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GYNECOL ONCOL:减肥手术大有裨益!?防癌!

2015-10-03 leaderbilly 译 MedSci原创

近日一项评估具有子宫癌症风险的肥胖女性行减肥手术效果的研究发现,该手术减少了研究受试者三分之一的体重并降低了其子宫癌前增生病变的发展。同时,该研究结果也指出这种减肥手术的其他影响,包括病人生活质量的提高、胰岛素水平的提高以及利用葡萄糖能力的提升,而后者则可能降低糖尿病的风险,甚至改变他们的肠道细菌的组成。这项研究阐述了减肥手术的好处以及肥胖对健康所产生的巨大损害。“如果你仔细观察美国女性癌症患者,

近日一项评估具有子宫癌症风险的肥胖女性行减肥手术效果的研究发现,该手术减少了研究受试者三分之一的体重并降低了其子宫癌前增生病变的发展。同时,该研究结果也指出这种减肥手术的其他影响,包括病人生活质量的提高、胰岛素水平的提高以及利用葡萄糖能力的提升,而后者则可能降低糖尿病的风险,甚至改变他们的肠道细菌的组成。

这项研究阐述了减肥手术的好处以及肥胖对健康所产生的巨大损害。“如果你仔细观察美国女性癌症患者,你会发现如果这些患者能够拥有正常的体重,那么她们之中的大约五分之一的癌症死亡将能够得到预防,” 弗吉尼亚大学的癌症中心医学博士Susan C.苏珊说,“在与肥胖相关的癌症中,所占群体最大的一个是子宫内膜癌,其次是结肠癌、乳腺癌、肾癌和胆囊癌。我们认为这种发生在子宫内壁的癌症,大约40%~50%是由肥胖引起的。”

手术对肥胖者体重的影响

这项研究观察了71名平均年龄44.2岁的女性,她们的平均身体质量指数(BMI)为50.9。在女性中,BMI超过30被认为是肥胖,而BMI超过40则被认为是病态肥胖(这比通常女人所认为的理想体重约重100磅),尽管几乎三分之一接受减肥手术的女性并不认同自己是肥胖。

这项研究观察了在一个相对短的时间内减肥手术的效果——手术后一至三年。在最初同意受试的70名女性中,共有68名参与者进行了该项手术,两个选择放弃手术,一个在手术之前死于心脏病。手术对体重的影响是非常显著的:平均体重减少超过100磅。

手术对肥胖者预防肿瘤的影响

在参与本研究的受试者中,约百分之十的女性没有进行子宫切除术但发现子宫粘膜出现癌前变化,而这种病理状况在其接受减肥手术后得到的解决。“我们讨论的是少数群体,真的是少数,”该项研究的参与者之一Modesitt指出该研究的不足之处,“所以我不能说这种防癌效果是确定的,但这为我们日后的研究提供了线索,鉴于我们都已经知道子宫内膜癌和肥胖之间存在着不可脱离的联系。”

UVA妇产科属下的妇科肿瘤科的Modesitt对本研究中所发现的肠道微生物代谢变化产生了巨大的兴趣。“研究结果表明,受试者的肠道菌群代谢在其接受减肥手术后发生了显著变化,然而,我目前尚不清楚这能说明什么,但这一发现对于研究肥胖和癌症之间的联系具有重要意义。正如在诺贝尔奖获得者Marshall博士的开创性工作发表之前,并没有人知道胃癌以及胃溃疡与细菌相关。目前并没有人知道肠道细菌在促进肥胖的过程中可能发挥的作用,但本研究发现的受试者在接受手术后其肠道细菌的代谢参数/标记发生了显著改变这一客观现象是毋庸置疑的。”

虽然这项研究证明了减肥手术有变革性影响,Modesitt博士敦促人们应该首先避免体重的增加,选择运动以及健康饮食,把减肥手术作为次之的选择。“我们真的应该从一开始就在饮食和运动方面努力,从整个社会开始,从我们的孩子开始。体育锻炼更多的是保护,即使你没有减去所需的体重,但它绝对有好处,”她说,“有很多研究表明锻炼可以提高你的胰岛素,血糖和所有相关的因素甚至致癌效应都将发生改变。几乎每个人都同意增加锻炼是很奇妙的并且在很多层面上改善健康,当然减掉多余体重也是极好的。”

原始出处:
Susan C. Modesitt, Peter T. Hallowell, Jill K. Slack-Davis, Ryan D. Michalek, Kristen A. Atkins, Sarah L. Kelley, Sanja Arapovic, Margaret A. Shupnik, Kyle Hoehn. Women at extreme risk for obesity-related carcinogenesis: Baseline endometrial pathology and impact of bariatric surgery on weight, metabolic profiles and quality of life. Gynecologic Oncology, 2015; 138 (2): 238 DOI:10.1016/j.ygyno.2015.05.015

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    2016-04-10 忠诚向上

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    值得学习

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    2016-04-10 忠诚向上

    值得学习

    0

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    2016-04-10 忠诚向上

    值得学习

    0

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    2016-04-10 忠诚向上

    值得学习

    0

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    2016-04-10 忠诚向上

    值得学习

    0

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    2016-04-10 忠诚向上

    值得学习

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    2016-04-10 忠诚向上

    值得学习

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