Vagal Nerve Therapy in the Management of Obesity: A Systematic Review and Meta-Analysis.

IF 1.7 4区医学 Q2 SURGERY

European Surgical Research Pub Date : 2023-01-01 Epub Date: 2023-08-04 DOI:10.1159/000533358

Michael G Fadel, Matyas Fehervari, Bibek Das, Payam Soleimani-Nouri, Hutan Ashrafian

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引用次数: 0

Abstract

Introduction: The vagus nerve has an important role in satiety, metabolism, and autonomic control in upper gastrointestinal function. However, the role and effects of vagal nerve therapy on weight loss remain controversial. This systematic review and meta-analysis assessed the effects of vagal nerve therapy on weight loss, body mass index (BMI), and obesity-related conditions.

Methods: MEDLINE, EMBASE, and CINAHL databases were searched for studies up to April 2022 that reported on percentage excess weight loss (%EWL) or BMI at 12 months or remission of obesity-related conditions following vagal nerve therapy from January 2000 to April 2022. Weighted mean difference (WMD) was calculated, meta-analysis was performed using random-effects models, and between-study heterogeneity was assessed.

Results: Fifteen studies, of which nine were randomised controlled trials, of 1,447 patients were included. Vagal nerve therapy led to some improvement in %EWL (WMD 17.19%; 95% confidence interval [CI]: 10.94-23.44; p < 0.001) and BMI (WMD -2.24 kg/m2; 95% CI: -4.07 to -0.42; p = 0.016). There was a general improvement found in HbA1c following vagal nerve therapy when compared to no treatment given. No major complications were reported.

Conclusions: Vagal nerve therapy can safely result in a mild-to-moderate improvement in weight loss. However, further clinical trials are required to confirm these results and investigate the possibility of the long-term benefit of vagal nerve therapy as a dual therapy combined with standard surgical bariatric interventions.

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迷走神经疗法在肥胖症治疗中的应用：系统回顾与元分析》。

导言迷走神经在饱腹感、新陈代谢和上消化道功能的自主控制方面发挥着重要作用。然而，迷走神经疗法对减肥的作用和效果仍存在争议。本系统综述和荟萃分析评估了迷走神经疗法对减肥、体重指数（BMI）和肥胖相关疾病的影响：方法：在MEDLINE、EMBASE和CINAHL数据库中检索了2000年1月至2022年4月期间报道过迷走神经治疗后12个月体重减轻百分比（%EWL）或体重指数（BMI）或肥胖相关疾病缓解情况的研究。计算了加权平均差（WMD），使用随机效应模型进行了荟萃分析，并评估了研究间的异质性：结果：共纳入15项研究，其中9项为随机对照试验，共1447名患者。迷走神经治疗可在一定程度上改善%EWL（WMD：17.19%；95% 置信区间[CI]：10.94-23.44；p < 0.001）和BMI（WMD：-2.24 kg/m2；95% CI：-4.07 至 -0.42；p = 0.016）。与不进行治疗相比，迷走神经治疗后 HbA1c 普遍有所改善。无重大并发症报告：迷走神经疗法可安全地轻度至中度改善体重。然而，还需要进一步的临床试验来证实这些结果，并研究迷走神经疗法作为一种双重疗法与标准外科减肥干预相结合是否能带来长期益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Surgical Research 医学-外科

CiteScore

2.30

自引率

6.20%

发文量

审稿时长

>12 weeks

期刊介绍： ''European Surgical Research'' features original clinical and experimental papers, condensed reviews of new knowledge relevant to surgical research, and short technical notes serving the information needs of investigators in various fields of operative medicine. Coverage includes surgery, surgical pathophysiology, drug usage, and new surgical techniques. Special consideration is given to information on the use of animal models, physiological and biological methods as well as biophysical measuring and recording systems. The journal is of particular value for workers interested in pathophysiologic concepts, new techniques and in how these can be introduced into clinical work or applied when critical decisions are made concerning the use of new procedures or drugs.