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Diabetes Obes Metab:减重手术可以使严重肥胖患者升高的GlycA回归正常

2018-08-01 xing.T MedSci原创

由此可见,这是首个证明了手术体重减轻可显著降低GlycA水平的研究。

慢性炎症会导致许多与肥胖相关的疾病,包括动脉粥样硬化等。GlycA是一种全身性炎症的标志物,具有比hsCRP更低的个体变异性,与心血管事件和死亡率独立相关。尽管GlycA在肥胖患者中有所升高,但与人体测量指标的相关性一般,并且体重减轻对GlycA的影响尚未明确。

近日,代谢内分泌疾病领域权威杂志Diabetes Obesity & Metabolism上发表了一篇研究文章,研究人员对接受Roux-en-Y胃旁路术(n=23)或袖状胃切除术(n=31)的肥胖(BMI为44.6±6.6kg/m2)、非糖尿病女性(33.7±8.2岁)在基线和术后6个月、12个月时进行了前瞻性研究。BMI正常的女性(n=14)作为对照者。

研究人员发现减重手术可显著降低6个月时的GlycA水平(451±47umol/L vs. 383±50umol/L; p<0.001),并在术后12个月时进一步降低(348±41umol/L; p<0.001),两种手术之间无显著差异。在术后12个月时,尽管41%的手术受试者BMI仍>30kg/m2,但手术组和对照组的GlycA水平没有显著差异(p=0.13)。增加的HDL颗粒大小与降低的GlycA水平密切相关(r=-0.49; p<0.001),并且发现由体重减轻相关的降低所占比例高达43%。

由此可见,这是首个证明了手术体重减轻可显著降低GlycA水平的研究。


在线免费使用:

理想体重
女性最佳身材在线计算器
Roux-en-Y胃肠减重手术后糖尿病复发预测评分(DiaRem评分)
Roux-en-Y胃肠减重手术后糖尿病复发预测评分(ABCD评分)

原始出处:

Arun Manmadhan,et al. Elevated GlycA in Severe Obesity is Normalized by Bariatric Surgery.Diabetes Obesity & Metabolism.2018. https://onlinelibrary.wiley.com/doi/abs/10.1111/dom.13481

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    2019-05-29 一闲
  4. 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20 05:41:00 CST 2019, time=2019-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335623, encodeId=efeb33562398, content=学习了,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Wed Aug 01 23:14:50 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335505, encodeId=270e33550564, content=学习了谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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  5. 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20 05:41:00 CST 2019, time=2019-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335623, encodeId=efeb33562398, content=学习了,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Wed Aug 01 23:14:50 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335505, encodeId=270e33550564, content=学习了谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLbTp9nZtjwVrSZNxAXbAicnKQWnic2eBdJUQYhxO36XdkstSicr7FVF8p5ReH4omtmsbnLdvZLiaJJ1A/132, createdBy=8bff2327056, createdName=kafei, createdTime=Wed Aug 01 09:49:48 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335495, encodeId=c78d33549553, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Wed Aug 01 09:46:21 CST 2018, time=2018-08-01, status=1, ipAttribution=)]
  6. 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20 05:41:00 CST 2019, time=2019-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335623, encodeId=efeb33562398, content=学习了,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Wed Aug 01 23:14:50 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335505, encodeId=270e33550564, content=学习了谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLbTp9nZtjwVrSZNxAXbAicnKQWnic2eBdJUQYhxO36XdkstSicr7FVF8p5ReH4omtmsbnLdvZLiaJJ1A/132, createdBy=8bff2327056, createdName=kafei, createdTime=Wed Aug 01 09:49:48 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335495, encodeId=c78d33549553, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Wed Aug 01 09:46:21 CST 2018, time=2018-08-01, status=1, ipAttribution=)]
    2018-10-08 guojianrong
  7. 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20 05:41:00 CST 2019, time=2019-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335623, encodeId=efeb33562398, content=学习了,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Wed Aug 01 23:14:50 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335505, encodeId=270e33550564, content=学习了谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLbTp9nZtjwVrSZNxAXbAicnKQWnic2eBdJUQYhxO36XdkstSicr7FVF8p5ReH4omtmsbnLdvZLiaJJ1A/132, createdBy=8bff2327056, createdName=kafei, createdTime=Wed Aug 01 09:49:48 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335495, encodeId=c78d33549553, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Wed Aug 01 09:46:21 CST 2018, time=2018-08-01, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=2082100, encodeId=c375208210010, content=<a href='/topic/show?id=7904811480' target=_blank style='color:#2F92EE;'>#GlycA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8114, encryptionId=7904811480, topicName=GlycA)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqcyT7aQIuoYGGYr889lEiaOVWSfvMQ4d2oxhTMlWzEr6lPmg6pxzCVvPScSZrne4JFSyyPRCOxllQ/132, createdBy=416a2500064, createdName=ms3323097325231039, createdTime=Sun Aug 26 23:41:00 CST 2018, time=2018-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1638712, encodeId=267d1638e12cf, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, 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20 05:41:00 CST 2019, time=2019-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335623, encodeId=efeb33562398, content=学习了,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Wed Aug 01 23:14:50 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335505, encodeId=270e33550564, content=学习了谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLbTp9nZtjwVrSZNxAXbAicnKQWnic2eBdJUQYhxO36XdkstSicr7FVF8p5ReH4omtmsbnLdvZLiaJJ1A/132, createdBy=8bff2327056, createdName=kafei, createdTime=Wed Aug 01 09:49:48 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335495, encodeId=c78d33549553, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Wed Aug 01 09:46:21 CST 2018, time=2018-08-01, status=1, ipAttribution=)]
    2018-08-01 惠映实验室

    学习了,谢谢分享。

    0

  9. 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20 05:41:00 CST 2019, time=2019-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335623, encodeId=efeb33562398, content=学习了,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Wed Aug 01 23:14:50 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335505, encodeId=270e33550564, content=学习了谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLbTp9nZtjwVrSZNxAXbAicnKQWnic2eBdJUQYhxO36XdkstSicr7FVF8p5ReH4omtmsbnLdvZLiaJJ1A/132, createdBy=8bff2327056, createdName=kafei, createdTime=Wed Aug 01 09:49:48 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335495, encodeId=c78d33549553, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Wed Aug 01 09:46:21 CST 2018, time=2018-08-01, status=1, ipAttribution=)]
    2018-08-01 kafei

    学习了谢谢

    0

  10. 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20 05:41:00 CST 2019, time=2019-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335623, encodeId=efeb33562398, content=学习了,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Wed Aug 01 23:14:50 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335505, encodeId=270e33550564, content=学习了谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLbTp9nZtjwVrSZNxAXbAicnKQWnic2eBdJUQYhxO36XdkstSicr7FVF8p5ReH4omtmsbnLdvZLiaJJ1A/132, createdBy=8bff2327056, createdName=kafei, createdTime=Wed Aug 01 09:49:48 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335495, encodeId=c78d33549553, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Wed Aug 01 09:46:21 CST 2018, time=2018-08-01, status=1, ipAttribution=)]
    2018-08-01 龙胆草

    学习谢谢分享

    0

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减重手术指利用医学外科手段,改善肥胖症患者的全身症状例如:体重超标、高血压、血脂高、糖尿病等症状的医疗方法,21世纪世界主要流行的四种医疗减重方法为:例如:缩胃术、胃旁路、胃束带、胃内水球疗法等。

青少年减重手术须谨慎,营养不良可影响发育

小胖墩越来越多,有些孩子的BMI指数早早就飙升到了超重。近年来,减重手术逐渐进入大家视野。上海交通大学医学院附属第六人民医院普外科主任医师张频表示,“16岁以下青少年不推荐手术,实在没办法的孩子手术前必须慎重再慎重,决不能盲目。”张频表示,减重手术的目的在于,让一些胖到病态的人能恢复到正常体重,以减少由肥胖引发的各种疾病。此外,Ⅱ型糖尿病患者也可能通过减重手术减轻体重、降低血糖,使患者摆脱长期服药

减重手术的营养与多学科管理专家共识

肥胖症与诸多代谢性疾病等慢性病的发生密切相关,已成为全球公认的导致人类死亡的重要原因。尽管减重治疗包括行为、心理及药物治疗等多种手段,但对中重度肥胖治疗效果有限。减重手术是近十余年来国内外临床研究公认的有效的中重度肥胖治疗手段,但由于国内缺乏减重手术的多学科管理特别是长期的营养管理监测,减重手术后患者面临营养不良、复胖、功能损害等问题。中华医学会肠外肠内营养学分会营养与代谢协作组与北京协和医院减重

2017 共识指南:阻塞性睡眠呼吸暂停减重手术围术期管理

世界范围内,减重和代谢手术不断增加,平均每年已超过500,000例。在接受减重代谢手术的患者中约有35%-94%的患者存在阻塞性睡眠呼吸暂停,本文主要针对该类患者接受减重手术的围术期管理提供指导意见。由15位国际专家组成专家小组针对术前筛查,治疗,术后监测,麻醉护理以及随访等内容共提出了58条声明和建议。

Metabolism :减重手术对人类皮下脂肪组织炎症的影响

减重手术是指利用医学外科手段,改善肥胖症患者的全身症状例如:体重超标、高血压、血脂高、糖尿病等症状的医疗方法。

2017 EASO实践建议:减重术后医学管理

减重手术是目前严重肥胖患者长期治疗和管理的最有效的方法,其应用已经被成人肥胖管理指南推荐。通常来说,减重手术安全有效,但是可能导致新的临床问题,因此需要特殊的诊断,预防和治疗。本文主要针对减重术后的医学管理出指导建议,内容涉及营养管理,微量元素补充,共病管理,术后药物治疗,术后妊娠管理和体重增加的预防等。

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