Lancet子刊:手术让严重肥胖青少年减重但也有副作用
  • 选取58名来自美国的严重肥胖青少年,跟踪随访这些患者在接受减肥手术后5-12年时间内的各项相关指标;
  • 在平均的8年随访时间内,这些患者的平均BMI从58.5kg/m²下降到41.7kg/m²;
  • 在随访时间内,高血压、血脂异常、2型糖尿病的比例显著下降;
  • 46%的患者在接受手术后出现轻度贫血,22%的患者出现甲状旁腺机能亢进,16%的患者出现维生素B12含量较低的症状。
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Long-term outcomes of bariatric surgery in adolescents with severe obesity (FABS-5+): a prospective follow-up analysis

对严重肥胖青少年(FABS-5+)进行肥胖手术后的长期结果

10.1016/S2213-8587(16)30315-1

2017-01-05, Article

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Background: Little is known about the long-term outcomes of bariatric surgery for severe adolescent obesity, raising questions about the durability of early responses to surgery. We aimed to analyse long-term (>5 years) outcomes of Roux-en-Y gastric bypass in a cohort of young adults who had undergone the operation during adolescence, in the Follow-up of Adolescent Bariatric Surgery at 5 Plus Years (FABS-5+) extension study
Methods: A cohort of young people aged 13–21 years underwent Roux-en-Y gastric bypass for clinically severe obesity at a paediatric academic medical centre in the USA. We did a prospective follow-up analysis of these patients’ outcomes 5–12 years after surgery. Outcomes assessed included BMI, comorbidities, micronutrient status, safety, and other risks. The FABS study is registered with ClinicalTrials.gov, number NCT00776776.
Findings : Between May, 2001, and February, 2007, 74 young people underwent Roux-en-Y gastric bypass in the FABS study. Of these, 58 individuals were eligible for the FABS-5+ study, could be located, and agreed to follow-up assessment. At baseline, the mean age of the cohort was 17·1 years (SD 1·7) and mean BMI was 58·5 kg/m² (10·5). At mean follow-up of 8·0 years (SD 1·6; range 5·4–12·5), the mean age of the cohort was 25·1 years (2·4) and mean BMI was 41·7 kg/m² (12·0; mean change in BMI –29·2% [13·7]). From baseline to long-term follow-up, signifi cant declines were recorded in the prevalence of elevated blood pressure (27/57 [47%] vs 9/55 [16%]; p=0·001), dyslipidaemia (48/56 [86%] vs 21/55 [38%]; p<0·0001), and type 2 diabetes (9/56 [16%] vs 1/55 [2%]; p=0·03). At follow-up, 25 (46%) of 58 patients had mild anaemia (ie, not requiring intervention), 22 (45%) had hyperparathyroidism, and eight (16%) had low amounts of vitamin B12 (ie, below the normal cutpoint).
Interpretation: Between May, 2001, and February, 2007, 74 young people underwent Roux-en-Y gastric bypass in the FABS study. Of these, 58 individuals were eligible for the FABS-5+ study, could be located, and agreed to follow-up assessment. At baseline, the mean age of the cohort was 17·1 years (SD 1·7) and mean BMI was 58·5 kg/m² (10·5). At mean follow-up of 8·0 years (SD 1·6; range 5·4–12·5), the mean age of the cohort was 25·1 years (2·4) and mean BMI was 41·7 kg/m² (12·0; mean change in BMI –29·2% [13·7]). From baseline to long-term follow-up, signifi cant declines were recorded in the prevalence of elevated blood pressure (27/57 [47%] vs 9/55 [16%]; p=0·001), dyslipidaemia (48/56 [86%] vs 21/55 [38%]; p<0·0001), and type 2 diabetes (9/56 [16%] vs 1/55 [2%]; p=0·03). At follow-up, 25 (46%) of 58 patients had mild anaemia (ie, not requiring intervention), 22 (45%) had hyperparathyroidism, and eight (16%) had low amounts of vitamin B12 (ie, below the normal cutpoint)

First Authors:
Thomas H Inge

Correspondence Authors:
Thomas H Inge

All Authors:
Thomas H Inge,Todd M Jenkins,Stavra A Xanthakos,John B Dixon,Stephen R Daniels,Meg H Zeller,Michael A Helmrath

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