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减肥手术对慢性病和严重肥胖患者的影响:多重链接的基于人群的队列研究
Yung Lee1,2, Francis Nguyen3, Sama Anvari4
1Division of General Surgery, McMaster University, Hamilton, Ontario, Canada.
The British journal of surgery
|August 28, 2025
概括
在慢性病 (CKD) 和严重肥胖患者中,代谢性肥胖手术 (MBS) 显著降低了死亡率和重大病不良事件 (MAKE). 这些好处在体重指数较高的老年女性中最为明显.
科学领域:
- 肝脏病学
- 减肥手术
- 公共卫生
背景情况:
- 肥胖是慢性病 (CKD) 的重要危险因素,增加了发病率和死亡率.
- 代谢性减肥手术 (MBS) 显示可能改善肥胖个体的脏结果,但长期数据有限.
研究的目的:
- 研究MBS与死亡率之间的关联.
- 评估MBS对慢性脏病和严重肥胖症患者的主要不良反应的影响.
主要方法:
- 在加拿大安大略省的一项队列研究中,包括患有慢性脏病 (eGFR ≤60 mL/ min/ 1. 73 m2) 和严重肥胖 (BMI ≥35 kg/ m2) 或在2010年至2016年期间接受MBS的患者.
- 非手术对照从初级保健数据库中进行了匹配.
- 多变量Cox比例风险模型分析了全因死亡率和MAKE (死亡率的组合,EGFR下降,透析,心力衰竭,心肌梗塞,急性损伤).
主要成果:
- 这项研究包括1538名患者 (563名手术,975名非手术),随访时间中位数为7. 7年.
- MBS与52%的死亡率降低 (HR 0. 48) 和53%的MAKE降低 (HR 0. 47) 相关.
- 在女性,55岁以上和BMI> 40公斤/ m2的人群中,益处更为显著.
结论:
- 在严重肥胖的CKD患者中,MBS与降低死亡率和改善脏结果有关.
- 这些发现表明,MBS对于高风险患者群体,包括老年人,女性和BMI较高的人来说可能是一个有价值的干预措施.
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