科接受代谢手术患者454例,根据手术时年龄分为青少年组(年龄≤19岁,n=61)和成人组(年龄>19岁,n=393),比较两组术前人体成分、肥胖相关并发症和血生化指标。结果与青少年组比较,成年组年龄、肥胖病程、DBP、WHR、躯干体脂率、Android脂肪/Gynoid脂肪、FPG、Hb A1c、2 hPG、TC、TG、UACR、叶酸、维生素B_(12)升高(P<0.05或P<0.01),身高、体重、臀围、全身体脂率、大腿体脂率、Gynoid体脂率、FIns、2 hIns、血尿酸、碱性磷酸酶、e GFR、血清白蛋白、血钙降低(P<0.05或P<0.01)。青少年组DM前期、1级高血压、高尿酸血症、心理疾病发生率高于成年人组(P<0.05或P<0.01),T2DM、2级高血压、3级高血压、肝纤维化、颈动脉斑块、阻塞性睡眠呼吸暂停低通气综合征发生率低于成人组(P<0.05或P<0.01)。结论青少年肥胖患者接受代谢手术前脂肪分布较成人健康,合并肥胖相关并发症严重程度较成人患者轻,需注意青少年患者术后精神心理健康监测及营养元素补充。Objective To investigate the differences in preoperative obesity-related diseases and body composition between adolescents and adults with obesity undergoing metabolic surgery.Methods A total of 454 patients who underwent metabolic surgery in Nanjing Drum Tower Hospital from July 2016 to July 2022were recruited and divided into the adolescent group(age≤19 years,n=61)and the adult group(age>19years,n=393)according to the age of surgery.Preoperative body composition,obesity-related complications and metabolic indicators were compared between the two groups.Results Compared with adolescent group,age,obesity duration,DBP,WHR,trunk body fat percentage,Android fat/Gynoid fat,FPG,Hb A1c,2 hPG,TC,TG,UACR,FOL and VitB_(12)were increased(P<0.05 or P<0.01),while height,weight,HC,total body fat percentage,thigh body fat percentage,Gynoid body fat percentage,FIns,2 hIns,SUA,AKP,e GFR,ALB,Ca2+were decreased in the adult group(P<0.05 or P<0.01).The incidence of prediabetes,grade 1hypertension,hyperuricemia and psychological diseases was higher(P<0.05 or P<0.01),while the incidence of T2DM,grade 2 hypertension,grade 3 hypertension,liver fibrosis,carotid plaque and OSAHS was lower in adolescent group than in adult group(P<0.05 or P<0.01).Conclusions The preoperative fat distribution is healthier in adolescent patients with obesity undergoing metabolic surgery than that of adults.Obesity-related metabolic complications have already developed in adolescent patients,but less severe than in adult patients.Psychological health and nutritional supplementation should be emphasized in adolescents after metabolic surgery.

关 键 词：代谢手术 青少年 成人 人体成分 肥胖相关并发症 

分 类 号：R723.14[医药卫生—儿科]